A psyche with a six pack

On Wednesday, I was invited to a stand up lunch at Mt Carmel Hospital together with all other civil and ecclesiastical dignitaries. It was World Mental Health Day and I was asked to contribute towards removing the stigma associated with mental illness simply by attending the event. It really was not too much to be asked.

As I listened to the President and the Prime Minister, the Leader of the Opposition and the Archbishop making their speeches, I could not help share most of the sentiments they expressed. There was talk of dignity of the person, of improvements made to facilities, of the need to work together to remove the stigma associated with treatment for mental illness.

On being invited I was specifically briefed on the wish of my hosts to keep mental health issues away from political controversy. My assurances may not have been sufficient because I was not asked to speak nor allowed to be controversial. I had no intention to stir things up anyway.

However, there were a few points I would have liked to make.

In meetings with stakeholders in the sector, the question of the Mental Health Act inevitably comes up. It has been on its way for something like nine years and appears to have bogged down somewhere in the innards of Parliament. It would have been nice for all the king's horses and all the king's men gathered on World Mental Health Day to announce to all those who could benefit from it that it will become law shortly, on such and such a day. While all the staff and hosts thanked me for being there I felt more than a little embarrassed. Simply being there is just too little. We have simply not done enough to make mental health a continuum as we have begun to do with disability and as it has become with physical fitness.

We have gone from staying alive and seeking medical health only in a crisis, to actively caring for our bodies through diet, exercise and by protecting ourselves from everything we know to be harmful. Those more aware already know that disability is a condition from which we all suffer to a greater or lesser degree and it is perfectly possible for us all to support the removal of obstacles for those who are affected by special disabilities.

Mental health is still nowhere. We tend to speak more of mental illness than care for our mental health. We have no idea of what to avoid doing and what to do for exercise. Mostly, we do not want to think about it.

When we are faced with the experience of mental illness we are often disoriented. The personality of a person close to us showing marked signs of change leaves us baffled and afraid. They need help and we need help to be able to relate to them appropriately but, often, we are reluctant to seek assistance. It would be different in the case of a physical injury or a disease.

Mental illness is not catching but how we respond to it can be crucial to our own mental fitness. Stress comes first to mind but also bias, prejudice and fear can combine not only to the detriment of the person who falls ill but also to those who jump the wrong way.

Prejudice and fear can make a manageable situation into a full-blown crisis, perhaps a tragedy. We may unwittingly prevent somebody who needs to talk out a problem from taking the first step to address it. We can prevent or delay recovery by our attitude. We can set ourselves up by our ignorance into not being able to recognise the signs of our own need for help.

Removing the stigma associated with mental illness is not an act of philanthropy towards an anonymous cohort of mentally ill people. It is an act of maturity, of civilisation.

We should all be able to accept that we are all mentally unwell at times just as we can concede that there are times when we are not as fit as we usually are. Placing ourselves under great stress and then overreacting irritably at the least provocation can be compared to wearing the wrong clothes and catching a chill. It happens.

Making the whole range from unattainable excellence to grievous illness a subject of polite conversation rather than sticking to gossiping about the mental illness of others, as though it were legitimate to gloat because we are immune, is a state of affairs we can achieve. Maltese society has made truly enormous advances in the way it perceives disability in recent decades. It could be the same with mental illness.

If we come to internalise the Roman saying, a healthy mind in a healthy body, there can come a time when we can actively care for our minds as we care for our bodies. Some of us already do so through yoga or meditation. The idea of a psychiatric spa may not be too far fetched.

Before anything of the sort can find the demand to sustain it, public awareness must grow to such an extent that mental health will become a political issue along with all other health services. Politicians will come under pressure to provide public mental services and to address identified causes of mental illness. I hope unnecessary political tension will be high on the list.

The WHO estimates that about 25 per cent of the world's population suffers from a mental health problem and it expects the figures to grow, reaching 33 per cent in a decade or two. Since Malta must be included in those statistics, perhaps it is not too early for us to begin to do something to avoid the prediction.

The first step must necessarily be the removal of any stigma associated with mental illness. If we are not able to talk openly about the problem how will we ever begin to deal with it? Perhaps we can start by making it easier for the mentally ill to live in their communities. It is not a matter only of facilities and services but also of our attitude and tolerance. It is our problem not theirs that we are unable to relate appropriately to them and, consequently, make their lives difficult if not impossible.

We may be collectively putting away part of our society with which we cannot cope. The presence among us of people suffering from a mental disability can make us more civilised, more real. It could also serve us to become aware of the need to nurture our mental health. Putting the mentally disabled or ill out of sight and out of mind is a convenient lie, a measure of our mental flabbiness. A person who is able to relate appropriately to others who happens to be mentally ill is, in fact, displaying a superb mental fitness, a psyche with a six pack. What a great way to show off!

Dr Vassallo is chairman of Alternattiva Demokratika - the Green party.

www.alternattiva.org.mt, www.adgozo.com