World Mental Health Day 2020 – Mental Health For All

One of the biggest days on the Mental Health calendar.

The theme this year is ‘Mental Health for All’ and this is what the World Federation for Mental Health said about that choice…


Psychosocial support and mental health national plans need to address the mental health consequences of the COVID-19 pandemic and its impact on citizens.

It is therefore of great significance and importance that the theme for World Mental Health Day 2020 will be:

Mental Health for All
Greater Investment – Greater Access

Mental health is a human right – it’s time that mental health is available for all. Quality, accessible primary health care is the foundation for universal health coverage and is urgently required as the world grapples with the current health emergency.

We therefore need to make mental health a reality for all – for everyone, everywhere.


It’s not a bad message in principal. Everyone deserves to have access to good mental health care, especially when going through the trauma of a pandemic. That would be incredible. But how governments will cope with all of the pandemic related cases when they can’t even handle the current number, I have no idea. In the UK, for example, they’d have to actively stop defunding the NHS and start directing funds back to it and specifically to their mental health services. And the system itself would need a drastic overhaul: we need a system of professionals that can accurately identify symptoms, prescribe medication, treatment, or a therapist if necessary, provide resources such as suggested reading and contacts for local support groups, and schedule regular follow ups. Even the language around mental health is long overdue an update. That’s a massive undertaking but if they can do it, then they have my full support.

But back to World Mental Health Day. This slogan makes me so angry that I almost couldn’t write anything today. Mental healthcare for all, right? We have to have a global pandemic that affects the mental health of the entire world for mental health to truly rise up the list of priorities? So… what? All of us struggling with mental health problems before the pandemic weren’t worth the effort? That’s what the message sounds like to me.

I was diagnosed with multiple mental illnesses at eighteen and Autism Spectrum Disorder at twenty, although I was obviously struggling long before we could put a name on what was happening. And that’s the simple version. The long version involves hundreds of hours of research and phone calls and appointments, tears and screaming and self harming, invalidated over and over and over again. Since receiving my diagnoses and getting support in various forms, when my physical and mental health have allowed me to, I’ve done everything in my power to raise awareness and support for those of us struggling with our mental health. I’ve donated money, taken part in fundraisers, volunteered for research projects, supported charities, attended conferences, and so on. I’ve created art about my experiences and dedicated the proceeds to charity.

I did not and do not expect to change the world alone with these actions but think about every single person who has been doing the same and more up until this point. The message being circulated today on World Mental Health Day with this slogan seems to invalidate all of that. To me, it feels like all of these organisations promoting this phrase are saying that we weren’t important enough before to dedicate serious help or resources to; that our mental health problems weren’t caused by a massive global trauma and therefore they aren’t as important; that there weren’t enough of us to make the effort worth it so they weren’t going to bother; “oh, but now look at how many people need help, that makes it worth doing.”

These organisations do a lot of great work and I’ve always had great respect for them but right now… this feels like a betrayal and a hard one to swallow. Maybe I’m the only one who feels like this, maybe I’m not, but this is my blog and my blog is where I come to talk about how I feel. So there you go.

More voices telling me that my experience isn’t important or valid doesn’t change anything though. I’ll keep working, I’ll keep writing, I’ll keep helping in whatever way I can. Because this is bigger than all of the politics and bullshit that constantly get in the way of improving the lives of people who suffer from mental illness. I truly wish I had something more positive to say, on today of all days, but I don’t. I’m angry. And I’m sad. And I’m exhausted. Never have I felt so let down by the community that is supposed to support me and after all I’ve experienced, that’s really saying something.

My Experiences with Therapy

Going to therapy hasn’t always been easy. I feel so, so lucky to have such an amazing therapist now but I had a lot of difficult experiences before I started seeing her. So I thought I’d share some of those experiences. Maybe they’ll be helpful.

After many, many appointments with my GP, I was finally referred to the local NHS Wellbeing service but the session didn’t go well. At this point in time, my anxiety was so bad that I couldn’t talk to people I didn’t know. I just couldn’t. Answers to questions would form in my mind but I couldn’t force them up my throat. So I sat there, in tears, while the doctor tried to get my Mum out of the room and told me he ‘wouldn’t’ help me if I didn’t talk. I don’t want to rant but I WAS STRUGGLING WITH A MENTAL HEALTH PROBLEM. I wanted desperately to be able to talk about it but I couldn’t. I don’t remember much about that appointment but I do remember standing in the street afterwards, shaking and crying and screaming and swearing. I couldn’t understand why no one was helping me when there was so clearly something wrong.

