Has the dawn of the internet age been good for our mental health? Or really bad?

There is great optimism: the digital revolution heralds a utopian, democratic, postmodern world where we are all connected, resourced, empowered, heard, transparent, authentic and free to be who we are. There was even a theory that the internet might flatten a chronically unlevel playing field, though perhaps only for those that have a smart phone and good wifi.

There is great pessimism: we’re entering a dystopian, virtual world where a person is reduced to an online profile to be swiped left or right, texts replace conversation, virtual friends replace real ones, “likes” replace activism, emoticons replace emotions (except for anxiety—lots more anxiety). Human intelligence outsourced to machines, vast amounts of time wasted, attention spans worse than a goldfish, retrograde evolution. We plug into a world wide web and watch helplessly as our humanity drains away.

To stay alive, and truly connected, we sometimes have to unplug.
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One story this week highlights the internet as a problem for our inner worlds; another explores its claims to be a solution:

Problem?
Parent Zone’s report, The Perfect Generation: Is the Internet Undermining Young People's Mental Health?, contains the results of a survey of teachers and teenagers. Among the findings:
• 44% of teachers think the internet is bad for young people’s mental health, compared to 28% of young people.
• 91% of teachers believe the frequency of mental health issues among pupils is increasing.
• Of these issues, schools report stress and anxiety (95%), depression (70%) and self-harm (66%) as the most common issues amongst pupils.
• 84% of schools say they do not have adequate resources to deal with pupils’ mental health issues.

Vicki Shotbolt, CEO of Parent Zone, says: “The internet has destroyed any notions we might have had about keeping some things away from children until they were ‘old enough to cope’. 
“All of the indicators suggest that the prevalence of mental health problems and the severity of those problems are increasing. Some people are linking the internet to the increase.”

​The report concludes that new problems require new solutions, that schools need much better resources for responding to mental health issues, and that tech companies “should recognise both their duty of care and their unique opportunity to create online spaces that are positive and inspiring.”

U.K. NEWS
  
“I wanted a new kind of mental health support group:
we meet in the pub"
The Guardian
 
Jessica Spires tells the story of the creation of Let’s Go Mental, “an informal, peer-led support group for young people with experience of mental health issues.” They meet once a month in a London pub:
 
One day I met with a friend for coffee, and inevitably some of the unfounded anxieties I was having about my relationship came up. Instead of the usual response, “I’m sure that won’t happen, don’t worry about it”, I was met with an answer so refreshing it was like a verbal slap around the face: “I totally get what you mean; I think that all the time too.” Those few words brought more relief than all of the conversations I’d previously had about my anxiety put together.
I wanted that feeling again. I turned to Google (naturally) to look for a support group, but found very little that appealed, and mostly they weren’t local. So I decided to start one myself. The paradox of mental illness is that even though I felt alone, there were so many people around me going through the same thing, but I had to reach out and find them. I think Let’s Go Mental (LGM) was born at that very moment.
 
....I wanted LGM to be different than the depictions of support groups I’d seen on episodes of BBC crime dramas. No sitting around in a circle of chairs in a starkly lit room with a few bourbons and some weak tea. I wanted to recreate the ease of that conversation I’d had over coffee with a friend. Where is the best place to make British people feel at ease? The pub, of course. That’s how it happened, the premise of the group is really that simple. We go to the pub, we hang out and have a drink, and we talk about mental health.

 
“We must have change”
BBC News
 
Conferences of the great and the good in areas like science, health and politics take place at Oxbridge colleges most weeks of the year. But this one was like few others.
Conceived and organised by the father of an 18-year-old who had taken his own life barely a year earlier, this one-day gathering offered a broad and challenging view of the state of mental health care of young people in England.
It revealed a widely shared view that notwithstanding the recent publication of NHS England's Mental Health Taskforce report, there is a lack of drive and joined-up thinking in government and the health service.
Steve Mallen has already shared his grief and anger at the loss of his son. A talented straight A-grade student, Edward was set to go to Cambridge University. But in a matter of weeks he succumbed to depression and took his own life.

• She waited 18 months for counselling: heartbreaking Facebook posts before falling to her death (Mirror.co.uk)
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University of Edinburgh hits record number of students seeking counselling services
The Student
 
A study into mental health at 24 of the UK’s top universities has found that the number of students seeking counselling has increased from 34,000 to 43,000 in just three years.
In all the universities surveyed, the University of Edinburgh saw the largest increase in students pursuing counselling services with figures rising by 75 per cent in the three year period, with a 15 per cent increase in the last year alone.
In an interview with The Student in February, Edinburgh University Students Association (EUSA) Vice President Societies and Activities Andy Peel said the counselling service received one hundred referrals a week.
Anxiety was the most common reason for attending counselling services, with more than 6000 students reporting to suffer from the condition.
 
 
Exercise may help young people with psychosis
Live Science
 
For young adults who have experienced severe mental health disorders, exercise may help reduce the severity of their symptoms, a new, small study suggests.
In the study, researchers looked at 38 adults, ages 18 to 35, who had experienced an episode of psychosis — a serious mental disorder in which a person loses touch with reality and may experience delusions and hallucinations. All of the people were receiving antipsychotic medications and mental health care through early-intervention mental health services in England.
 
