It’s only natural Jackie Taylor - Senior Development Officer 12th March 2021 There’s an awful lot in the media at the moment about mental health - the following selection of headlines reflects the alarm that is being raised on what seems like a daily basis: UK ‘sleepwalking’ to mental health crisis as pandemic takes its toll (The Guardian 17th October 2020) Country facing a 'mental health crisis' due to coronavirus pandemic (ITV news 22nd December 2020 ) COVID-19: Children seeking mental health treatment 'sky rocketing' during pandemic (Sky News 11th February 2021) The Royal College of Psychiatrists has described the impact of the pandemic on mental health as like a tsunami. Of course, living through a pandemic is, to say the least, challenging, if not downright miserable at times. The far reaching restrictions to our daily routines and contact with others, plus the uncertainty, worry and distress about the virus, our family and friends, work, education and money is understandably having an impact on our wellbeing. We are going through a crisis which has threatened every aspect of our lives so it is not surprising that we might feel afraid, anxious, bewildered, worried, sad and overwhelmed. It seems perfectly rational and natural to me that we should be feeling some or all of these things. As the World Health Organisation says: “Fear, worry, and stress are normal responses to perceived or real threats, and at times when we are faced with uncertainty or the unknown. So it is normal and understandable that people are experiencing fear in the context of the COVID-19 pandemic.” While for some, feelings of anxiety and depression are lower than before the pandemic, for others the current situation is exacerbating the emotional distress and troubling feelings they were already coping with. As has been said elsewhere, we are all in the same storm but definitely not in the same boat. What I find troubling and highly questionable though is the rush in some quarters to frame perfectly natural responses to an exceptional situation as symptoms of mental health difficulties or “disorders”. But then, it is not surprising given that our whole mental health system is built upon the diagnostic labelling and pathologising of understandable human responses. The medical model of human distress dominates not just the professional mental health arena but also the narrative of the media and the general public. There isn’t the time or space here to examine in any detail the myth of the disease model way of thinking about mental health difficulties, or the fundamentally unscientific ideas that underpin the approach. There is a sizeable and burgeoning body of evidence that tells us the origins of human distress lie not in biological mechanisms, but in traumatic childhood experiences, difficult life circumstances and events, and social factors such as discrimination, poverty, violence, inequality and abuse. Put simply, distressing things distress us. When human distress is seen as a sign of underlying disease, then the problem is individualised and the logic is to fix the person. However, it is not just that there are no scientific underpinnings of this approach, it is also patently clear it is not working. Research suggests that despite continuous growth in the availability of mental health services, only about 15 – 25% of those referred significantly improve or recover in the long-term. One in five of the adult population of in the UK takes a psychiatric drug on any one day and the numbers are rising. I find it worrying to think that our natural human responses to living through this pandemic could for some of us mean a diagnosis of a disorder, prescriptions of medications of dubious efficacy and a view of ourselves as broken and needing expert help. For people with a learning disability, who experience discrimination in so many areas of their lives, the over-use of psychotropic medication and incarceration in locked inpatient units in response to what is labelled as ‘challenging behaviour’ is just one example of how the medical model of human distress has for far too long overshadowed other more psychosocial approaches. And with over 2000 people with a learning disability and autistic people still in assessment and treatment units the indications are that approaches to date are not working. There are concerns that during the pandemic some people with a learning disability have had medication increased as an answer to their struggle to cope with the restrictions under lockdown. Of course, none of this is to deny or minimise the reality of the suffering and emotional pain that some people are going through now as a result of the pandemic, or otherwise as a response to the things that have happened to them, sometimes requiring skilled, therapeutic support. However, if instead we understand human distress in context – of the person’s life experiences and the circumstances they find themselves in - social and political factors are acknowledged and the potential for change lies not just with the person. Perhaps it might be more helpful for us to see more in the media from the growing body of voices that advocate a different narrative that encourages more open conversations about understandable human reactions to discrimination, inequality and injustice in our world and our communities. Throughout the pandemic, there have been heartening examples of people working together to tackle local issues in their community and creative use of the internet to foster and maintain connections with each other. And maybe, as we emerge from this pandemic, rather than more diagnoses and medication, what is needed is to build more of a focus on real, community level responses that encourage and support the social connections we know strengthen our resilience and sustain us.