Obsessing about mental health is making Scotland's crisis worse. Here's what to do instead

According to Public Health Scotland, it is estimated that one in four people in Scotland are affected by mental health problems in any one year, “which is why improving the mental health and wellbeing of everyone in Scotland is a public health priority”.

“Mental health is an integral part of overall health and well-being. Good mental health can foster improved physical health and healthier lifestyles. It can strengthen resilience, improve overall quality of life and social relationships and support recovery from illness,” it adds. Dr Hofstadter would not approve.

Developing emotional resilience

And, according to a real-life expert in child and adolescent psychiatry, Professor Andrea Danese, while greater awareness of mental health has “generally been a positive thing”, it may have "inadvertently contributed to over-pathologising distress in young people".

"Facing challenges and distress is normal and important in terms of individual growth," he told the BBC. "That's how young people develop emotional resilience – they learn coping skills in the face of many small challenges and build self-confidence about their ability to cope. The narratives we build matter."

His message is far from “buck up”, but it does present a challenge to the modern-day obsession with mental health among some. I recently saw two people chatting about a friendly little dog owned by one. The other began to stroke the dog and explained that it was “good for my mental health”. An everyday, ordinary, pleasant experience turned into a form of medical treatment.

It is important to stress that mental health problems cannot be dismissed. Indeed, they are potentially life-threatening. In addition to the risk of suicide, those with mental health conditions have a higher risk of developing a physical illness and that this will be diagnosed later, and have higher mortality rates.

Elderly have better mental health

Professor Danese’s point that the narratives we tell one another matter is a fundamental one. The way people think about themselves and the world is strongly influenced by those around them, by societal norms.

According to The Scottish Health Survey 2023, published in November, older adults score better on the Warwick-Edinburgh Mental Wellbeing Scale than younger ones. There are concrete reasons why this should be the case. Young people were hit harder by the psychological effects of the Covid lockdowns, have to deal with the relatively new stresses caused by social media, and can also struggle to get on the property ladder, for example.

But the question needs to be asked whether, by focussing so much on mental health, we as a society are talking ourselves, and particularly the young, into a bigger problem. If we constantly think about our mental health as if it is a delicate flower that must be cherished, nurtured and protected from harm, then surely that is what we will become – a delicate flower unable to cope with the least stresses and strains of ordinary life.

Serious economic costs

The health survey found those aged 25 to 44 were the most likely age group to report that their job was either very or extremely stressful. And while ten per cent of adults reported feeling lonely most or all of the time, that figure rose to 19 per cent for those aged 16 to 24.

With two-fifths of all work-related illnesses in the UK thought to be caused by work-related stress, there is a serious economic cost to all this unhappiness. An economic cost that will exacerbate poverty, one of the leading reasons why people develop mental health problems, creating a dangerous downward spiral.

The ultimate solution to all this, I suggest, cannot be a medical one. Prescribing anti-depressants is obviously necessary in some cases, but for society as a whole to rely on this approach alone would be an abrogation of responsibility by its leaders. Instead, we need to find ways to build the “emotional resilience” that Professor Danese talks about.

A miracle cure

By far the best way to do that on a societal scale, rather than an individual one, is through organised sport. Public Health Scotland’s view that “good mental health can foster improved physical health” is true, but so is the reverse.

Don’t believe me? Well, here’s an excerpt from an article in the Bulletin of the Royal College of Surgeons of England that may change your mind: “If exercise were a drug, it would be a miracle cure. The evidence for the impact of regular small amounts of exercise in the prevention and treatment of common conditions is overwhelming.

“... Being physically active reduces a person’s risk of dementia by 30 per cent, depression by 30 per cent, heart disease by 40 per cent, type 2 diabetes by 40 per cent, breast cancer by 25 per cent and osteoporosis by 50 per cent.”

I experienced this effect in reverse. After years of competing at a relatively high level in rowing – I was once in Scotland’s fastest club eight – the end brought a real sense of sadness that lingered for quite a while and I’ve struggled ever since to motivate myself to exercise regularly, as my waist-line reveals.

While I wasn’t depressed then and am not now, I’m convinced being physically fit did wonders from my mental health. It makes obvious sense that a body firing on all cylinders will help the mind to do the same.

As Scotland plots a way out of this mental health crisis, it needs to become a sporting nation, not a medicalised one. The biological effects of exercise and the camaraderie of organised sport are transformative and this – not ‘buck up’ or ‘delicate flower theory’ – is the narrative we must promote.