Reflecting on Mental Health Awareness Week 2019 – Body image

By Antonis Kousoulis and Bethan Harvey

Bethan: I am sat in my weekly therapy session on Tuesday 14 May, crying. This is the second day of Mental Health Awareness Week 2019 and my tears are connected to this year’s theme - ‘Body image’. 

They start as tears of shame and exhaustion and by the end become a release of pride. 

My name is Bethan, I am the Digital Engagement Officer at the Mental Health Foundation and I have been working on the content for 2019’s theme ‘Body image – how we think and feel about our bodies’. I have been internalising the shame that comes with it … ‘it’ being the shame that society has taught us to feel about our bodies. 

Initially I felt like I needed to hide my shaming feelings and by the end of the week I learnt that not only are they normal, but that I was not alone in feeling them.  

So, what does it mean, that a lot of us at the Mental Health Foundation have found working on this campaign quite hard?

It means that the theme of body image is personal, difficult, shaming, stigmatised and therefore worthy of shining a light on in the hope of creating positive change. 

The theme of body image is personal, difficult, shaming, stigmatised and worthy of shining a light on in the hope of creating positive change. 

Antonis: Not everyone agreed with us that this awareness is needed. “Haven’t we had enough awareness?”, was asked. One of the issues that came up straight away and that does every single Mental Health Awareness Week (and in fact less so on other awareness weeks), is that while awareness is important, talking is not enough.

It is fundamentally important that we take the nature of this "talking" seriously. Especially the public conversation around mental health, and how it can sometimes exacerbate stigma as much as address it. Our narrative at the Foundation is one that – we hope – navigates this issue well.

Here are my reflections on the complexity of the week.

Awareness or action

What happens when services cannot meet the demand of awareness weeks?

There are also debates in which people claim that we have gone too far with mental health awareness, and that this has resulted in services not being able to meet the demand.

The thing is, that for any health issue, raising awareness is a crucial step towards ensuring people take action to improve their health. All health issues need concentrated attention to prevent them, and we can all play a part in this once we are well informed. 

Not talking about mental health, not getting treatment, and only investing in supporting those in crisis causes substantial costs to people’s lives and sometimes costs people’s lives themselves. 

The demand on mental health services is not a result of too much awareness. It is a result of the failure to respond and act early and the failure to provide prevention and timely help in the settings where we spend most of our time.

The demand on mental health services is not a result of too much awareness. It is a result of the failure to respond and act early and the failure to provide prevention and timely help in the settings where we spend most of our time.

Haven’t attitudes towards mental health only just started to shift?

And then there are those who oversimplify or forget. A Newspaper Editor wrote on Monday that such a week would not have been possible a few years ago. This is very far from the truth. The Mental Health Foundation established and has been hosting Mental Health Awareness Week since 2001. What today, is a little step towards change, 18 years ago was a bold move. And this is perhaps what this week is all about. Even if you don’t learn anything during this week, even if you don’t talk about the theme, even if you criticise it, we have been here, slowly shifting attitudes and views for the past 2 decades.

‎Inspiring activism

I valued and took seriously the perspectives of many of our supporters and people that I see as experts by experience. They had told us that it was going to be a difficult, triggering and personal week for them. I respected that this meant that some important activists would not want to be involved with the theme. 

And I certainly valued the huge numbers of people that engaged in the debates during the week. People shared their own personal stories of their relationship with their bodies, others were open about how adverse medication effects impacted how they felt about their body and some people talked about their own insecurities. All these things helped to drive the conversation forward. 

A platform for the voice of experience is key if ‎we are to achieve any change in "awareness".

From my discussions with experts by experience I saw that for many, as well as for me, Mental Health Awareness Week is an opportunity to almost de-medicalise mental health. Move the conversation away from "it runs in your family, you poor broken person", to a conversation about distress, the social circumstances and traumas we experience and the broken society that play the biggest role in the development of mental health problems.

Move the conversation away from "it runs in your family, you poor broken person", to a conversation about distress, the social circumstances and traumas we experience and the broken society that play the biggest role in the development of mental health problems.

A broken society

On Monday, I read with interest, the new research sponsored by the British Heart Foundation, which showed that cardiovascular deaths are on the rise in the UK for the first time in 50 years, mainly because of the rise of obesity. On a radio interview ‎later that same day I got asked about this. 

**trigger warning – the next section mentions food, diet and exercise**

Why are we talking about obesity and our bodies so much?

If I am here representing the public health community, I am putting my hands up; and saying that we have failed. Our campaigns for too long have focused on patronising people. "This is good for you". "That is not good for you". "You ought to be doing this". "You will die younger because of that".

