My ambitions regarding young people in poverty and mental health in the U.K.
As candid as I've ever been
The Complexity around Mental Health
My mum would have an arsenal of one-liners to explain my melancholy when I used to isolate myself as a teenager. These ranged from “you’re always on that phone” to “you need to go outside and get some fresh air in your lungs.” Any emotional and/or mental toil was relegated to being something that could be remedied by stepping outside of social media and entering the real world.
I take issue with this perspective. It is indicative of the wider conversation surrounding mental health in the U.K. It is reductive, as if we can hinge an explanation entirely on one factor. It lacks regard for anything outside of the present. People rush to place the fault of poor mental health solely at the foot of social media which is simply not true. Mental health is a complex topic. Everyone has mental health, by extension, anyone can suffer from poor mental health/mental health illnesses.
I liken the flippance surrounding mental health and its intricacies to the minimisation of history when explaining the fall of the Soviet Union. People automatically point the finger at Mikhail Gorbachev’s reforms to the Soviet Union and disregard the latent factors in its demise. A contentious question for any modern historians is, was the fall of the Soviet Union inevitable? Regardless of what camp you fall into, it would be foolish to nominate one factor as the entire reason why the Soviet Union fell, and yet, many fall into this trap.
A similar approach is applied to mental health and social media. It is factually untrue to say the only reason why people experience poor mental health is due to social media. There are a multitude of reasons why mental health struggles and illnesses have increased visibility around them in the present day. If people were to argue that social media is the primary reason or the catalyst for why poor mental health appears to be so prevalent these days, I would disagree but I could not fault their argument.
One reason why social media cannot be the sole reason for the prominence of mental health problems, or even at the root of it, is because mental health struggles as we know it have always existed. It can even be dated back to the days of ancient Mesopotamia. Mesopotamian and Egyptian papyri from 1900 BC attributed women experiencing what we would regard as mental illness to a ‘wandering uterus.’* It is within the modern period that we have given clinical definitions to mental conditions our predecessors previously used euphemisms for.
Even in our current world, some older generations prefer to use euphemisms to refer to mental health illnesses. In my family, one of the most common ones is ‘nerves’. My aunt in Jamaica and I are frighteningly similar, we live with chronic anxiety. My first introduction to having my anxiety validated was by my aunty. We were in my grandmother’s house and I was nervous because we had convention, an annual event for Jehovah’s Witnesses, the next day. The memory is fuzzy but what sticks out is her saying something along the lines of “you have nerves just like your aunty.”
Mental illnesses have always existed and produce tangible, material implications. Despite this, some people 'do not believe in mental health’. They believe it is fictitious and others who ‘do believe in’ it are buying into hysteria. That illustrates the complex nature of mental health. It is not like physical health, where you can see that someone has a broken bone or that they are presenting symptoms of a cold. Those around you cannot always see that you are struggling with your mental health. You validate your mental health problems by firstly acknowledging that mental health illnesses exist and they it exists if for you. Others will only know if you tell them.
My family has always been hesitant to label mental health illnesses when it comes to its members. Perhaps because doing so makes it real, and means that it is no longer an unnamed phenomenon that they can just brush off. I remember when the COVID restrictions began to ease in Spring 2021, I was returning to football and I was sick with anxiety, I barely ate at dinner and sleep evaded me the night before my Saturday training session. I confided in my dad about this, stating that it was another case of anxiety. He told me that everyone worries and you shouldn’t label yourself. Reflecting on it, it could only be anxiety because it was so irrational; I had known my teammates for at least 4 years and I was physically recoiling at seeing them again after a (significant) disruption to my regular programming. But my dad didn’t see it like this because, for him, mental health was something that you could will yourself through, that would not affect you if you did not give power to it by acknowledging it.
My Ambition
To guide my writing, I often think of what my anchor is.
What is the core of the post? What do I want to dig into? What do I want to leave myself and the reader knowing more about? I found it challenging with this post because there are so many moving parts to the topic of mental health. For the sake of clarity and an overview, we need generalisations; it is so nuanced I found myself making caveats at every corner.
