‘Head Above Water’– a 9 metre high, interactive sculpture located on the South Bank.

I'm Fine… Honest!

12th October 2018

If you ask a colleague or a friend or a relative how they are, do you expect them to tell you the truth? And what should you do if you think they’re lying? Claire Moulds investigates...

If a single phrase could sum up the difficult relationship that we, as a nation, have with mental health, then ‘I’m fine’ would have to be in pole position. Seemingly innocuous, those two little words reflect a society where people would rather attempt to cope with their problems single-handedly – even if the foundations of their world are currently collapsing beneath them and they’re finding it hard just remembering to breathe – than experience the palpable discomfort of being seen to be anything less than ‘okay’ in the eyes of their family, friends and colleagues.

But why do we have this knee-jerk reaction, seemingly pre-programmed into us, to reassure others that we are indeed on top of everything, when the reality is that we’re struggling just to make it through each day on our own?

Is it because popular culture tells us we should be strong, independent people who don’t betray any signs of weakness that we feel we must portray ourselves as being invincible 24/7? Someone whom problems bounce off, who never has any issues to deal with and who is constantly calm and in control? Because to say anything otherwise is to reveal yourself to be vulnerable and, therefore in the eyes of others, flawed?

It’s fair to say that I’m as guilty as the next person of saying ‘I’m fine’ when I’m not, but the truth is that it’s hard to break from the party line when everyone around you is putting on the same façade. After all, nobody wants to be the one to say that they are finding things tough, especially when all your peers seem to be coping with whatever life throws at them.

And yet, because we’re doing it ourselves, we suspect deep down that others are playing the same game so it becomes, at best, a very pointless charade and at worst a situation where nobody really knows the truth about how anyone else is feeling and, critically, who at any given time is in most need of a friendly face, a cuppa and a chat.

The extent to which we all deceive ourselves, and each other, was revealed in a study of 2,000 adults by the Mental Health Foundation (MHF) where they found that the average adult will say ‘I’m fine’ 14 times a week, but only 19% will really mean it. Tellingly, when we ask ‘how are you feeling?’, 59% of us also expect the answer to be a lie.

New research just released by the mental health anti-stigma campaign, Time to Change, shows even more worrying statistics, revealing that over three quarters (78%) of us would tell friends and family we are ‘fine’, even if struggling with a mental health problem. Time to Change is urging people to ‘Ask Twice’ if they suspect a friend, family member, or colleague might be struggling with their mental health. The campaign says the simple act of asking again, with interest, shows a genuine willingness to talk and listen.

Jo Loughran, Director of Time to Change, says, “We all hear it dozens of times a day: ‘How are you?’ ‘Fine thanks, how are you?’ Our research shows that, as a nation, we find it hard to answer honestly. This could mean someone close to you is struggling with their mental health – they might just be waiting for your cue to talk about it. Asking twice is a simple, effective way to show our friends and family members that we are asking for real; that we are ready to listen, whether that’s now or whenever they’re ready.”

Any mental health professional will tell you that bottling up feelings and not asking for help and support when you need it will only exacerbate the situation. Worse still, by sticking to the ‘I’m fine’ script, we negate the value of people ‘checking in’ with us – while it might, on the surface, appear as though we’re all sharing how we’re feeling openly and honestly, if nobody feels that they can actually tell the truth (with one in ten people in the survey saying they always lie about their emotional state) then it defeats the purpose.

While the British stiff upper lip no doubt has some part to play in our widespread reluctance to tell people how we’re really feeling, there’s also the knowledge that the listener might not know how to cope if we do unburden ourselves on them. In their shoes would we know what to say and do? Interestingly, 44% of survey respondents also revealed that they had regretted asking somebody how they were doing in the past, as they received an answer that they were simply not prepared for.

Good friends will look past their own discomfort, though, and will lend you their ears for as long as you need. And, while it might be incredibly uncomfortable to share what’s troubling you, it will feel an awful lot better afterwards – not only to have got it off your chest but also to have someone in your camp who can act as an independent sounding board and who can help you to move forward. Sometimes a fresh perspective on a situation can make even the steepest of mountains seem more like a rather large hill, and therefore eminently more climbable.