An industry built on fuelling unhealthy habits

And while we have been taking this false educational approach, the same people that we wish to serve have been growing older in an environment which is built by an industry with advanced marketing tools - that fuels and feeds obesity‎ and unhealthy habits. 

Think about all the chocolates and crisps around the tills at supermarkets. Think about the ubiquitous messaging around soft drinks. Think about the pricing of healthy vs unhealthy foods. Think about most of the snacking options you get in a café.

An industry built on shaming us into buying products and exercise fads

And once we eventually get caught in this and we become overweight, underweight, guilty, insecure (add the appropriate word for you), we move into a parallel environment - built by another industry with advanced marketing tools - that shames us into buying products, starting exercise regimes, systematically losing weight, changing our appearance, editing our photos … so that ‎we can move towards a single body and image ‘ideal’ that is meant to be aspirational to all 7 billion people on this planet.

A digital platform built on consumerism, celebrity and external appearance

And when we turn away from this physical environment, we travel into a parallel digital environment - built by yet another‎ industry with advanced marketing tools - that is increasingly consumerist, increasingly celebrity orientated and increasingly focused on external appearances.

Asking people to take back control against these marketing giants

And amid all this, we in public health come back into the picture asking people to take control of their health, like they're superhumans.

1 in 8 people have experienced suicidal thoughts and feelings because of their body image. 

Throughout the week I got asked a lot if I am surprised by our survey finding that 1 in 8 people had experienced suicidal thoughts and feelings because of their body image. 

To the 8 million people in the UK that have felt like that, I'm sorry. We have failed you; our society has failed you and, most disappointingly, we're not even able to make the logical connections that lead from A to B.

Let's get better at this.

Making change happen

A nanny state?

Of course, talking about controlling the environment that people spend their lives in is also debatable. I am embracing the challenge of this debate.

If we are to succeed in a public health mission of improving people's health, we need to do our best to empower everyone, not patronise. But if we'd like people to be empowered to make those healthy decisions for themselves, we need to take measures to protect them from the social harm in their environment.

If we are to succeed in a public health mission of improving people's health, we need to do our best to empower everyone, not patronise.

Moving forwards collectively towards positive change

‎Our Parliamentary reception and our Schools event during the week showed that we are ready to have this conversation. Ministers, MPs, activists, teachers and students acknowledged the role that they must play in protecting and improving mental health for all. It is inspiring to move collectively to this direction. 

Changing the way we talk about and understand our mental health

During the week we also debated our relevance and response to the Jeremy Kyle Show incident.‎ There is no easy consolation for the bereaved family. The fact that the actual public conversation and launch of the inquiry happened during Mental Health Awareness Week though, is a sign of how times have changed. 

The clear goal of the week has always been to change how we talk about and understand our mental health. Our evidence clearly shows how the language we use, and our behaviours can affect the mental health of others. 

Shows that attract huge TV audiences by showing participants being made to feel afraid, ashamed or angry are obvious examples where broadcasters have a clear and strong duty of care towards both their participants and viewers.

‎The culture change is happening. We need action on "psychological pollutants" in the same way we take action on environmental pollutants. 

‎The culture change is happening. We need action on "psychological pollutants" in the same way we take action on environmental pollutants.

Finding the space

To stay innovative, creative and energised in order to influence change, we need "space". Breaks from the day-to-day to focus on creating, debating, thinking, designing and listening.

This year, I kept my week free of regular meetings ‎and, instead, I enjoyed the opportunity to walk around the office, talk and support my colleagues who were feeling stressed, respond to supporters who were overwhelmed and think hard on how we'll keep the theme going beyond Sunday 19 May 2019.

Mental Health Awareness Week - is and has always been about action 

Mental Health Awareness Week, for us, has always been about action. This was the case this year as well – from taking steps to realising our policy recommendations to spreading advice for everyone, from having powerful art to partaking in difficult media conversations, from better regulating advertising to preventing the harm caused through social media and the cosmetic industry, and from further research on overlooked groups to a stronger narrative on how change will happen. 

This action for us does not stop on Sunday.

PS. This blog post, as is the case with all our work, is collaborative. It has been discussed with Bethan and also used ideas of, taken inspiration from conversations with, or simply plagiarised text‎s written by a number of people I admire (in no particular order): M‎ark Rowland, Chris O'Sullivan, Matt Haig, Mark Brown, Ruth Simmonds, Priscila Hernandez, Isabella Goldie, Jo Watson, Jay Watts, Jonny Benjamin.