My second attempt at therapy was a bit better. I started Cognitive Behavioural Therapy (CBT) with a really lovely therapist. She was very patient and very open to working around the anxiety that kept me from talking. She was also happy to have my Mum in the room: it helped my anxiety and meant she could provide information. Slowly I started to trust her and started answering questions myself. But it was exhausting, bone achingly exhausting. As hard as we worked, I didn’t feel like we were making any progress and it was too hard to go through that to make no progress. I really liked her and I could tell that she was a really good therapist but the approach wasn’t right for me. I found the format too rigid. In simple terms, CBT is about breaking down your problems and then trying to create change in those areas. I felt, and still do feel, that my problems are too murky for a short stint of CBT. I know now that many of my problems originate from my Autism and the fact that it went undiagnosed for so long but even with that knowledge, the difficult things still feel overwhelmingly huge. I can see CBT being useful for a specific anxiety. For example, we tried to work on my anxiety around making phone calls. But I think the reason it didn’t work is that it wasn’t an isolated problem; it was a piece in a much bigger puzzle. I don’t think you can solve that sort of problem if you don’t know what’s causing it. Plus, being rational about what you’re struggling with in the controlled setting of therapy and being rational when it’s overwhelming you are very different things. CBT sort of assumes that you can still apply the skills you’ve learnt in therapy regardless of how you’re feeling, which can feel impossible, especially if you live with really powerful emotions. But maybe that’s just my perception.

The next thing we tried was Eye Movement Desensitization Reprocessing (EMDR), recommended by a family member. In the few months between finishing CBT and starting EMDR, my anxiety had sky rocketed so starting a new therapy was really hard. It was so bad that I actually never spoke to the guy I worked with. But despite that, and my difficulty with eye contact, communicating with him was easier than it had been with previous therapists. He was fantastic. He accepted my difficulty speaking and suggested writing on a whiteboard. I considered that and it felt possible so that’s what we did. He asked me questions and I replied, scribbling as fast as I could. It worked. And to take the pressure off, we would spend part of the session on the floor, playing dominoes while he asked me questions. I felt absolutely safe there. It was incredibly strengthening to have someone accept my anxieties as they were, to have someone recognise that I wasn’t just being difficult, that I was genuinely struggling with something really hard. And although it didn’t turn out to be the right thing for me, the sessions are still really important to me. For several months, we worked hard. We tried. I felt supported. And even though I didn’t ever speak, I did once sing for him and he almost cried. That was a pretty big moment.

After that, I didn’t go to therapy for a while. There was a lot of life stuff going on and there just wasn’t the time to find someone new. But I did start seeing a new psychiatrist. He prescribed me Phenelzine (which I’ve previously written about) and we spent a lot of time trying to figure out what was causing my problems. I guess it was a type of therapy. We went through my history and analysed my emotions, trying to find a diagnosis. The medication helped and we managed the side effects but it still took a long time. When my university said that they couldn’t help unless I had a diagnosis, I pushed for this and in January 2015, I could finally put names to the issues I was struggling with (apart from the Autism diagnosis which came several months later). My psychiatrist recommended Dialectical Behaviour Therapy (DBT) so we started looking for another therapist.

My current therapist is the first one we met. I just knew she was right; me and Mum walked out, looked at each other, and said, ‘she’s the one.’ We did meet another one but my mind was made up. And we were right. She’s amazing. I’ve been seeing her for three years now and I’m so grateful to have that safe place. DBT suits me much better. It’s based on CBT but, as the Mind website says, it’s “been adapted to help people who experience emotions very intensely.” They both help with changing unhelpful thoughts and behaviours, but DBT also helps you to accept yourself. It’s about a balance between acceptance and change. That really makes sense to me and always has.

