28 Sep 2023

Helping or harming? Our modern mental health conversations

From The Detail, 5:00 am on 28 September 2023

Our mental health systems are creaking, we don't have enough psychologists, and more and more people are knocking on the doors of professionals to find out what's wrong with them. Is it time to change the direction of our conversations around this issue?

Doctor (gynecologist or psychiatrist) consulting and examining woman patient's health in medical clinic or hospital health service center

 "We're all on scales of things, I think," says psychologist Karen Nimmo. "We don't want to rush to slam labels on to ourselves when they may not be helpful."  Photo: 123RF

Mental Health Awareness Week is over for another year. 

It's something we talk about now, more than ever. 

But are we saying too much? 

Are our conversations around mental illness, and particularly suicide, now doing more harm than good? 

Today on The Detail we look at how the treatment of these issues has changed, and the results of being "too aware" in a time of an internet frenzy of wellbeing – described by clinical psychologist Karen Nimmo as "the wild west of mental health".

"You've got so many people on there making videos, talking about their lived experiences; and while that offers hope to many people, and it can give you tips on how to manage your own struggles, that lived experience doesn't qualify you to diagnose or treat mental illness. It doesn't enable you to gauge safety and risk well. So there are concerns around that sort of thing. 

Karen Nimmo

Karen Nimmo Photo: Supplied

"There are a lot of people on the internet in the mental health field perhaps for the wrong reasons, seeking fame and money and that sort of thing. You have to be pretty careful to separate them out. 

"The other thing is there is a lot of self-diagnosis around now. You can jump on the internet, you can do your research, you can do some online tests, and as a psychologist there's a whole lot more to diagnosing mental health issues and mental illness than a bunch of symptoms or lists. 

"Things like a person's social factors, their culture, their relationships, their home life, their personal resilience, their strengths ... and all that sort of thing, which is not factored in.

"We've got more and more people thinking they've got conditions that perhaps they haven't, or they've just got one or two symptoms that fit the criteria. That can lead to an increase in stigma." 

The other aspect is that it results in more and more people lining up for diagnoses. 

"Awareness creates demand. And we have a mental health system that is creaking." 

Nimmo says professionals are getting more and more requests for specific assessments because people believe they have ADHD or OCD.

"We're all on scales of things, I think," she says. "We don't want to rush to slam labels on to ourselves when they may not be helpful." 

Journalist, author and mental health speaker Jehan Casinader thinks we are at a crossroads with this issue, particularly with suicide, and the messaging has to change. 

He's written an opinion piece for Stuff titled 'Is our suicide conversation helping or harming?'.

A screenshot from an ad. An aerial view of a beach. The tide is out. "HOPE" is written in big letters on the sand. John Kirwan is walking away in the distance carrying a big stick he used to write the letters. On the right of the screen, in white letters, it reads: "DEPRESSION - THERE IS A WAY THROUGH IT"

A still from John Kirwan's 2006 television ad for the National Depression Initiative. Photo: Ngā Taonga Sound & Vision

It's a strong reaction to recent reporting where a coroner allowed the publication of harrowing details of a teenager's last months before she killed herself. This is a stark departure from the reporting of many years ago when any talk of suicide was kept out of the news. 

It's been nearly 20 years since John Kirwan wrote HOPE in the sand at Bethells Beach, something that 33 year old Casinader remembers from high school.

It was an ad for the Ministry of Health targeted at men suffering depression – and it worked. 

"Mental Health Awareness Week was created back in 1993 at a point when we weren't having this conversation at all," he says. 

Jehan smiles at the camera. He is wearing a navy pinstripe suit and a white shirt. In the background in soft focus is the interior of a gently-lit house.

Jehan Casinader. Photo: Supplied

"Mental health was still a taboo in many of our communities. Most people had probably grown up in that 'take a concrete pill and harden up' culture. So it's taken many, many years to chip away at that. "

Now – "there's a multi-billion dollar industry that's sprung up around wellbeing, and certainly during the pandemic, many businesses and organisations threw a lot at mental health and wellbeing because they knew, rightly, that people would struggle at that time. 

"I think now we're really at a crossroads and we have to ask ourselves: how do we shift from awareness towards action? And how do we make sure that if we're talking about this stuff over and over again ... that we're actually helping?" 

Listen to the podcast for Casinader's list of new challenges that have contributed to these problems  and for some surprising statistics on our suicide numbers. 

Where to get help:

Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.

Lifeline: 0800 543 354 or text HELP to 4357

Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Depression Helpline: 0800 111 757 (24/7) or text 4202

Samaritans: 0800 726 666 (24/7)

Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz

What's Up: online chat (3pm-10pm) or 0800 WHATSUP / 0800 9428 787 helpline (12pm-10pm weekdays, 3pm-11pm weekends)

Kidsline (ages 5-18): 0800 543 754 (24/7)

Rural Support Trust Helpline: 0800 787 254

Healthline: 0800 611 116

Rainbow Youth: (09) 376 4155

If it is an emergency and you feel like you or someone else is at risk, call 111.

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