Mental Health and resilience

 I've read several conflicting articles over the past couple of weeks about how much better our industry is coping with mental health since the pandemic. Some claim that we're really getting on top of it all now with lots of additional help being put in place, others claim that we're still not doing enough, and we're about to witness a massive era of crash and burn.

Now as the person that started campaigning for better education around mental health in drama training some 7 years ago now, and as someone that was instrumental in launching the #time4change mental health charter some 5 years ago I'm finding the conversations really difficult - and here's why. We're focused on the symptoms, not the cause. We're working off the assumption that the industry is making people ill, whereas it seems to me that with 1 in 3 in the arts susceptible to mental illness, shouldn't we be moving a few steps backwards and try to deal with the fact that people who might already be experiencing symptoms of mental illnesses are entering our industry. For sure our industry makes it worse, but for lots of reasons, our industry attracts a certain demographic.

What am I basing this brazen statement on - 12 years of running a drama college with a clinician heading up my pastoral care team. I am truly gobsmacked at how many of my students over the years were attempting to deal with obvious mental illness symptoms and yet nobody had diagnosed them. Instead, there are countless stories of GPs, teachers, and even parents normalising their symptoms, putting it down to teenage angst etc when all the time they just needed treatment. I've witnessed first-hand the life-changing effect of treatments like CBT, talking therapy and sometimes where indicated, a chemical intervention. 

The trouble with the new culture of declaring your mental health is that we're failing to build resilience and we're failing to address the real issue. We all have crap days, and we all have days where we have to push through 'a mood' but for some, this is indicative of an illness. The answer isn't necessarily to have a day off though. For example, if our students hit a crisis at college we support them to come in as much a possible. Physical exercise is one of the best endorphin hits around and my lot dance for 3.5 hours every morning.  For sure we can give them moments outside of the space to breathe, but then it's back into the studio as soon as possible. Distraction is also really useful.

Now clearly there can't and shouldn't be blanket rules, this is not a black and white issue. For the student suddenly diagnosed with bipolar who is in a depressive episode, and who is attempting to get the right treatment, college is not the right environment for them, you can't 'push through' that. So it's about having a clinician on hand to advise us how best to help.

Anxiety is through the roof at the moment for all of us, but for some people, they've been living with anxiety their entire lives, so this is just the icing on a really big cake. Yet not many people seem to realise that anxiety is a treatable condition. So why learn to live with the symptoms when you could be living your life symptom-free? 

Some of these symptoms are incredibly nuanced, and would not be picked up by the much-lauded mental health first aiders, just like an underlying condition would not be picked up by a St John's first aider.  Here's the rub though there is no longer a shame about having a bad mental health day, but there's still a shame in actually having a mental illness.

Until we address the taboo that some people were literally born with a genetic loading stacking the odds against them from the off (just like we're genetically loaded to have other illnesses) then this is always going to be an unsatisfactory conversation.

The discussion around wellbeing has (I'll say it again) hijacked the much-needed conversation around mental illness. As one of my students once said, if eating vegetables, taking nature hikes and yoga could have cured their depression then they shouldn't have hit a major crisis. For them, the only solution was a medical intervention, their clinical depression needed a chemical reaction to rebalance them. No amount of broccoli, sea air and downward dog could replicate what their brain actually needed.

Early intervention is key, primary schools are slowly edging towards a whole school approach to mental health, in the interim though colleges should be the final safety net to catch people. 

#time4change 5 Years On

TW: This blog discusses mental illness, depression, anxiety, eating disorders, anxiety, OCD plus a healthy dose of ignorance about all the above!

Last week I had the absolute pleasure of chatting to Hazel Leishman, one of my 2020 graduates, on an instalive as part of a series that The MTA's been running called "In Conversation". Mostly I just get to catch up with my graduates during these discussions. Sometimes the graduates have asked to use the platform to get certain messages out there eg Eva Bortalis a 2018 grad used it straight away after the George Floyd murder in order to air her views about the then growing BLM movement, or Paris Hoxton, also a 2018 grad who used it to raise awareness of living with bipolar. In fact we've had quite a few mental health awareness discussions, Sarah Hjort (2019) discussed living with anxiety and David Murphy (2017) had a hugely thought provoking chat about living with depression. In fact David's words have really stuck with me. When asked what were his early symptoms of depression his replied without hesitation - always looking happy. A stark reminder that we shouldn't assume that the depressed person who's at most risk, is the one rocking in a corner.