In the beginning, I needed my Mum in the room with me and she would answer all the questions. We’d always talked about everything so she knew pretty much all the answers. But over time, I felt more comfortable there. I needed Mum there less and less and eventually I started doing the whole session by myself. Three years later and it’s really, really important to me. It’s a huge part of who I am. It’s not easy; it’s really hard work and I often come home exhausted, sometimes falling asleep on the sofa afterwards. But it’s really satisfying to talk things through, to make connections, to see change happen. I’ve talked about things that I never, ever thought I would talk about and I’ve worked through things I never thought I’d let go of. That’s so huge that I can’t really comprehend it.

So that’s my therapy journey. For me, it’s DBT that works but I’ve seen the others help people too. You need to be ready, you need to find the right approach, and you need to find the right person. It’s not easy but it is worth it.

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Hannah Jane Parkinson on Mental Health and Mental Illness

Not long ago, I read an article in the Guardian Magazine and I really wanted to share it with you guys. Hannah Jane Parkinson writes about her experience with mental illness, the conversation around mental health, and how we can make real change happen. She doesn’t pull any punches, which can make it hard to read, but that’s exactly why it needs to be out there because even though we are making progress around mental health, there’s still a long way to go. And that’s what this article is about. I really recommend reading the whole thing (you can find it here) because I just cannot do it justice without posting the entire article.

The whole article is important but here are some of the most important points:

“We should normalise the importance of good mental health and wellbeing, of course. Normalise how important it is to look after oneself – eat well, socialise, exercise – and how beneficial it can and should be to talk and ask for help. But don’t conflate poor mental health with mental illness, even if one can lead to the other. One can have a mental illness and good mental health, and vice versa.”

A very important point as it’s so easy to blur the two together.

“Like the rest of the population, I instinctively love the NHS, from the junior doctors to the consultants to the community psychiatric nurses. But, really, if you asked me right now? I hate the NHS. I hate the thin film of skin on its bones. It is incompetent and ailing. I used to blame the system. Mostly it is the system: those never-ending cuts and closures; the bureaucracy; the constant snafus of communication; the government’s contempt for staff.”

This is such an important issue to talk about. I feel exactly the same way. I love the NHS and I’m so grateful that it exists: it has literally saved the lives of several of my friends. I would fight to the death for it. But when it comes to mental health and mental illness, it’s incredibly lacking. I saw so many people who either couldn’t help me because of how the system works or wouldn’t help me because they didn’t understand, or even know of, what I was struggling with. And I know many people who’ve had the same experience. It’s a really upsetting, difficult situation and there’s no simple solution.

“The truth is: enough awareness has been raised. We – the public, the health professionals, the politicians – need to make our words and actions count for more. First, the Conversation needs to be more inclusive when it comes to rarer conditions, and to people whose voices are less loud. Second, we need to recognise that posting “stars can’t shine without darkness” on social media might piss someone off in the midst of desperation and that, actually, anxiety can be a normal reaction and is different from general anxiety disorder, a serious condition. That feeling down is not the same as depression.

Then, action. Donate to Mind; volunteer as a Samaritan. Vote for politicians who aren’t going to decimate our National Health Service or who support policies that lead to greater incidences of mental health problems (because it’s not just physical; society and environment plays its part).

What does the government need to do? Hire more staff, and then more. Enough staff to provide a service that meets individual needs. That means better working conditions and pay, and not piling all funding into a single type of therapy or care path. Clinical commissioning groups need to spend money earmarked for mental health on mental health. Prescription charges for long-term conditions should be reviewed. Funding and research must be increased.”

One of the things that, I think, sets this article apart from others I’ve read is that it includes concrete steps that we can all take. So often, articles talk a whole lot about how we need to create change but then they finish without actually telling us how to do it. I finished reading this article and felt empowered, like I could actually make a difference when, usually, the situation makes you (or, at least, it makes me) feel overwhelmed and hopeless.

These are some of the big points made in the article. But as I said, go and read the whole thing. It’s a really important piece of writing.

It’s taken me a really long time to write this out because the article talks about issues that make me really emotional and because there are so many quotes that I could pull out and talk about. While our experiences of mental illness are very different, there were so many things in this piece that I related to, this one maybe most of all:

So I am a newspaper journalist – for now. But I don’t know how long for because the illness might grip itself around me so tightly that it cuts off everything I love and hold dear, and my ability to lead a normal life.”

Thank you, Hannah Jane Parkinson, for writing such an important, moving piece.