And be prepared to return the favour in the future, by honing your own listening skills. Many of us are very poor listeners, either zoning out of a conversation or formulating our response while the speaker is still talking, instead of really concentrating on what is being said. Part of effective listening is also asking questions to clarify what’s been discussed, to ensure we really understand what we’ve heard and haven’t misinterpreted it. It’s also important to look out for non-verbal clues as well, such as body language, to get a complete picture of the situation.

Remember, nobody is expecting you to solve all their problems just because they’ve shared how they are feeling with you, in the same way that you wouldn’t expect them to solve all yours. The important thing is to be ‘there’ for each other: physically, mentally and emotionally (ie not with one eye on your phone monitoring the latest developments on social media).
We’d all probably admit that life is a little bit harder than it once was – as a result of political uncertainty, job insecurity, financial pressures and our ‘always on’ culture. Permanently connected to the outside world via modern technology, we struggle to escape the resulting constant intrusions on our time to gain the peace, quiet and headspace that mental wellbeing requires.

The statistics make for scary reading. Another recent survey by the MHF found that only a small minority of people (13%) in the UK were found to be living with high levels of positive mental health. Moreover, the study revealed that our collective mental health is actually deteriorating: 65% of respondents said that they had experienced a mental health problem at some point in their lives, with younger people more likely to have been affected.

It’s therefore time for us to stand up and admit that we’re not ‘fine’ as a nation and to seek help before the situation worsens even further. The urgency of the issue was further underlined by the information that 32% of respondents had experienced suicidal thoughts or feelings because of stress, and 16% said that they had self-harmed.

One organisation looking to turn the tide is Mental Health First Aid (MHFA) England, which aims to train people to offer the mental health equivalent of physical first aid. While course participants are not trained to be therapists or psychiatrists, naturally, they are provided with the skills and confidence to recognise the signs and symptoms of common mental health issues, to offer initial help through non-judgemental listening and reassurance and to effectively guide a person towards the right support, be it via self-help or through accessing professional therapy services.

The organisation’s mission is to train one in ten of the population in mental health first aid, in order to raise mental health literacy, break stigma and support more people to access the right help at the right time. As well as training participants to help others it also teaches them to look after their own mental wellbeing with the aim of ultimately creating a mentally healthier society.

In the meantime, we all need to take responsibility for our own mental health – which is why it’s more important than ever that we each talk truthfully about how we are feeling, what is and isn’t going well for us at present and how we’re coping. Crucially, we also need to change our mindset so that, going forward, we appreciate that the strongest person in the room isn’t the one that struggles on in silence, but the one who finds the strength to say ‘actually, I’m not feeling fine at all’.

Pic, top: British designer Steuart Padwick made a dramatic change to the city skyline during the London Design Festival (15 - 23 September), in support of mental health and the Time to Change campaign, with ‘Head Above Water’– a 9 metre high, interactive sculpture located on the South Bank. This giant wooden head, elevated above the Thames, was installed to challenge attitudes and stimulate perception and understanding around UK mental health. It was deliberately gender-, ethnicity- and age-neutral: a symbol of hope, bravery, compassion, positivity and change for those who have come through or are still confronting mental health issues, and the people who support them.

At night ‘Head Above Water’ was lit and people were able to engage with its changing colours to reflect how they are feeling through a designated Twitter feed in real time. Dr Sally Marlow Phd, Engagement and Impact Fellow, The Institute of Psychiatry, Psychology & Neuroscience at King’s College London advised on the changing colours to reflect different emotions.

As Jo Loughran, Director of Time to Change, identified, in such a bustling location, ‘Head Above Water’ was seen by millions, prompting contemplation and encouraging interaction. It was an opportunity to bring mental health ‘proudly into the light’, instead of confining it to ‘hushed conversations in quiet corners’…

Now a new short film, also called ‘Head Above Water’ and launched earlier this week on World Mental Health Day (10 October), supports mental health awareness by following the journey of this monumental and symbolic sculpture. It’s both powerful and compelling. It’s showing across the UK in independent cinemas, and is also available online (https://vimeo.com/290775070).

Time to Change is a movement of people changing how we all think and act about mental health problems: www.time-to-change.org.uk

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