Last year when we started the series Hazel had commented that we should have somebody speaking about Eating Disorders as part of the series.  Now that's easier said than done as I would never ask somebody to speak about a mental illness, the impetus and request must always come from the 'guest'. At the time Hazel dallied with the idea of going 'live', but I actually stopped it, as I didn't feel that she was well enough to do it. Whilst she was clearly over the worse of her own experience at that time, I always feel that the best stories that would have the most positive outcome are the stories from the people that have truly got their illnesses under treatment, or in remission, or indeed cured. So we agreed to shelve it.  Cue Hazel coming back to me this year to tell me how well she had been doing and how she was about to launch a social media platform on which she was going to be open about her own EDs, with the aim of helping people that found themselves in the same position as she had found herself in, and so she was now ready to have the conversation.

So little is known about Eating Disorders, the misconceptions around how they start are legendary, Hazel went straight into myth busting mode, naming from the outset that the majority of EDs come from a place of needing to be in control. In fact they're very similar to OCD insomuch as control is often the major contributing factor.  For sure other things can trigger them, but the widely perceived logic that people just want to look smaller is often miles off the mark (yet I guess easier for people to try and make sense of loved ones starving themselves to death, or binging, or . . . well . . you know the rest). EDs, like OCD, PTSD, schizophrenia are often the ugly side of mental illnesses that people don't really like talking about - they've never made the popular list.

Even after the recent high profile death of Nikki Grahame this insidious illness still managed to hide in plain sight. As a few posts started to go online about the ludicrous situation that people suffering with EDs had to be essentially 'ill enough' to even start treatment (and by 'ill enough' please understand that sometimes that translates to 'too ill to treat effectively) within a few days it had crept away again to a few niche posts. 

Then fast forward to this week and on another social media platform I watched one of those autobiographical "A Day in the Life of a dance/drama/music Student' videos. I always find it interesting to see a day from the students' perspective. What I didn't expect in this specific "A Day in the life of  Dance Student" was this sentence "then we went to get weighed".  In fact I watched the video several times thinking that I must have misheard it.  Then I read the comments. Lots of people had also questioned this part of their 'average day' - even more alarmingly the people posing the question of WTF were "reassured" that this was part of this particular college's strategy to PREVENT eating disorders!! By regularly monitoring the students' weight they could spot an issue before it arose.

I immediately did my usual twitter rant to find out if everybody knew about this practice, but as per usual those posts never really 'take off' and promote the discussion that's actually needed. I mean interestingly pop up a post about wanting to see more 'normal' shaped people in roles and they go viral in a heartbeat, as of course 'self interest' will always prompt a viral response. 

Heigh ho, the post did prompt a few interesting private messages though. So did you know that some colleges and some work places (specifically cruise companies) will make students/casts sign a contract which essentially ties them into a specific weight (give or take a few pounds)? That's right you did read that correctly - people are made to sign a contract to keep them within a certain weight parameter. Let's not discuss hormonal weight flux, or muscle mass etc, let's just pop people on a scale to see how they're doing.  Believe it or not - this is meant to be helping mental health in the workplace or during training. I'm going to chose not to share some of the techniques and secrets that were shared with me that people did in order to get around some of these conditions, as I know that people with EDs are clever sods who are always on the look out for a get around - however let's just say that you should never undermine the intelligence & creativity of a person in the middle of an ED, those illnesses are bloody crafty.

Let's quickly recap back to Hazel's opening gambit - EDs are usually about control. Notice the bloody massive issue here?

However that's not all I've learned recently. I've also discovered that certain cruise companies are STILL not issuing contracts to people who have named that they're on anti-depressants.  I mean it makes sense doesn't it? People that are on a treatment for depression should not be permitted to work in the middle of the ocean.  Far, far better to essentially force people to either lie, or indeed (and I've witnessed this myself) make people chose between a treatment or a job. I mean - that's never named, but I've known people that have chosen to come off a treatment dose that is helping them in order to fulfil a contract on a cruise ship. The thinking being that work, sun and sea will essentially do the work of the medicine, failing to understand that vitamin D helps all of us feel a bit happier, but for many people they require a much more robust chemical treatment in order to recover from a mental illness. Those same people wonder why they're in their dream job, in a luxurious part of the world, having a mental health crisis. 