... The researchers found that the people who participated in the exercise program experienced a 27 percent decrease in the overall severity and frequency of their symptoms over the 10 weeks, on average. In comparison, the severity and frequency of symptoms among the people in the control group decreased by nearly 8 percent, on average, over the same period of time, they found.   

WORLD NEWS

Sweden: We Need to Talk About Europe's Refugees
Care2.com
 
Given their tough circumstances and traumatic pasts, it’s no surprise that refugees are more likely to experience depression, anxiety and PTSD than the general population. But what about more serious mental health issues—is psychosis, too, more common among the exiled?
According to a Care2 story, yes:
 
Researchers based at the Karolinska Institute in Sweden and the University College London in the UK have attempted to gain insight into this serious health issue.
In an article published in the British Medical Journal this month, researchers describe how they used anonymous data from a cohort of 1.3 million people born after 1984 — excluding those below age 14.
 
...the researchers found that refugees in Sweden were around 66 percent more likely to develop nonaffective psychotic disorders than migrants — people not claiming refugee status — from the same geographic location.
This finding contributes to a body of research that already demonstrated a greater risk of psychosis among migrants. But this is the first study to look at the particular situation of people claiming refugee status.
 
...“The dramatically increased risk among refugees shows that life events are a significant risk factor for schizophrenia,” lead author Anna-Clara Hollander explained.
 
                                                 
U.S.A.: Undivided attention—Mental Health Reform Act
Care2.com
 
Lawmakers in the Senate Committee on Health, Education, Labor and Pensions have just released the draft text of a bill that, they hope, could bring about a much needed update and reform of mental health care in the United States. It also shows that bipartisanship is not dead, and that when lawmakers work together the potential for serious legislative change is still possible.
The bill is being worked on by Senator Lamar Alexander (R-TN), leader of the Senate Health Committee, with Democrat Senator Patty Murray (WA) and Senators Chris Murphy (D-CT) and Bill Cassidy (R-LA).
The legislation is known as the Mental Health Reform Act of 2016, and it aims to achieve what could end up being the biggest overhaul in mental health care in decades by dramatically cutting the federal bureaucracy around mental health programs. It would increase state funds for certain mental health services and increase treatment options and availability for at risk groups such as children, people with no fixed address, and people who are already at risk of suicide.
 
 
Lebanon: “Karim” delivers psychological support to Syrian refugees
The Guardian
 
More than 1 million Syrians have fled to Lebanon since the start of the conflict and as many as one-fifth of them may be suffering from mental health disorders, according to the World Health Organisation.
But Lebanon’s mental health services are mostly private and the needs of refugees – who may have lost loved ones, their home, livelihood and community – are mostly going unmet.
Hoping to support the efforts of overworked psychologists in the region, the Silicon Valley startup X2AI has created an artificially intelligent chatbot called Karim that can have personalised text message conversations in Arabic to help people with their emotional problems. As the user interacts with Karim, the system uses natural language processing to analyse the person’s emotional state and returns appropriate comments, questions and recommendations.
Eugene Bann, the co-founder and CTO of X2AI, says: “There are barely any mental-health services in refugee camps. People have depression, anxiety, a sense of hopelessness and fear of the unknown.”
 

Indonesia: The living hell of people with mental health conditions
Human Rights Watch
 
More than 57,000 people in Indonesia with mental health conditions have been chained and locked up in overcrowded rooms or filthy sheds at least once in their lives. About 18,000 are still believed to be shackled, despite a 1977 government ban on pasung, as the practice is called. Access to support and mental health care is desperately needed. Yet with only 48 mental hospitals for the country’s 17,000 islands, families continue to either admit relatives with psychosocial disabilities without their consent to institutions where they are subjected to a wide range of abuses or to chain or lock them up at home.
Human Right Watch’s Kriti Sharma visited 18 mental hospitals, social care centers and private institutions run by faith healers or traditional healers and interviewed about 150 people across Indonesia’s heavily populated islands of Java and Sumatra. Her new report, “Like Living in Hell” for the first time gives those who have been locked up for years a voice.
 • Govt prepares mobile counseling for teens (Jakarta Post)

 
Myanmar: Lacking support, mental health patients suffer in silence
Mizzima News
 
When Chit San was finally released through an amnesty in 1996 his struggle, however, was not over. Like many thousands of former political prisoners in Myanmar, he suffers from symptoms of depression, anxiety and post-traumatic stress disorder (PTSD), which he developed as a result of the psychological and physical trauma he experienced at the hands of the former regime.
Another legacy of the military government, the country’s wrecked healthcare system, means that many of those suffering from psychological problems, whether from torture or other causes, cannot receive much-needed psychological treatment from government healthcare facilities.
Cultural stigma and a lack of public understanding in Myanmar about common disorders, such as depression and anxiety, further worsens their plight. Many people choose to suffer in silence rather than face being labelled 'ayoo', or crazy.
 
