Mental Health is Everybody’s Business - World Mental Health Day 2021

by Paula Caruana,Clinical Psychology Practitioner

Every year, on the 10th of October, World Mental Health Day is internationally commemorated. The aim of this day is to raise awareness on mental health, its significance, and the struggles associated with poor mental health, around the world. The World Health Organization (WHO) notes that this day is also an opportunity for all stakeholders to talk about, and discuss, what is needed to increase access to mental health services and wellbeing worldwide.

So what does ‘mental health’ really mean?

Although it is often wrongly used interchangeably with the term ‘mental illness’, it does not mean that. We all have mental health. Mental health includes our emotional, behavioural, cognitive, and psychological wellbeing. Therefore, it includes what and how we feel and think, and our interactions with others. A significant part of our mental health is, in fact, influenced by our relationships and social interactions. Our mental health is influenced by our quality of life, and basic life necessities, like food, shelter, safety, and sleeping patterns. Biological, genetic, and physical factors, family experiences, and our childhood and development, can also shape our current mental wellbeing.

Our mental health can also be influenced by societal, cultural, geographical, and climate issues. Political turmoil, extreme weather conditions, or cultural expectations, could influence our wellbeing. They could also influence if and how we talk about mental health or its distress, or whether to even seek help for it (Bhugra, Watson, & Wijesuriya, 2021).

We all have mental health, just like we all have physical health.

Whilst not all of us will experience mental illness, everyone is susceptible to having periods of time of struggle, distress, or lethargy, just as we could all catch a cold or feel under the weather from time to time.

We cannot deny, for example, the possible effects on our mental wellbeing, when living through the Covid-19 pandemic these past 20 months. Whilst most people around the world were required to carry out social distancing and quarantine, drastically changing life, work, or school routines, and limiting social activities, many even contracting the virus, or losing people they cared for… it is not surprising that numerous people struggled emotionally.

Whilst some weren’t emotionally affected, many individuals experienced a “languishing”, dreadful feeling, apart from others who experienced severe psychological distress. The term “languishing” became a prominent term to describe an experience of emptiness and helplessness that seemed to be a universal experience during the pandemic. This term, in reference to mental health, was coined by Corey Keyes, a sociologist, who referred to thriving mental health as “flourishing,” a combination of feeling good about and functioning well in life. On the other hand, “languishing” referred to not feeling too good and not functioning well in life. These terms further aid at expanding the view on mental health.

This refers to the continuum of psychological wellbeing.

Often, mental health and symptoms of mental health problems are wrongly referred to as “black or white/ill or well/us or them” descriptions, but this is not the case. Stigma and shame surrounding mental health problems may have further created a divide that if one experiences certain symptoms or seeks professional help, then they must be labelled as “ill” or “weak”, or, even worse, described as “crazy or insane”. These derogatory terms can trigger shame and hesitation, leading to individuals avoiding speaking about anything mental-health related to their closest of friends and families, refusing to seek professional help or even avoiding psychiatric medication or hospital admission. This of course can have detrimental consequences of severe distress or, even suicide, in some cases. Indeed, talking can save lives.

Instead, our mental health can be described as a range of experiences, a spectrum – a variety of possibilities: from flourishing, to typical mood fluctuations, from having a bad day, a bad period, to just coping with life, from relationship hitches to severe relational struggles, from distress and trauma, to severe emotional pain and suffering, or living through chronic mental illness. This description is, of course, incomplete, because our mental health experiences are vast and unique to the individual. Recognizing that our psychological wellbeing is not a “well or ill” binary lessens stigma, as it normalizes that we all have mental health, and are all susceptible to emotional struggles. Viewing mental health through this lens also highlights the importance of taking care of our psychological wellbeing throughout all the continuum, and not until we are in crisis.  

Indeed, mental health struggles might not always be diagnosable, mental health disorders, but may, instead, reflect the “the tangled landscape of our rich and painful lives”, as psychologist Lucy Foulkes eloquently describes in The Guardian article (https://www.theguardian.com/commentisfree/2021/mar/29/conversation-mental-health-psychiatric-language-seriously-ill).

