I remember when my children were very young, wanting to find the “Ready Brek” glow with which to envelop them, to protect them from physical, social and emotional harm. That wish was consuming, and, as they grew, only increased. While being a clinical psychologist comes with some knowledge, there is no personal or family immunity.
I’m delighted to be increasingly involved in conversations about mental health with greater interest and openness about this issue. As a mother with four children, I find myself on numerous social media sites. It seems that mental health gives us yet another potential threat about which to angst, while having little understanding of the size, shape, form or antidote. It’s easy to be the “expert” at work but harder to ensure setting up one’s own family with the repertoire and skills to manage their own physical and psychological health.
There is no doubt that modern life throws us ever-increasing challenges. Children worry about everything from schoolwork to relationships, peer-group acceptance to Facebook friends. We may dislike Facebook, Instagram or the pressure to own the latest pair of Yeezys but, short of relocating to the Isle of Skye, this is the world in which our children live.
Resilience is described as the “rubber ball” factor, the ability to bounce back in the face of adversity. Put simply, resilience is the ability to cope with, and rise to, the inevitable challenges, problems and set-backs met in the course of life; to come back from them stronger, or, at least better prepared to face future challenges.
Mental-health understanding has moved on from viewing mental health purely as a factor of genetics or biochemistry. No one faces inevitable biological decline and no one is exempt.
There is a wealth of evidence indicating the numerous risk factors that can make some more vulnerable to mental-health issues. However, there is no single cause and no inevitability of poor mental health in response to adversity. Rather, we have the important knowledge that mitigating stressors, increasing resilience and introducing evidence-based interventions can make a huge difference to well-being.
Risk cannot always be removed but, with the right help, we can support young people to cope better despite difficult circumstances. As communities, we may reasonably argue that risk factors such as family breakdown, bereavement or parental mental illness are beyond our control. However, recognition and management of this stress is within our gift and will, without doubt, impact on the well-being of our young people. The good news is that resilience can be learnt. But building resilience requires practice. However, as the number of resilient individuals within a community grows, the strength of the whole community is enhanced. We become better able to understand and support each other and to engage in conversations sharing our humanity and compassion.
The Jewish community is particularly well placed with Jewish schools embracing the importance of pastoral care and Kvutzah (community). I feel gratified to see programmes that are far wider than academia alone.
JCoSS, for example, proudly reports a programme of teaching students everything from resolution of friendship disputes, mutual respect, conflict resolution and the benefits of community participation. Regularly, the syllabus will focus on ethics, diversity, self-reflection, and self-respect. Life is tough but we can engage in practice that will begin to immunise our families.
Of course, we can’t ignore the fact that some people will develop more significant difficulties and will need to seek help from specialised agencies.
There is an overwhelming evidence-base showing that early and speedy access to the right treatment is key in helping people suffering from mental distress. Timely access to the right treatments improves prognosis and prevents a vast range of secondary problems.
Three weeks ago, the community participated in the first “mental health Shabbat” led by Rabbi Daniel Epstein. It involved more than 80 synagogues of all denominations across the country and was designed to provide “a suitable launch-pad for discussions on the nature of mental health”. There has always been a stigma around mental health and sadly, although improving, this is still the case in the Jewish community. In the words of Bill Clinton, “mental illness is nothing to be ashamed of, but stigma and bias shame us all”.
Sadly, it isn’t just the stigma that we need fear. It’s what the stigma does. It inhibits individuals from seeking help; it escalates self-loathing; and it continues to allow mental-health services to remain under-resourced.
The World Health Organisation (2013) estimates that worldwide, 20 per cent of adolescents in any given year may experience a mental-health problem and 75 per cent of those with a mental-health condition start developing it before the age of 18. Although mental ill-health accounts for 28 per cent of the total burden of disease (and almost 50 per cent of the burden for those under 65), it gets just 13 per cent of the NHS’s budget and just 5.5 per cent of total UK health research spending. This is scandalous but this inequality is placed on those who have until now been shamed and hidden. Imagine if our NHS told us that, while guidelines showed us effective treatments for cancer, there was no resource to deliver them.