I suppose my anchor for this post is my current ambition. To create a charity for young people in poverty who have considered and/or attempted suicide. The seeds for this ambition have been sowed across my teenage years and early adulthood; the epiphany did not transpire until this year when I began working in the education system.
If I could pinpoint the beginning it would be with 16 year old Adrienne. This is when I had my first definitive experience of poor mental health. This was beyond sleeplessness at night and missing meals due to anxiety. I didn’t want to get up, I didn’t care about tomorrow because I didn’t want to see tomorrow. It resulted in me laying on the floor of my bathroom clutching my chest writhing in pain. I remember pressing my hand closed into a fist roughly against my heart and willing myself to get up, to tell my mum (and myself) the truth that had been bubbling underneath the surface for months. Thankfully, I was able to, and my parents were receptive. But outside of my family, the responses by institutions around me were baffling. A 16 year old had threatened to take her own life; only my family and my sixth form provided meaningful support.
In my experience, the NHS was not helpful. CAMHS* told me to ignore the thoughts poisoning my mind. When I first arrived in the hospital, the nurse instructed my parents to not have it recorded on my file as it would spoil my future opportunities. It was evidence I had struggled with, and been momentarily defeated by, my mental health. That particular anecdote is paramount to the reason why I advocate for a radical improvement in our public mental health services. If it were not for my strong support system and my school essentially forcing me to do counselling, my mental health would have declined to an even more negligible position and I might not have been here writing to you today.
This cannot continue to happen, our young people matter, their minds matter. We need to take co-ordinated, systematic action that reminds them of this and gives them a reason to want to stay with us. My solution is still embryonic and is predicated on the experience that I had at 16. I currently work with young people and see that the flaws that I experienced with the NHS and their provision of mental health services continue to persist to this day. As such, my desire to start my own mental health organisation for young people was birthed.
The Problem
So, why young people in poverty?
The answer to this question has two parts.
Firstly, young people are my focus because I was a young person and I felt failed when it came to the support provided by mental health professionals.
Moreover, it is about young people in poverty because I recognise the privilege I had when I was 16. Yes, mental health problems can affect anyone. However, this universality does not apply to mental health support. Everyone does not have the same access to mental health professionals and mental health support. I was able to access counselling and learn to vocalise what was plaguing my mind because of my school. If I did not have this opportunity, my parents would have struggled to provide me with something similar. And if they did, it would have been at the expense of other necessities.
Every young people cannot say the same. For young people living in poverty, they may not attend a school which has mental health provisions or have parents that try to understand their struggles with mental health. If there is anything this job has taught me, it is that this is more widespread than we may initially believe. So many young people are inhibited from accessing effective mental health support and suffer in silence because they know they cannot afford to help themselves.
The organisation Mind has an excellent report that demonstrates the link between poverty and mental health and proposes suggestions for this link. One of these suggestions is the scarcity mindset, found amongst people living in poverty. It is created when financial difficulty “reduces our mental bandwidth and distorts our ability to make decisions.” One of the behaviours associated with this is tunneling, which makes people focus on what seems more imminent at the expense of other factors. I had a brief stint of unemployment and it made me truly understand just how much worse life is for those already struggling with their mental health and stuck in material deprivation. You cannot face mask and “it’s okay not to be okay” yourself out of poverty and mental illness.
Imagine a 16 year old teenager struggling with suicidal ideation. Both of their parents work but still cannot make ends meet. Our teenager gets a weekend job, alongside their studies, to try and alleviate the financial pressure on their parents. They work to afford the things they want because they cannot ask their parents. But, they cannot pay for effective mental health support such as counselling because the money they have is limited. If they are in post 16 education, they may take responsibility for their travel and their lunch money. That is already a substantial amount of their wages gone.