...With government care almost non-existent, non-profit organisations and overseas supporters have stepped in.
Programs like the Mental Health Assistance Program (MHAP), of the Thailand-based Assistance Association for Political Prisoner's (AAPP), provide such support. Funded by Johns Hopkins University in the United States, MHAP uses a psychotherapy treatment method called Common Elements Treatment Approach, which is suited for low-resource settings like Myanmar.

On June 23, citizens of the United Kingdom are being asked to vote whether or not we should remain faithful to the European Union.

Should we try to patch things up and make it work? Or, perhaps citing “irreconcilable differences,” opt for a separation and divorce?

Stay or go? Such a stark, black-and-white choice in a scenario characterised by multiple shades of grey. Does it feel too good to leave—but also too bad to stay?

There are push and pull factors on both sides of the ledger:

Stay: pull factors
• We like Europe and the Europeans, and they like us. The way you wear your hat, the way we sip our tea. We learn from each other. Our doors are always open to each other. We’ve known each other such a long time. We’ve been through such a lot. We work well together. We’ve more or less kept the peace for decades and our joint finances are successful. Let’s stay together.

​Your relationship referendum
The EU referendum is powerful metaphor for your more personal, intimate relationships, partnerships, marriages. Are you unhappy? Should you stay or should you go?

Again, there will be a tapestry of circumstances. Some push factors foreclose any other considerations, for example domestic abuse. Others can be big but not necessarily insurmountable, such as an affair or betrayal. And there are always pull factors keeping you together: your shared history, the convenience of the status quo, and, above all, children.

And how will it be on your own anyway? The stereotype is that women feel the immediate emotional impact of a break-up more than men, but long-term fare much better on their own than men do. A piece of research from 1972 suggests that marriage is bad for the mental health of women, which given the power dynamics of some very traditional marriages isn’t surprising, although later figures show no gender difference.

You imagine a glamorous bacherlorhood perhaps, free of obligation and duty, exploring all those things you wanted to do but never had the time. Maybe the reality is you are home alone in an indifferent world. There are no invitations to dinner or weekends away. Just you and the deafening sound of the phone not ringing. Who wants to be lonely? But maybe some loneliness would be good for you?
 
Preliminary investigations
• Jannah Walshe recommends a clear-headed assessment of the relationship—not so much the other person—first alone and then together, with questions like these: Is this relationship serving us both or just the other person? Do I spend more time questioning whether the relationship is right or wrong than enjoying it? Is there more to learn for me in this relationship, or can I best learn and grow outside of this relationship? Would leaving this relationship be an act of self-care?
• Similarly, Bruce Derman Ph.D. offers 7 questions to ask if you’re thinking of divorce, starting with: Were you ever really married? Was there a time when you has an us, with reciprocal, mutual intimacy? Or have you always been a bit like flatmates who sometimes have sex?
• Take Relate’s relationship MOT quiz.
 
It’s good to talk
The best advice if you’re not happy is to return once again to a simple, four-letter-word: talk. It’s not easy, especially if one of the problems in the relationship to begin with was not talking.
• Relationship and marriage expert Dr. John Gottman claims couples wait an average of six years of being unhappy before speaking out. You will never get those six years back again.
• Belgium has the highest divorce rate in the world, 71 percent, and the second-highest suicide rate in Western Europe. These facts are often attributed to “binnenvetter”—a characteristic Flemish personality who bottles things up inside.
• It is so much easier to talk with a mediator, referee, coach, guide—a couples counsellor. Find one online or through organizations like Relate or the Tavistock Centre. In “Hold me tight,” Dr. Sue Johnson advocates “emotionally-focussed therapy”: “seven conversations for a lifetime of love” that explore and promote each partner’s emotional responsiveness to each other. “Emotion comes from a Latin word emovere, to move,” she writes. If a couple is going to reconnect, they have to “let their emotions move them into new ways of responding to each other.”
 
Tough decisions can be made with compassion
• In his book ”I love you but I’m not in love with you,” Andrew G. Marshall says “the ILYB conversation,” with 100 percent honesty, can lighten the path to a relationship renaissance—or to the exit sign. If the latter, the ILYB talk will help you to make sense of the breakup. Having a clear, truthful narrative about why the partnership ended is crucial to the mourning process—to be left, cheated on or suddenly “ghosted,” without explanation, can cause months and years of misery.
• Whether you stay or go, it’s never black and white, and you have some control over what the shades of grey look like. In “Rewriting the Rules,” Meg John Barker writes that you don’t have to follow the old stereotypical rom-com/sitcom rules of a break-up which dictate it’s completely over, there’s a good guy and a bad guy, and the former will never speak to the latter again. Relationships don’t end, says Barker, they change. Breaking up with someone with love and respect can spare a lot of pain all around.
 
Stay or go? Or something else? Perhaps if you listen, you might just hear the generous, loving voice of your own wisdom. It knows it's not all your fault. It knows it's not all your partner's fault, either. It has compassion for you both.  It knows what to do. Trust it.

​To partners past, present and future—to Europe—let’s give thanks, and be grateful. We had some really special times together, didn’t we? We’ll always be there for each other, on some level. Things die, love lives on.