Mental health - A hidden secret?

By Craig Halpin, Registered Mental Health Nurse, Nurse/Operational Manager, the Mental Health Centre of Excellence, Al Jalila Children’s Speciality Hospital

Do you have physical health? Or, have you ever had a physical health problem? It can be assumed that most people feel no shame discussing their physical health. But what if you were asked if you have mental health? Or, if you have a mental health problem? Would you answer truthfully and honestly? Would you feel shame discussing how you feel mentally? If the answer is yes, you are not alone. Stigma and prejudice with regards to mental health is a worldwide issue. We all have mental health, yet many of us don’t always talk about it. It is often our own personal secret.

In its simplest form, mental health is ‘a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’. It is an integral part of our health; there is literally no health without mental health. Mental health problems do not discriminate; they can affect people of all ages, genders, ethnicities and socio-economic backgrounds. We all have mental health, and respectfully, no matter who you are – you have mental health and you are at risk of developing a mental health problem. However, some are more at risk than others, whereas some are more protected than others.

The World Health Organization (WHO) estimates that 1 in 4 adults, and 1 in 8 children are at risk of developing a mental health problem or disorder. What is more concerning is that every 40 seconds worldwide, someone will commit suicide; this includes young people under 18 years. The very sensitive nature of mental health, along with cultural stigma and prejudice often means that we don’t always discuss it; yet paradoxically, it’s the ‘secrecy’ about our mental health that can be a contributing factor to developing mental health problems, and/or why some people commit suicide.

Mental health, problems with mental health and suicide are understandably harsh topics to openly discuss, which means that many people are unnecessarily suffering in silence. Many people are afraid to speak up or to get help. Yet, specialist help is available by qualified and experienced clinicians. Importantly, evidence shows that early detection and early intervention can result in better outcomes; the sooner help and support is sought, the better. Nevertheless, many are still silently suffering. Although mental health problems and suicide can affect both genders, males are significantly more at risk of ‘silent suffering’. This is mainly owing to the stereotypical views that men should be ‘strong’, and that feeling sad or upset is a sign of weakness or is effeminate. Males from a very young age are often told statements such as “man up”, or that “crying is for girls”, which further emphasises the belief that males should be strong, and not feel normal emotions. This has catastrophic consequences; the fact that suicide is the second leading cause of death globally in males aged 15 – 29 years of age is a prime example. What if these males openly discussed how they were mentally feeling? What if they did not feel judged or stigmatised because of their mental health? What if they could openly feel sad or upset without feeling that they are weak? Would the rate of suicide still be the second leading cause of death? Maybe not.

Regardless of gender (as both genders do suffer), it’s crucial that we all feel comfortable talking about mental health. We all need to be the ‘Change Makers’ in shifting attitudes towards our own, and others mental health needs. Your attitude to mental health could literally change someone’s life.

Talking openly about mental health, especially with children is very important. As children, we need to learn how to recognise and manage different feelings and emotions, and to understand our own well-being. Our well-being evolves from a combination of factors, in which physical and mental health are fundamental contributors. Openness and transparency about mental health, particularly from a young age can create a sense of ‘mental health normality’. We can literally empower children to recognise that there is no health without mental health; that there is no shame in having emotions and feelings; and, that it’s okay to feel sad or angry. The first steps in empowering and educating is to openly talk about our health – from both a physical and mental perspective. Both are interlinked and do affect each other. More so, recognising that our mental health is on a continuum, and that movement happens between different stages is also important. This movement is dependent upon influences such as risk factors and protective factors, including stress and vulnerability.

For example, you might be extremely stressed because you have lots of exams or other urgent deadlines, which consequently moves your well-being into the ‘reacting’ stage. Yet once the exams are over or the deadlines are met, you move back to the ‘Health’ stage. This process is entirely normal and is a reaction. It is when we move into the ‘Injured’ and ‘Ill’ stages that professional help and support is often needed; these stages can significantly impair the day-to-day functioning of people. Early detection and early intervention is key.

If you are worried about your mental health, or the mental health of someone else, seek some help. Specialist help is available, which includes receiving assistance, support, assessment and treatment from trained mental health professionals who have the experience, knowledge and skills to work with children, adults and families. Sadly, stereotypical views of mental health services still do exist – for example, people imagine padded cells or patients strapped to beds in cold and dark rooms (just like in the movies!) – be assured that this is not the case. Together, we can improve mental health of the children, young people and adults within the UAE. Let’s start talking about mental health, let’s speak up. It doesn’t need to be a secret.

References available on request.

Halpin will be speaking on “Patient safety in a mental health inpatient department” on October 25, day two of the Nursing conference, at Patient Safety Middle East.