So next time you're reading all the positive posts about people being more open about mental health and mental illness these days, next time you're celebrating the 50th person you know becoming a Mental Health first aider, please know that at a very basic level, during training and during jobs, our industry has a hell of a long way to go in order to get on top of this epidemic. 

Next time you see the "It's OK not to be OK" mantra that's become so popular, or the "My DMs are open" invitation to chat to an understanding mate, what would be better is if we actually dealt with mental illness (not just look at mental health, it always has to be both, and) at a grass roots level, because you know what's better than being OK? Being well or being in recovery.

#worldmentalhealthday #time4change

105 Organisations have now signed up to the #time4change Mental Health Charter. In reality that 105 individuals that have gone to their partners, Boards, associates and said that Mental Illness is real and that we ALL have a moral obligation to do something about it.  More than that it's 105 people that weren't afraid of saying those 2 words....'Mental Health'

Today is World Mental Health Day, as ever their message is to talk.  This year their hashtag is #Iamwhole with a campaign for "Tea and Talk"
Mental Health is such a taboo in the UK we have to be persuaded to 'talk' about it. Man when I get ill I want everyone to know,  so that I can garner at least one version of 'poor you', 'are you OK?' 'can I help?'. Yet when people are ill, but not in a physical way, there is often no conversation. Even with themselves, the conversation can simply be 'it'll pass'.

I used to suffer from migraines. I wanted everyone to know about it. I'd walk around with the face of someone begging 'recognise that I'm ill'. People were thoughtful, asked me if light was bothering me (did I need to sit in a dark room for a bit)? Was noise an issue? As maybe discussions could happen somewhere elsewhere.

What if you're depressed though? What do you do then?

The general population think that the depressed person should either 'pull themselves together' and just 'get on with it', they think that it's 'a phase'. I mean. . . if they were really  depressed they'd be crying,wouldn't they? They'd be the person huddled up in the corner of the room, with everyone else feeling awkward about it?

So here's the thing. . . very often the most severely depressed person is the person sitting next to you smiling. Asking you  if you're OK? They're probably listening to your  problems. The depressed person is seldom the one that you think.

What about the 'anxious' person - well they all need to just 'take a deep breath' because it'll be 'OK'. You encourage them to go and do the activity that's making them anxious, as 'they'll feel better when they're there'. Anxiety is surely just nerves, butterflies in your tummy?

Here's the thing though. . . those bits of advice, however well meaning they might have been, might have just been wasted air.  Did you ask them what they needed to help them in that moment? Does your 'anxious' mate prefer to be alone or with company during an anxiety attack? Have you asked them? Have you found out what their anxiety attack looks like? It might not be the panic attack that you've heard people talk about. I mean what exactly is a panic attack anyway? Then you see one - it scares you because you've never seen one before;  someone gasping for air, scared that they just can't take air in, scared that they might even die, the sensations are so bad? Everyone is so different.

Eating Disorders are easy to spot though, aren't they? I mean people just suddenly look thin, and you ask them if they're OK...and then you tell them they need to eat more. Sorted!
What about Bulimia though - they tend not to lose the weight? How do you spot them?

We need to talk EVERY day about Mental Health, just like we do EVERY day about our physical health. If you have a cold...don't you tell people when they ask you if you're OK? That's a viral thing, a thing that couldn't be helped, a thing that took over your body that you had no say in. My migraines were physical, I had no say in them, they just arrived and I had to deal with them. Mental Health is a thing that takes over your brain that you have no say in. What's the difference?

When you're physically ill don't you look for treatment to help you get better? Why is it so different for Mental Health?

This week I was thrilled when the owner of the website 'Not A Pushy Mum' got in contact with me to find out how they could get involved in #time4change. They have a unique 'in' with the parents of children going into the arts.  As we're hearing in nearly every government review at the moment Mental Health in the young is on the increase. If all those parents that are so desperate for their children to do well in life read the charter, they might, just might read something that starts to ring some bells for them.  Then if they're very brave. . . they'll address what they've just discovered. They'll do this because they'll want the best possible start for their child's life (even though they might be scared of what they've discovered/realised)

The majority of colleges have now had their Fresher's week - I'm already hearing the figures of people that have presented at counselling services looking for support. The figures are staggering. The person that once mentioned a Tsunami is not wrong.

