Martha Gill’s argument that mental health definition has become so widened as to become almost meaningless makes a fundamentally important point (Comment). As a society, we have amalgamated several meanings under the umbrella term “mental health”. Mental health should be thought of as three concepts:
• wellbeing that is relevant to all of us, whether we have a mental health disorder or not;
• common mental disorder such as mild to moderate depression and anxiety, which can be discomfiting and need treatment;
• severe mental illness such as psychosis, schizophrenia, bipolar disorder and severe personality disorders, addictions and severe depression.
As a psychiatrist, I note this third group remains one of the most neglected groups. Resources are scarce, there are not enough community, recovery and inpatient services and these are all understaffed. Several of us think the conflation of all three strands in media and public discourse has done society a great disservice and attention has shifted from where the need is greatest. Consequently, systemic discrimination and health inequality against the most disadvantaged groups hide in plain sight. Being “aware” of mental health issues is not enough; we need to be mental-health literate so we can prioritise areas with greatest need.
Dr Musa Sami, consultant psychiatrist,
Nottingham
While I agree with Gill about the need to destigmatise severe and enduring mental ill health, she has mischaracterised the purpose of our Mental Health Awareness Week campaign on anxiety. We are highlighting the scale of feelings of anxiety because we know they can become persistent and develop into more serious problems.
In our polling of 6,000 UK adults, of those experiencing anxiety 45% were keeping it a secret and nearly a third were not coping well with those feelings. That’s why our campaign focuses on encouraging people to share their experiences, and providing evidence-backed guidance on how to manage feelings of anxiety to prevent them from getting worse. An awareness week will not solve the mental health crisis, but it gives us the opportunity to share tools with people to help them cope with challenging emotions in a healthy way. It helps us normalise conversations so that people are more comfortable seeking support if and when they need it.
We also need governments to ensure communities and environments support people to live well, which is why we are urging them to develop and deliver 10-year mental health strategies with a strong focus on prevention of poor mental health.
Mark Rowland, CEO, Mental Health Foundation, Glasgow
We have long held similar concerns to those of Gill in her excellent piece. The more we have campaigns raising awareness of mental illness but fail to have services to respond to those in crisis, the more we paradoxically reinforce the stigma we seek to erase. Only by recognising the profound pain of people with serious mental illness will we be able to separate their needs from those who can benefit from wellness initiatives. My experience, over three decades, is that, despite campaigns, many with conditions such as schizophrenia and severe depression can remain sidelined and forgotten. The downside of all the good that campaigns can do is to raise expectations that, if unmet, reinforce feelings of exclusion and despair.
Marjorie Wallace, chief executive, Sane, London N7
On the wrong track?
The subheading on Rowan Moore’s article about the redesign of London’s Liverpool Street station says the plan “seems ill-conceived, even with Herzog & de Meuron on board” (“Is Liverpool Street station about to hit the buffers”, New Review). Even with! Surely it’s because it’s Herzog & de Meuron? No one who has experienced their stunningly awful design for Tate Modern, in which staircases don’t take you where you want to go and floors are cunningly bypassed, would entrust them with a station, where the first imperative is clarity.
Ruth Brandon
London NW3
Politicians, show compassion
We agree with Kenan Malik (“It’s no longer ‘the will of the people’ to turn our back on asylum seekers”, Comment): Britons want politicians to show compassion to those seeking asylum.
We polled 2,000 people with Opinium and found more opposed than supported plans to imprison refugees without visas (41% vs 31%). Similarly, more opposed than supported using offshore detention centres (38% Vs 33%). We found respondents to be more likely to support proposals that treat asylum seekers with compassion, with 50% in favour of allowing family members of those living in the UK to join them, as is the case for Ukrainian refugees, twice as many who said they opposed the proposal. In a poll with YouGov and the Global Compassion Coalition, a majority of respondents said they wanted politicians to be more compassionate. Now is their opportunity to reflect more accurately the nation’s wishes and abandon the illegal migration bill.
Matt Hawkins, co-director, Compassion in Politics, London SE23
Take pleasure in real cooking
I was brought up in continental Europe, where cooking from scratch is the norm and where they have not succumbed to ultra-processed food (“Too tired to cook. Too easy to open a packet. It’s not our fault we eat junk”, Comment). Until we gain pleasure from exploring our bounty, rather than mindlessly grabbing a ready meal or other poor-quality food, we will continue to graze on our broken food choices. Economics comes into play, thanks to mind-boggling price hikes, but there is a way around this: ditch the ultra-processed food and embrace the pleasures of real cooking.
Carol Godsmark
Chichester, West Sussex
What’s age got to do with it?
It was recently made very clear to me that sex is regarded as the prerogative of young people, when I published my first novel, Because You Were There, at the age of 75. On receiving a preliminary edit, a large section was highlighted in which one protagonist, a widow, begins to feel the stirrings of attraction towards a man she first met half a century ago. My editor was uncomfortable with this, and suggested I should omit it.
As I hope she will learn, age and sex are not mutually exclusive. I thank Kat Lister for her sensitive article (“‘I miss the sex’: Why are the sexual needs of the bereaved still taboo?”, Magazine). Spoiler alert: reader, she married him.
Joan Lewis
Saint-Étienne-de-Gourgas, France
