Introduction
We all have mental health. Good mental health is an asset that helps us to thrive. This is not just the absence of a mental health problem, but having the ability to think, feel and act in a way that allows us to enjoy life and deal with the challenges it presents. Yet it can be easy to assume that ongoing stress is the price we have to pay to keep our lives on track. It is time to challenge that assumption.
In March 2017, commissioned by the Mental Health Foundation, NatCen conducted a survey amongst its panel members in England, Scotland and Wales. This aimed to understand the prevalence of self-reported mental health problems, levels of positive and negative mental health in the population, and the actions people take to deal with the stressors in their lives. 2,290 interviews were completed, with 82% online and 18% by phone.
Key findings
- Only a small minority of people (13%) were found to be living with high levels of positive mental health.
- People over the age of 55 report experiencing better mental health than average.
- People aged 55 and above are the most likely to take positive steps to help themselves deal better with everyday life - including spending time with friends and family, going for a walk, spending more time on interests, getting enough sleep, eating healthily and learning new things.
- More than 4 in 10 people say they have experienced depression
- Over a quarter of people say they have experienced panic attacks.
- The most notable differences are associated with household income and economic activity - nearly 3 in 4 people living in the lowest household income bracket report having exprienced a mental health problem, compared to 6 in 10 of the highest household income bracket.
- The great majority (85%) of people out of work have experienced a mental health problem compared to two thirds of people in work and just over half of people who have retired.
- Nearly two-thirds of people (65%) say that they have experienced a mental health problem. This rises to 7 in every 10 women, young adults aged 18-34 and people living alone.
Conclusions
- Current levels of good mental health are disturbingly low. The barometer of success of any nation is the health and wellbeing of its people. We have a long way to go before we can say that we are a thriving nation. Although we have made great strides in the health of our bodies and our life expectancy, we now need to achieve the same for the good health of our minds.
- The survey suggests that our collective mental health is deteriorating. Overall most of us report experiencing a mental health problem in our lifetime. However, young adults report this at a higher level, despite having had fewer years in their lives to experience this. While there may be an element which reflects a greater ease at acknowledging a mental health problem, nevertheless this suggests a real and emerging problem. It is possible that it is linked to greater insecurities in life expectations for work, relationships and homes. The reasons and solutions warrant investigation.
- The figures show that the experience of poor mental health, while touching every age and demographic, is not evenly distributed. If you are female, a young adult, on low income, living alone or in a large household, your risks of facing mental ill health are higher.
Ten steps we can all take to thrive
As this report sets out, some people and communities are at greater risk of living with negative mental health and/or with mental health problems. However, no one is immune from developing problems and there are steps we can all take to understand, protect and sustain good mental health. In much the same way as it is now accepted that people should seek to maintain good physical health, we all need to acknowledge the importance of acting to support good mental health for ourselves and for those around us.
- Talk about your feelings
Talking about your feelings can help you stay in good mental health and deal with times when you feel troubled. However, as our 'I’m Fine campaign highlighted, many of us find it difficult to let people know when we are struggling. Talking about your feelings is not a sign of weakness, it is part of taking charge of your wellbeing and doing what you can to stay healthy. - Keep active
Regular exercise can boost your self-esteem and can help you concentrate, sleep, and look and feel better. Exercise keeps the brain and your other vital organs healthy and also offers a significant benefit towards improving your mental health. Exercising doesn’t just mean doing sport or going to the gym. Walks in the park, gardening or housework can also keep you active. Short periods of high intensity activity also carry particular benefits to brain health as you get older. - Eat well
One of the most obvious yet under-recognised factors for mental health is nutrition. What we eat and drink affects how we feel, think and behave. Your brain is an organ. It needs a mix of nutrients in order to stay healthy and function well, just like the other organs in your body. Strive to eat a balanced diet including lots of different types of fruit and vegetables, wholegrain cereals or bread, nuts and seeds, dairy products, oily fish and plenty of water. In tandem, try to limit how many high-caffeine, sugary drinks and portions of processed food you have. - Drink sensibly
Occasional light drinking is perfectly healthy and enjoyable for most people. However, we often drink alcohol to change our mood. Some people drink to deal with fear or loneliness, but the effect is only temporary. When the drink wears off, you feel worse because of the way the alcohol has affected your brain and the rest of your body. Drinking is not a good way to manage difficult feelings. Whenever possible stay within the recommended daily alcohol limits. - Keep in touch
Good relationships are crucial to our mental health. Friends and family can make you feel included and cared for. There is nothing better than catching up with someone you care about face to face but that is not always possible. You can also give someone a call, drop them a note or chat to them online instead. It is worth working at relationships that make you feel loved or valued. However if you think being around someone is damaging your mental health, it may be best to take a break from them or call it a day completely. - Ask for help
We all sometimes get tired or overwhelmed by how we feel or when things do not go to plan. If things are getting too much for you and you feel you cannot cope, ask for help. If you are concerned that you are developing a mental health problem you should seek the advice and support of your GP as a matter of priority. Your GP may suggest ways that you or your family can help you or they may refer you to a specialist or another part of the health service. If you are in distress and need immediate help and are unable to see a GP, you should visit your local A&E. - Take a break