Many students arrive at college wanting to be different, wanting to reinvent themselves. It is BRILLIANT when part of that reinvention is dealing with a mental health issue. It's sometimes easier to address this when away from your parents.

How sad then that I'm also hearing about long waiting lists, about counsellors not even returning calls as a 'holding' strategy.

We need more colleges on the #time4change charter. We then need to sit down and look at how we talk together, in a way that promotes best practice, and in a way that maybe manages to support each other too.

These are the stats released today:

Latest suicide statistics* highlight young suicide in the UK at its highest for the past 10 years. In 2015 1,659 young people under 35 years took their own lives; an increase of 103 more than in 2014 and 58 above the previous highest recorded figure (1,631 in 2011).

“Suicide is the biggest killer of young people in the UK. It is a national crisis that can no longer be ignored,” said Ged Flynn, chief executive of national charity PAPYRUS Prevention of Young Suicide.

These well-meaning campaigns should not be happening, because Mental Health is real, it's happening, and we should be discussing those illnesses like we discuss a migraine or a cold.

#time4change is ongoing. Are YOU an individual that could make a difference today?

It's #time4change?

Back in March I blogged about a Mental Health conference, that we, at The MTA had instigated: http://althomasmd.blogspot.co.uk/2016/03/mental-health-in-drama-schools-conference-time4change.html This had been borne out of 7 years of quiet, and then not so quiet campaigning to encourage drama colleges to think differently about their 'Mental Health Policies'.  Back in Christmas 2014 I wrote this: http://www.thereviewshub.com/blog-annemarie-lewis-thomas-support-each-other-in-2015/ It was meant to be an impassioned plea to get colleges to look at this ongoing issue anew, but instead I discovered that it did nothing more than raise certain hackles,  It felt like however I approached the subject it was wrong.

Since actively campaigning I have been told (and I confess that I'm paraphrasing here), that I should stop 'going on' about Mental Health, as I'd run the risk of becoming digital wall paper (I should quickly add that this was from someone most definitely supporting the campaign); My stance came across as too aggressive, turning people off from the content (said by the person that practically gave me a geographical reference point when I asked the question where young performers could go when in crises, missing the fact entirely that I was speaking much more metaphorically, and having missed the critical sentence that I'd written, about the fact that when in a mental health crises, some people couldn't get out of bed, let alone go to their GP's for help).  I've written letters to various organisations which have been met with a resounding 'we do all of this...haven't you read our policy?' failing to stay curious for just one moment that whilst their intentions couldn't be faulted, maybe their services were failing to follow through somehow?  I've been patronised, placated and down right insulted by the best of the best.  Whilst screaming from the rafters that we, as an industry need to keep doing more, I've felt my head patted several times, like some naughty but playful dog that just won't 'stop playing'.

Then there are the amazing people that I've met along the way, some long standing associates, some very new, who have reinvigorated the campaign at times when they probably didn't even know that I was just about to throw in the towel (again). How did they do it? Well they just listened and then reiterated that we really MUST do something.

For the conference, I attempted to collate some informal empirical evidence about the silent epidemic that was hitting our industry.  The emails that I received have literally kept me fighting these past 3 months. Story after story of people that had been let down by these so called 'policies', people who had left our industry prematurely due to Mental Illness.  Colleges (or more specifically, unskilled staff at respected colleges) offering up helpful advice like 'the industry is tough get used to it'..right through to the classic 'if you can't stand the heat, get out of the kitchen'.  Brilliant advice for young performers struggling with their own sense of self, and in some instances, even their grasp on reality?

Whilst discussing the campaign with industry friends and colleagues every single person, without exception, has acknowledged that we have an issue in our industry.  People that are struggling, entering our industry (or indeed have been in it for years)...clearly needing help and guidance.  The MTA graduates are constantly returning to college with various anecdotes about how much mental illness they are seeing out there, and how that, even more scary, when they broach the subject with their new found friends, they are being answered with the same scared voices that have engulfed our industry for too long.  Mental illness is not a thing to be talked about . . . it is our industry's taboo.

