Edward Davies: Work and relationships are the core components of mental health. The lockdown has damaged both.

4 Nov

Edward Davies is Director of Policy at the Centre for Social Justice

The Coronavirus crisis will have many knock-on effects, but one of the biggest – the decline in the nation’s mental health – is already daily headline fodder.

Research published in the British Journal of Psychiatry found that recent suicidal thoughts had increased from one in 13 to one in 10 respondents since March: that’s the equivalent of an extra 830,000 adults thinking of ending their life.

A mega-survey conducted by Mind, the mental health charity, found that more than half the adult population reported a deterioration in their mental state during lockdown. Even six months on from telling us all to ‘stay at home’ ONS analysis finds almost four in 10 adults reporting high levels of anxiety in October.

The Department of Health in England has said, predictably, that it is increasing investment in mental health services in response. But maybe it shouldn’t. We need to learn from the last few months that addressing the mental health needs of the country is not about an ever-increasing spiral of public service spending.

Child and Adolescent Mental Health Services (CAMHS) are overwhelmed, and the knee-jerk response to expand them is understandable. But by the time a child gets there they are already likely to be suicidal. We must go much further upstream.

The last six months have reminded us that good public services, important though they are, are not at the root of mental wellbeing. In fact, the two core components have little to do with public services or government at all, and were profoundly undermined by the lockdown: our work and our relationships.

First, on work, there are few more important things to a person’s mental health than having a reason to get up in the morning. The Royal College of Psychiatrists is unequivocal about the importance of employment for people with mental health problems, they say it is “central to personal identity; provides structure and purpose to the day; gives opportunities for socialisation and friendship; and increases social networks – a core component of social capital”.

And secondly, on relationships, the evidence is even stronger. The Grant Study, a landmark 75-year longitudinal study of Harvard students, is utterly unequivocal about the importance of our relationships to mental and physical health:

“So what have we learned? What are the lessons that come from the tens of thousands of pages of information that we’ve generated on these lives? Well, the lessons aren’t about wealth or fame or working harder and harder. The clearest message that we get from this 75-year study is this: good relationships keep us happier and healthier. Period.”

The quality of our close relationships is fundamental to child mental health, too. Family instability is the single biggest reason that children report attending CAMHS. But, deeper than that, NHS data shows the very structure of our family relationships has a fundamental impact on the mental health of our children.

A primary school child with married parents has a six per cent chance of a mental disorder. It rises to 12 per cent for cohabiting parents and 18 per cent for lone parents.

This overwhelming evidence on work and relationships is reflected in the “happiness data” initiated by David Cameron and still quietly being collated by the ONS. After our health itself, the two most significant factors in an individual reporting that they are satisfied with their life is their marital status and employment status – way more important than other items we might assume, such as housing or income.

So what does that mean coming out of this crisis? It means that whenever policy talk turns to mental health, we need to remember the lessons of both this recent pandemic and thousands of years of history and evidence.

Public services are hugely important, but we will not prevent this problem by constantly pouring water on the fire.

If we want to truly tackle mental health problems in this country, we need to go deeper. We need to ask why, if close relationships are so important, we have allowed the most stable relationship form – marriage – to collapse to a quarter of the rate of a generation ago.

Why do our homes get smaller, our commutes get longer, and more people than ever live completely alone? As a start we should invest in greater relationship support in the early years of children’s lives and revive the Government’s Family Test to ensure housing and economic policy supports rather than hinders families’ wellbeing.

The Government has committed (but not spent) £2.5 million to conduct research into family hubs; this shouldn’t be a dry exercise, but should be done quickly enough to provide a road map to the delivery of family hubs in every part of the country.

Rev-up family support at pivotal moments like the birth of a first child. Birth registration should be a gateway into family support at the very moment parents need it most. Simply fire-fighting this problem with well-intentioned hoses of ever more school counsellors and spiralling public services will never prevent it in the first place.