So what can we do? Firstly, we can continue the fantastic work of Rabbi Daniel Epstein and of Jami, the Jewish mental-health charity. Let’s take the fear out of mental-health problems and ensure that everyone in our community understands that it’s not terrible; you won’t be locked in an asylum; your friends and families will not cross the road to avoid you, and you are not doomed to a life of decline and disability. Mental health is treatable and recovery is expected. Statistics show us that the outcomes for those who seek help are excellent.
Research consistently shows the positive impact of one supportive person whom you know is there for you. A sense of belonging is critical to our well-being, the well-being of our families and our ability to fully engage with all aspects of life. We all like to feel listened to and important. “That’s obvious,” I hear you say but are we sure that we reflect that message to those who are closest to us?
All of us are good at something, but perhaps we more readily acknowledge some achievements over others. This isn’t good for those who fail to attain the coveted A* grades but it also has problems for those who do. I’ve seen many a high-flying academic who has been crushed by depression for feeling that nothing else they do was worthy of accolade.
Beth, a 21-year-old with outstanding academic achievements (4 A*’s and a first from Oxford) was off work from her high-powered job with a major firm of management consultants. Despite Beth’s amazing academic achievements, her own standards were so high that no manner of success was ever good enough.
Furthermore, her narrow focus on academia meant that no other accomplishments, friendships, quirks or activities added to her sense of self, pride and worth. Any failure to achieve “perfection” was met by an internal sense of judgment, negativity and catastrophe.
If we don’t celebrate the lopsided cake, the good film found on Netflix or the hug from a friend, we miss the point and set ourselves up with targets that are often too high, too narrow, too joyless and too overwhelming.
By celebrating all (and I do mean all) our achievements, we become more able to gain a positive view of ourselves. Our achievements are not just the grades, the parties or the promotions. They are saying no when you are tired, being there for a friend, finally cleaning the saucepan that has been soaking for three days, or just being able to maintain perspective when things don’t go to plan.
Beth has learnt that she is more than just a work appraisal or comparison on a salary scale, that all her quirks, humour, sense of fun and listening ear are worth celebrating, too. She continues to excel but is able to accept that when “performance” is less than optimal, other aspects of her more than compensate.
Teach yourself and your children to trust yourselves to solve problems and make appropriate decisions. Remember the ways that you successfully handled hardships in the past and use this to build the strength to handle future challenges. If the outcome wasn’t great, what could you differently next time?
Try to learn not to take yourself too seriously but to laugh at your own mistakes and foibles. We all do foolish things from time to time — myself more than most. Instead of feeling embarrassed or defensive, embrace your imperfections.
While some life events are undeniably sad, most don’t carry an overwhelming sense of either grief or delight. Occasions can be fun, or can be turned to a stressful and overwhelming challenge.
Try and remind yourself that not everything has to be done in a certain way or to a certain standard to be worthy or enjoyable. Some of the best laughter and the most enjoyable evenings have been had over the worst culinary disasters.
We need to see asking for help as a sign of strength, not weakness. We don’t feel we should solve all our practical, social and medical problems ourselves, so why hold this notion about emotional glitches. Allow others to help you set goals and small steps in building future resilience. Show your children that it is OK to fail, OK to ask for help and OK to receive it.
We are not born with the skills to manage all situations or withstand all adversity. However, we can allow others to help us build that “Ready Brek” glow that might help us to manage our way out of the twists and turns of our personal life maze.
Glenn Close said “what mental health needs is more sunlight, more candour, and more unashamed conversation about illnesses that affect not only individuals but their families as well”.
So, go on, talk to those around you, share your pride in them, ask how you can help and mostly, be there for them.
Dr Julia Renton is Head of Psychological Services for West London Mental Health Trust. She will be speaking at Jami’s conference on Family Resilience on Sunday.