When famous performers become infamous overnight by breakdowns and illnesses that we can't even name, then we are doing something wrong aren't we?  Stephen Fry walked off a set in 1995 due to illness, and the press nailed him to the nearest cross. The language that they used just last year to explain the 'walk out' included that classic 'admitted' word. He 'admitted' to being Bipolar.  I'm asthmatic - I've never had to 'admit' to that fact...I've sometimes told people about this physical impairment, but it's never involved a full confession.  I was extremely short sighted for years...I never 'admitted' that I wore contact lenses, I told people so that they could share in the same relief that I had when I put my lenses in.

The goldfish bowl of social media has magnified the issue to a crazy degree (pun intended). We no longer wait for a newspaper to publish the 'facts', the audience of that night will tell you within minutes what's gone down at a theatre. We have twitter accounts helpfully telling us the news 'as and when it happens'. We have speculation and rumours flying around before the curtain has come down on Act One.  At least pop stars get a warning from 'an insider' that someone is going to grass on them, so that their management have time to put together a damage limitation plan (usually dressed up as a scoop for one of the tabloids).  Theatre folk don't have that luxury. Live theatre nowadays equals live, real time, gossip.  It doesn't matter what you write, as we have forgotten that we're actually writing about humans...and probably humans in so much pain at that time.  Those same humans go home and read the crap that's been written about them,  if they're foolish they'll try to answer their critics. . . but it's lost. At that moment the 'battle is lost'. The next thing you know what should have been a discrete issue between you and a maximum of 2000 people (usually much less), has become a headline. . . a news story.

Let's go back to my critics though . . . as we don't have a problem in our industry. . . do we? Sarcastic? Moi?

In other words Mental Health and the stigma around it, is still prevalent in our industry.  This amazing industry that accepts everyone for who and what they are, just as long as they have talent. We not only accept, but we embrace flaws. . . maybe to the point that it quashes our desire to fix this problem?

So for all the people out there struggling today, for all the people out there that feel just a bit out of kilter with the rest of the world, but you can't just put your finger on the issue, we've come up with an industry wide Mental Health Charter.  We are looking for colleges, production companies, theatres and agents to sign up to the Charter.  It costs you nothing. . . it contains simple guidelines for each of those areas.  It contains a Fact Sheet that we want to get out there to as many industry folk as possible.  It's your 'break glass in an emergency' piece of virtual paper.  A simple PDF that we ask you to download onto your desktop, or add to a well used folder, so that IF you find yourself with an issue that you're going to need to 'admit to'....you now have an instant reference point to attempt to try and find out exactly what you're 'admitting to'. A reference point that isn't a generic Google search (which is in itself enough to make anyone ill), but a list of criteria drawn up by Angie Peake our Health and Welfare Consultant (who I should add, volunteered her services to do this work), but designed to 'keep it real'.

The #time4change initiative is not the answer  to the difficulties that we all face in this industry - but if it helps one person then it's been worth all of the above, and then some.

We should celebrate ill performers fighting their inner demons, be they dressed up in comedy, addiction, or even meltdowns, in order to go back into work.  To return to a job, which let's not forget, holds each and every one of us, up to public scrutiny night after night.  Or if currently looking for work, an occupation that puts you up for scrutiny and rejection every day. . .without ever telling you why.  A career, which for most people, means only being able to engage in it a few times a year, and even then probably won't be paying you a decent wage.

All of this and yet STILL we brush mental health under the carpet, because I guess it's the ultimate monster.  If it got a hold of so and so. . . are you next? PR machines go into overtime to deny that their clients are 'ill'.  Agents feel the need to cover up a truth, and discretely try to let their client know that there might be something wrong.

It's #time4change.

It's time for all of us within the industry to at least have an open dialogue about Mental Health.  To be able to say, without recrimination that we have depression or anxiety or bipolar or. . . whatever.  For our industry to understand those words without fleeing in a stricken panic. I am asthmatic, I have a pump, I am OK. People will know where to find the little blue plastic thing that I occasionally need to breath.  I am short sighted. In my pre-laser days, people knew where my lenses were for those 'special mornings' when I maybe, just maybe, I'd lost the ability to be thoughtful the night before in disposing of them.  If people suffer from a mental illness they should have the freedom to name it, and we should have the knowledge to understand what that means, and what support, if any that person needs.

It's #time4change

If you'd like a copy of the Charter, and think that it could help inform you, your clients, your production company - just drop me a line at Annemarie@theMTA.co.uk naming the subject as #time4change. It won't cost you anything, but it might make a huge difference to somebody's life. . . if not your own