London-based Healthtech startup Spill were founded in 2017 with a mission to help companies remove the barriers stopping their team’s from accessing emotional support. They set out why their platform is important right now. Note: this piece was written before the outbreak of COVID-19.
Mental health is, by all accounts, having a bit of a moment. It’s the topic of endless conferences, training sessions and charity initiatives. A raft of celebrities from Stephen Fry to J.K. Rowling have spoken out about their diagnoses. Depression and anxiety, once completely taboo subjects, are now proudly displayed hashtags on Instagram and the subject of advertising by all sorts of brands, from Ford to Lloyds Bank. It looks like the stigma around conditions like these is slowly dismantling, at long last.
However, it’s not a case of a rising tide lifting all boats. Only 17% of people in the UK have a diagnosable mental health condition. Yet 87% describe their mental health as less than good, and almost three in four were so stressed or anxious at some point last year that they felt “unable to cope”. Those with a formal condition are therefore merely the tip of a much larger — and growing — iceberg, estimated at over half (56%) of the total population: the undiagnosed strugglers.
The system is tackling the wrong issue. Nearly all medical research into mental health focuses on treatment; less than 4% looks at prevention. Much of the impetus is on improving prescription drugs for the most extreme cases, rather than therapies for earlier-stage interventions. Headlines in newspapers, when they do come, protest about the NHS waiting times for those with diagnoses. The often-heard call these days for mental health to be treated more like physical health — ‘there’s no stigma around a broken leg’ usually being the refrain — is well-meaning but dangerous. Whilst most physical health diagnoses are binary — there’s no such thing as a bit of a broken leg — mental health works across a full continuum. Our medical system isn’t built for continuums: it only helps those it can label.
Those without a label are suffering in silence. While people with a formal condition are most likely to talk about it and seek help — thanks to more widely accepted terminology and readily available medication — the undiagnosed strugglers don’t have the language to speak out. We live in an era when it’s easier to say ‘I’m having panic attacks’ than ‘I’m having a hard time getting by’. Depression and anxiety have been medicalised and therefore othered; struggling is internalised and therefore seen as shameful. No wonder, then, that Brits tell people they’re fine 14 times every week — but only mean it twice.
As long as mental health support remains medicalised, it will remain limited. The healthcare system will only ever be able to treat those who actively reach out, and only at a stage when things have reached breaking point. Early-stage, preventative support cannot be the responsibility of an already-stretched NHS: the number of people we’re talking about here is simply too large.
There are other institutions better placed to step in. Employers and universities, namely. They already have communication channels established with their employees and student body respectively. They are naturally placed to spot early signs of an issue, for example lapses in attendance or changes in behaviour. They have the financial means to provide support. They have a vested interest to prevent mental health issues sooner rather than later, as employee turnover and student dropouts both hit the bottom line. And, most importantly, these institutions have a higher-level responsibility to their employees and students; they owe them more than just a salary or an education. They owe them the decency of supporting the whole person. But, despite this, most of their mental-health-related activity revolves around trying to raise awareness.
Talking about it is half the battle, but it’s now the less important half. We live in an age where the arena of competition has moved from action towards attention. It’s simultaneously easier than ever, and more important, to have an opinion — and that applies to organisations as well as individuals. Raising awareness and reducing the stigma around mental health conditions will no doubt continue to have a positive effect. But, with suicide now the leading cause of death in men under 45 in the UK, attention alone is not going to put an end to all the unnecessary suffering that our modern world has brought on. We need action. We need proper support, at scale. And we need it now.
Face-to-face mental health support has always struggled to achieve true scale, while technology has a historical knack for putting previously inaccessible resources into the hands of large numbers of people at a fraction of the cost. That’s why we started Spill, an all-in-one emotional support solution for companies. It lets employees ask a therapist a question, access mental health content and tools, or book video therapy sessions — all through one easy Slack app. Now mental health support, instead of being intimidating and difficult to access, can be just a few clicks away.