A change of scene or a change of pace is good for your mental health. It could be a five-minute pause from your day, a half-hour lunch break at work, or a weekend exploring somewhere new. Taking a break may mean being very active. It may mean not doing very much at all. Take a deep breath… and relax. Try yoga or meditation or mindfulness, or just putting your feet up. Listen to your body. If you are really tired, give yourself time to sleep. Without good sleep, our mental health suffers and our concentration goes downhill. Sometimes the world can wait. - Do something you are good at
Enjoying yourself can help beat stress. Doing an activity you enjoy probably means you are good at it and achieving something boosts your self-esteem. Concentrating on a hobby or interest, like gardening or the arts, can help you forget your worries for a while and can change your mood. It can be good to have an interest where you are not seen as someone’s mum or dad, partner or employee. You are just you. - Accept who you are
We are all different. It is much healthier to accept that you are unique than to wish you were more like someone else. Feeling good about yourself boosts your confidence to learn new skills, visit new places and make new friends. Good self-esteem helps you cope when life takes a difficult turn. Be proud of who you are. Recognise and accept the things you may not be good at but also focus on what you can do well and have achieved. If there is anything about yourself you would like to change, are your expectations realistic? If they are, then work towards the change in small steps. - Care for others
Doing good does you good. Caring for others is often an important part of keeping up relationships with people close to you. It can bring you closer together. Why not share your skills more widely by volunteering for a local charity? Helping out can make us feel needed and valued and that boosts our self-esteem. It can also be particularly beneficial if you are unemployed or unable to work for a period of time and can help build skills that can support job-seeking or life more generally.
Five steps for a mentally thriving UK
There are steps we can all take to support our own mental health and the mental health of our friends, family and neighbours. However, there is also much that is beyond our control. Significant responsibility lies with the governments across the UK at national and city level to protect and improve mental health for all.
We are calling on government to take the following specific steps:
- A National Thriving Mental Health Programme to spread public understanding about how to look after our mental health and to build community resilience.
A key plank of any resilience programme must be delivered in schools. Teachers and peer educators need the right training and the resources to support delivery. However, mental health resilience across all age groups is also essential. Workplaces are a good place to reach many adults and public sector employers (including NHS bodies) can show the way to the private sector. Online resources will be needed to reach small businesses, small charities and the self-employed. Community groups will have a particularly important role in using their reach into communities where more people are likely to be struggling. We need to use the leadership role of local groups including charities, faith groups, children’s groups and local networks who are actively engaged in neighbourhoods. Trained local leaders and peer supporters can play a crucial role in helping to develop individual and community resilience and to bring people together to identify and address (or to press their elected representatives to address) the main drivers of poor mental health in their areas. - A Royal Commission to investigate effective ways to prevent poor mental health and to develop good mental health and highlighting opportunities to reduce risks.
Past focus has understandably been on the problems with services. It is time for an authoritative inquiry into the solutions to prevent mental health problems developing and what creates a foundation for good mental health in our society. This would draw on best practice and knowledge from across the world. The Commission should consider what steps can be taken to address the key drivers of poor mental health, with evidence taken from mental health stakeholders, academics, practitioners and crucially the voice of people living with and affected by mental health problems. - A Mentally Thriving Nation Report each year to track progress, emerging issues and actions required.
The governments of the countries of the UK should report annually to their respective parliaments or national assemblies on the prevalence of mental health problems, levels of good mental health and the priorities for action. This would introduce a more action focused approach to mental health, share successes and encourage innovation. Annual reporting will encourage transparency and the search for solutions that can be applied in the areas where there is known to be the greatest risk of poor mental health. - A ‘100% Health’ Check to help people to manage their mental health and reduce their risks as well as identifying where they need professional mental health support.
Regular check-ups for those at higher risk of particular physical health conditions, coupled with good advice on self-management and links to peer support groups, have reduced many levels of physical ill health. A regular check-in, available to all, is needed for the health of our minds. This will need to take account of capacity constraints on GPs and offer people a range of ways to check up on their health, including online options. These will need to be able to link people to evidence-informed self-management advice; peer support or to the right level of professional mental health support. Given that approximately a third of GP appointments have a mental health element, the right preventive programme could, over time reduce the pressure of mental ill health on primary care as well as secondary care. - Fair Funding for Mental Health Research, commensurate with the scale of mental health problems in our society.
We now live longer healthier lives thanks to a significant extent to research into preventing physical health problems and to identifying and addressing them early. If we are to lead truly healthy lives, the same approach must be taken in mental health. There is wide gulf between the research funds made available for physical health and those for mental health. Mental health receives 5.8% of the total UK health research spend despite representing 23% of service demand. Most funded research investigates treatment rather than prevention. We are calling for government to rectify this historic imbalance by doubling mental health research funding by 2022, representing a commitment to parity of esteem for mental health and reflecting the full range of potential interventions to create a mentally thriving UK.