The Challenge

Today, in the third decade of the 21st century, it is virtually impossible to find a single human being who has not been touched in some way by mental illness, either personally, through family members or friends.

Each year, the number of people suffering from mental health problems – such as depression, anxiety, bipolar disorder, OCD, as well as the alcohol or drug addiction issues that result from systemic failures in support, and other, rarer mental health conditions – is on the rise.

According to Our World in Data, a not-for-profit global data measurement organization, the last global estimate in 2017 reckoned that around 800 million people lived with a mental health disorder. This is almost one out of every 10 people in the world.

In Scotland, the rate of mental illness is even more disturbing.

A study conducted by Public Health Scotland revealed that in 2018/19, 12% of adult Scots suffered two or more symptoms of depression alone, and 7% reported having previously attempted suicide. Both of these data points represent steady increases over time.

In the United States, a country which has utterly abandoned responsibility for the mental wellbeing of its citizens, a shocking 26% of Americans over the age of 18, more than 1 in 4 adults, suffers from a diagnosable mental disorder in any given year.

This is the result of a treatment model that has been given up to profit-hungry pharmaceutical companies, psychiatrists who spend 10 minutes with patients figuring out which drug to prescribe, and the lucrative “talking-therapy” industry. Not only is this a failed system in which commitment to an individual’s long-term support, dignity and recovery is notably absent, it is in dire need of change and should never be emulated anywhere.

The root causes of mental illness are as varied as each person’s suffering. However, we know genetics are unlikely to play a part – but trauma, in some instances trauma before we are born – have far-reaching effects on our mental health.

We also know that long-term depression is often rooted in the hopelessness and loneliness of the place in which we find ourselves.

As a society, we ask the wrong question of mental illness sufferers: “What is wrong with you?” This is an ignorant and isolating question, and one which leads to pharmaceuticals being prescribed to manage and mask mental health condition – often over a period of decades. A far better line of inquiry might be: “Why are you in pain and how can we help you live with independence and dignity?”

No mental health condition ever healed in isolation.

Not only are mental health problems distributed unevenly across the Scottish adult population, with inequalities evident for age, gender, deprivation and socioeconomic status, there is increasing evidence that current models of mental health care are failing in Scotland and across the UK.

Glasgow is the biggest city in Scotland with unique challenges in terms of health and wellbeing, with poorer physical and mental health, and higher rates of premature death, sometimes described as the “Glasgow Effect”.

Glasgow also has by far the highest rate of drug-related deaths in Europe – and this is continuing to rise. Meanwhile, the comorbidity of mental illness and substance abuse, and the widespread phenomenon of “self-medicating”, is well documented but still barely recognised at a policy level.

Too many have shared Joshi’s tragic experience, in which individuals become lost – and effectively abandoned – in a system of one-size-fits-all therapies and endless, often- pointless medications, with no continuity of support for recovery.

Strides have indeed been made toward suicide prevention. Yet little has been accomplished in the areas of community-based mental health programmes or proper follow-through systems that cater for an individual’s long-term recovery, dignity and full inclusion into the communities in which they live.

Sadly, the development of community mental health services in Scotland has stagnated over many years and, in most places, has led to fragmentation and discontinuity of care.

As a nation, we have the power in our hands to create a world-class system of mental health treatment and care that benefits every individual, every family and every community.