We need a shift in thinking about mental health

How to move from languishing toward flourishing

There’s never been a time when governments have spent more money on mental health. The pandemic fuelled this spending, but it was already a strong trend. The bulk of the money has gone to treatment: in hospitals, acute and crisis care and in primary care settings. But spending on awareness and destigmatisation has also increased substantially. “We should make people aware of mental health issues and encourage them to come forward to get help without fear” has been the thinking.

And yet the more we talk about lowering barriers and destigmatising mental health support, the worse the mental health status of our society seems to get.

It’s a genuine conundrum.

The rates of mental health issues are increasing as support increases.

We absolutely do want people to seek help before they become acutely unwell. And we know that support can be the difference between life and death. But lowering barriers for those in acute crisis may have had unintended consequences.

The rates of mental health issues are increasing as support increases. It’s possible that the existence and awareness of the layers of support that are now available have, ironically, lowered resilience. There are analogies in other spheres. Children can’t learn to be independent and assess risks without being exposed to risks. As we age, we are encouraged to continue with plenty of weight-bearing exercise because our muscles and bones benefit from resistance and grow weak if not regularly challenged. And so, likewise, we grow in our mental resilience as we face difficulties – particularly when we do so by drawing on our own internal reserves.

Australia has run many awareness campaigns to get people to access help and that has been relatively successful. But high awareness without the right encouragement towards personal responsibility and action carries risks.

Sometimes destigmatisation leads people to be diagnosed (or self-diagnose) with a mental health condition and to believe that this diagnosis now forms a part of their identity forever. A kind of ongoing dependence and languishing can occur when someone feels stuck. They begin to order their life, lean on ongoing support and build expectations for the future around continued poor wellbeing. This can lead to decision-making and choices that prolong poor states of mental health and erode resilience.

The reality is that no one gets better from mental health conditions without action.

When we think about mental health with a medicalised mindset, we expect to be treated. We go to a GP as a “patient” (a word that makes us seem entirely passive). We hope the GP or a specialist is going to diagnose us and make us better. The availability of medication for mental health conditions adds to the plausibility of this way of thinking. But recovery just doesn’t happen that way.

A better way to imagine mental health treatment and recovery is comparing it to a physiotherapist. We make an appointment and see a physiotherapist. The physio shows us some exercises but unless we follow up on our own and do those exercises regularly, no recovery will happen.

The reality is that no one gets better from mental health conditions without action. Medications for mental health conditions are wonderful when they are available (and effective), but they are most often used to provide relief from immediate symptoms and give actions and change the best chance of success. Action always involves the painful exercise of putting one foot in front of the other, wrestling with the fine line between what is beyond your control but also what is within it. Aside from the small minority (around 4 per cent) of the population diagnosed with long-term clinical disorders, there is always something a person can do that is within their control. There will remain small choices towards pathways that either support mental health or compromise it.

Models that include spiritual health alongside mental health can lead to outstanding outcomes.

For Christians, understanding our identity as God’s children and our purpose as his people in the world is a vital part of the way we approach mental health issues and seek support. Mental health professionals who are able to integrate models of spiritual care and mental health care within the faith tradition of their clients are rare. But models that include spiritual health alongside mental health can lead to outstanding outcomes. So, for Christians experiencing poor mental health, it’s worth seeking a psychologist or counsellor who is both excellent as a mental health practitioner and also able to help you explore how your faith intersects and supports the mental health actions you are taking.

Today, 10 October, is World Mental Health Day: a mammoth global awareness campaign. We can convert awareness into recovery by encouraging action. Choosing recovery doesn’t necessarily mean you will be cured, or never struggle again, but it does mean that you are making the conscious decision to change: to move from languishing toward flourishing.

Jenny George is CEO of Converge International, with provides mental health and spiritual care services to more than two million Australian workers, and is majority-owned by Reventure, a Christian not-for-profit organisation.