Whilst some might prefer seeking professional help immediately when their mental health isn’t thriving, others may choose to reach out to closer people they trust. Time, self-care, taking a break, doing exercise, or investing time in oneself or a hobby, could be enough for a person’s mental wellbeing to return to its ‘good enough’ or feel good state. However, others may seek and require professional support, such as psychological and/or psychiatric interventions, perhaps needing medication or perhaps not. When people experience certain particular distressing symptoms (such as having a depressed mood, feeling helpless, or experiencing panic and anxiety), over periods of time, and when their quality of life and routine seem to be impacted as a result, they might be also given a diagnosis. For this reason, it is important to realize when to seek professional help, and this is why mental health education is vital.

Normalizing mental health talk does not mean that all emotional experiences are one and the same. It does not mean that feeling sad necessarily means feeling depressed, or feeling anxious automatically equates to having an anxiety disorder or having OCD. Unnecessary labels cause a challenge and may undermine the severe pain and distress that living with a mental illness entails.

Nevertheless, being given a diagnosis by a professional can provide relief and safety to the person, and their caregivers, and leads to the correct interventions and proper treatment being given.

Mental health talk has helped raise awareness about seeking professional support. Although this is vital and extremely useful for millions of people around the world, caring for our general mental health wellbeing begins with a simple conversation. Starting with ourselves and questioning, "how am I really feeling today?” encourages the momentum of openness with being okay with our range of emotions, therefore challenging the ‘toxic positivity’ mentality. The expectation of constant happiness is a flawed and dangerous one. Awareness can lead to conversations within families and communities, challenging the view of mental health talk being “weakness”, but rather one of bravery, authenticity, courageousness, and simply of being human.

“How are you?” / “Kif int?”, as we would ask in Maltese, has also become the name of a local website where one can receive general information about mental health (www.kifint.com). Education is key at raising awareness, normalizing mental health discussions, and thus reducing stigma.

Let’s hope World Mental Health Day can continue to raise awareness by encouraging conversations within families, friendships, education and employment sectors, social media, between stakeholders, governments, and beyond. After all, mental health is also a political and societal priority. Encouraging children and adults to talk about their mental health requires the appropriate professional support to be available.

If you or a loved one wishes to know more about mental health or is interested in professional support, several local NGOs and public services offer free or subsidized care and educational information. Some of these are found below: (This is not an exhaustive list and some other great organizations might not be listed)

Services in Malta and Gozo

-        Visiting any GP who can refer you to free psychology services and Mental Health Clinics around Malta and Gozo

-        Employee Support Services - for all public service and government employees https://publicservice.gov.mt/en/people/ESP/Pages/Accessing-the-Service.aspx

-        Foundation for Social Welfare Services (FSWS) https://fsws.gov.mt/en/sedqa/Pages/Care-Services/Community-Services-.aspx

-        Richmond Foundation https://www.richmond.org.mt/

-        Olli.Chat https://olli.chat

-        Kellimni Online Chat https://kellimni.com/

-        Victim Support Malta https://victimsupport.org.mt/

-        Mental Health Association https://www.mhamalta.com/

-        Caritas Malta https://www.caritasmalta.org/

-        Several companies or businesses fund a number of therapy sessions for their employees, so get in touch with your HR department if you happen to have this work benefit.

-        The University of Malta, Junior College, MCAST, Giovanni Curmi Higher Secondary School and most schools in Malta and Gozo offer free counselling services to their students.

If you prefer to attend appointments in private clinics, several professionals, such as psychologists, psychotherapists, counsellors, psychiatrists, social workers, occupational therapists, speech and language pathologists or psychiatric nurses, among others, provide online or in-person services around Malta and Gozo, with TAASC being one of them. Contact us if you wish to know more about our services.

If you or a loved one is in a mental health crisis, such as having suicidal thoughts or plans, being in severe emotional distress, or experiencing loss with reality (eg: hearing voices), you are encouraged to visit your GP immediately, or the A&E Accident & Emergency Department at Mater Dei Hospital.

179 is the National Supportline

1770 is a 24 hour mental health helpline run by Richmond Foundation

Ms Paula Caruana, Clinical Psychology Practitioner -

Paula Caruana graduated with a Bachelors in Psychology (Honours) in 2014. Following work experience in education and mental health rehabilitation with Richmond Foundation, she pursued a Masters in Clinical Psychology at the University of Malta in 2017. As part of her studies, Paula researched the impact of caregiving on the couple relationship, when adult children have a mental illness. Apart from mental health rehabilitation, which is one of Paula’s areas of interest, she practised briefly in the areas of education and social welfare services and is presently employed as a psychology practitioner with the local Mental Health Services.