Being well

‘The medical model doesn’t perfectly fit mental health – and it confuses a lot of people.’ (Emma McAdam)

Is mental health all in the mind? I don’t think so, but I do believe we’re sometimes getting a bit lost in how we think about and approach it. Take Sam. He’s 27, talented and full of potential. Yet Sam often finds himself these days feeling jittery and irritable and struggling to concentrate. His partner finds his mood swings and erratic behaviour increasingly difficult to cope with. Feeling concerned, she took him recently to see his GP who referred him for a mental health assessment. The assessor asked Sam briefly over the phone to describe his symptoms, diagnosed his state as ADHD and recommended prescription medication to resolve it.

Now step back with me for a moment. Consider human factors that lead to a sense of mental, emotional and physical well-being, and which can influence a corresponding felt-experience of unwellness if persistently absent in our lives. Things such as: safety and security; sense of purpose; engaging in positive and meaningful human relationships; ability and opportunity to exercise free choices; feeling of making a valued contribution in the world, especially for the benefit of others; achieving something worthwhile; fresh air; change of scenery; prayer, intimacy; sex; physical exercise; personal hygiene; laughter; diet; sleep; rest.
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Sam stays mostly indoors; sleeps until mid-afternoon; rarely washes; spends all night, every night, playing intense computer games; eats junk food; lives on high-caffeine energy drinks. He did have a job for 2 weeks at a call centre but resigned because he felt unhappy dealing with customer complaints. He has now been unemployed for some time and lives on state benefits. From a psychological and relational perspective, we could view ‘feeling jittery and irritable and struggling to concentrate’ as natural outcomes of Sam’s lifestyle choices, not as a pathological dysfunction requiring medication. Social prescribing could be a healthier response.