The scarcity mindset is in operation, to them, their mental health is at the bottom of the list of priorities of things they have to pay for. Everything else is more immediate; commuting to school, eating, contributing to the house and funding an occasional outing with their friends if they are lucky. This is already a significant amount of pressure and demanding that they improve their mental health without doing anything tangible to support them only adds more pressure. It is another expense which has the question mark of how it will be paid for looming over it.
There is evidence to support anecdotes in the notion that young people in poverty are more likely to experience mental health problems and need improved access to mental health services.
The Chief Medical Officer for England reported young people ‘living at a socio-economic disadvantage’ are more at risk of developing mental health problems. (Iris Elliot, Poverty and Mental Health: A review to inform the Joseph Rowntree Foundation’s Anti-Poverty Strategy 2016, pg 8)
Mental Health problems more diagnosable in families that have a gross weekly household income of less than £100 compared to families with a gross weekly household income of £600.
Mind’s Report details how people living in poverty often refuse public mental health services and lists one of the reasons as the support being inadequate. Mind concluded that “ do not feel that their experiences [regarding mental health problems] are represented, and they feel left out of the conversation. There is a sense that openly talking about mental health is a White middle-class privilege…”
(Mind Report, pg 19)
What I have observed from people who grew up in poverty is the veneration of practicality. The intangibles are dismissed, thrown haphazardly and pushed away into respective Pandora’s boxes never to be touched because they will unleash problems that do not have solutions. Mental health falls under this umbrella. My dad served in the army for over a decade, there are a multitude of factors that helped produce the following statement, but what I think is the primary factor was the way he grew up. I asked my dad if he was ever scared of being in the army and his response, what I deemed flippant at the time was, “Yaad mi grow up enuh” (I grew up in Jamaica).
This was not just a reference to him being a born and bred Jamaican, but more specifically, to the material conditions he grew up in as a youth. Being born into deprivation, especially in a developing country, breeds a certain type of steeliness. There is no welfare state; necessities such as education and healthcare are not supplemented by the state. It truly is survival of the fittest. It produces a feeling of inevitability, in which people believe they can overcome anything presented to them because they escaped the clutches of poverty.
Fin?
I had two intentions for this post.
Firstly, I wanted to create understanding for people who have what we deem as dismissive attitudes towards mental health. Writing this post has been cathartic for me. I spent a substantial amount of my late teen years frustrated with my parents for not understanding me. It wasn’t until recently, that they started using explicit language regarding my mental health and it has made me feel seen. In the same way that they had to try and understand me, I have spent my adolescence trying to understand them. Unpacking our parallel childhoods, identifying the similarities and differences, and trying to decipher the trajectory that has carried us to where we are.
My parents grew to understand that it was more than the phone that was affecting my mental health and I learnt to understand that the reason they initially had this misconception was because they did not grow up with the verbiage nor in the climate that I was grown in. Their priorities in their development was ensuring they had a roof to return to by the end of the day and food to eat. There was no time for pondering over why their ‘nerves were bad’ or why they were ‘in a mood’ and the mindsets represented by these euphemisms translated into their child-rearing.
There is no point in lamenting about this topic and not proposing any suggestions to push the conversation further. Through lived experiences, personal and in the work I do now, I can see the uniform, top-down approach to towards the mental health of suicidal young people is not fit for purpose. I’ve supported students on calls with public mental services who have felt distressed, who have felt like taking their life. Any want for support is stifled by the bureaucracy of the NHS, i.e. continuing to be referred to different services without any effective support.
This is why I advocate for an increase in grassroots organisation that work in tandem to support the mental health of young people living in poverty. This requires further funding and a provision of salaries that are above simply being liveable so the people doing these taxing roles can afford to actually care about the work they are doing. It is an undoubtedly expensive approach, but mental health is an expensive topic, which we won’t see favourable results in if we don’t give it the dues it requires.
*I.G. Farreras, History of Mental Illnesses
*CAMHS - Child Adolescent Mental Health Service
If you or any young person you know struggles with suicidal ideation, please reach out to any of the following organisations:
SOS Silence of Suicide (Suicide Helpline)