John Humphrys - Mental Health : What Are We Talking About?

March 26, 2021, 5:45 PM UTC

You may have seen that a bunch of the more junior ‘lords of the universe’, first-year analysts at Goldman Sachs investment bank, has been complaining that their punishing work schedule is seriously harming their mental health. Their boss, David Solomon, said the firm was taking the complaint ‘very seriously’. Other leaders in the world of high finance and corporate law have piled in to say that an excessive work culture can be both damaging for the individuals involved and unproductive for the organisations for which they work: tired people don’t tend to make the best decisions. What interests me in the story, however, is not so much the mad work ethic but the almost routine way we now talk about mental health. Is this no more than just the current fashionable way of speaking, or is the language claiming to refer to something real, something related to mental illness? In short, are we sure we know what we’re talking about, and does it matter?

As with so much these days, the Goldman Sachs story originated on social media, went viral and then hit the mainstream. A group of thirteen young analysts starting their careers at Goldman Sachs, claimed they were working 95 hours a week and were expected to make do with only five hours sleep a night. As one put it: ‘I didn’t come into this job expecting a 9ams to 5pms, but I also wasn’t expecting consistent 9ams to 5ams either.’ So they concocted a survey among themselves to compare their mental (and physical) health before and after joining the bank. It turns out that, pre-bank, they said their average mental health rated 8.8 out of 10 and that this had collapsed to 2.8 Their physical health had gone from 9 to 2.3. Whether these very precise figures mean anything at all is anyone’s guess, but we get the picture.

Your first response may be to say: ‘Well, … Goldman Sachs! What did they expect when they signed up to take the Goldman shilling? Didn’t they do any research, like talking to people already working there? And if they’re so bothered now about what it’s all doing to their relationships with partners, family and friends, shouldn’t they just get out, stop moaning and realise what the rest of us already know, that money isn’t everything?’

I’m not about to quarrel with any of that and although I like work myself, even to the point of being accused of being addicted to it, I concede that working an average of 95 hours every week isn’t much good if you also want to be a human being.

But my real interest is this phrase ‘mental health’ and it made me think of my father. He was of a generation that would have never used the expression and probably wouldn’t have known what it meant. But that’s not to say he didn’t experience something akin to what those who so widely use it now experience. In fact I know he did. When I was about ten he had what we then called a ‘nervous breakdown’. As it happens, it wasn’t because he was working a 95-hour week but because he was barely working at all and had a large family to support. He was a self-employed French polisher and there was no work to be had.

In that context it’s tempting to suggest that these Goldman Sachs kids don’t know they’re born. The average wage at the bank is about £190,000 a year. That’s the average! But that’s not really the point. Things can overwhelm people in all walks of life, at both ends of the income spectrum, and no matter how self-confident they may previously have appeared to the outside world it may feel very different to them when they’re under pressure.

Whatever language one uses to describe their comparable experiences, one thing my father and the young Goldman pups have in common is that none of them (on the evidence we’ve got) could be described as mentally ill. When I witnessed my father’s breakdown I didn’t dare talk to him about it. Years later I asked my mother I asked my mother whether he had been mentally ill. She was shocked by the very question. Being mentally ill in those days meant being carted off to a mental hospital – ‘loony bins’ as everyone casually called them. And mental illness carried a terrible stigma: it was something to be ashamed of.

As it turned out, my mother never had to face the stigma or the shame because my father soon recovered. In the sixty years since then the stigma and shame associated with mental illness have, thankfully, evaporated and, thanks to an enlightened minister of health in the late 1950s (one Enoch Powell, now generally remembered for other things), most of the big mental hospitals were closed. We now recognise that mental illness is as much a part of the human condition as ordinary ‘physical’ illness. Indeed the distinction between the two is dodgy in itself as we realise how much the mind and the body interact with each other. And just as we go on identifying new physical illnesses, so the range of what constitutes mental illness is likely to expand.

The issue is how do we distinguish what should legitimately be considered mental illness from what is better regarded as just the natural ebb and flow of our mental states? The answer is that there isn’t a clear way to make the distinction. It’s not just that I, a mere journalist, don’t know where the border lies between the two; nor does the medical profession. Or to put the point more precisely: they don’t discover where it lies, they decide where it lies.

You can see this by looking at how doctors diagnose illness. If you think you’ve got something wrong with your heart you can get a doctor to take a look at it – literally. When they see something that’s not as it should be they can diagnose your problem and offer you a treatment. With mental illness it’s not so easy, even at the diagnostic stage. Many mental illnesses are categorised as ‘syndromes’, each referring to a certain pattern of behaviour. Each syndrome has a set of diagnostic symptoms against which you’re tested and if you tick enough of them, you’ve got the syndrome. But you’ve got it only because doctors have decided this is a useful way of interpreting your behaviour not because they can actually look and discover what’s wrong (as the heart consultant can do). This is just how it has to be with mental illness and, post-diagnosis, they can try to treat you either with a pill (that’s what psychiatrists are for) or by a ‘talking cure’ (therapists) or both.

But it’s because mental health is a matter of interpretation of symptoms that the question of how we talk about those symptoms is so important. And it brings me back to those young, overworked bankers and the talk of their ‘mental health’. They are far from alone in using such language. It has become almost de rigueur to do so. We have all heard the interviews over the last year with school kids being asked how they’ve found lockdown and not being able to go to school and see their mates. It is now commonplace to hear them answering: ‘it’s affected my mental health’.

You’d have to be a complete idiot not to recognise that the Covid year is likely to have been harmful to children in all sorts of ways, but this language to describe it is new, significant and surely potentially harmful in itself.

I can sense your scepticism. Isn’t it just the way kids (and the rest of us) talk these days, a verbal shift not amounting to anything very much? After all, language changes all the time and whereas earlier generations might have talked of ‘being a bit low … feeling pissed off … out of sorts … not feeling myself recently… depressed’ and so on, saying ‘it’s affected my mental health’ is just the current mode.

Maybe. But I think there’s more to it. All those other ways of putting it are subjective expressions: they describe how the person feels, how they think they are. The current phrase doesn’t do that: it refers instead to something supposedly objective about themselves, their mental health. It borders on the idea that they think there’s something they might have got: real mental health concerns with the shadow of actual mental illness hanging over them.

This objectification of a mental feeling really gets going when professionals take over and start to talk of mental health ‘issues’. We are now moving rapidly into the world of syndromes.

Of course there is something potentially valuable about this. Someone who’s got real ‘issues’ probably could do with some help and I’d have thought that many kids who have been through the last year would certainly benefit from help provided from those with the knowledge and experience to be able to judge what help they might need. But there’s a danger here too. If I too readily start to talk about myself not in the subjective terms that describe the ups and downs of my mental experience but in the objective mode of mental health ‘issues’ I may ‘have’, I am making a move towards saying it’s for others to sort out. The experts. The doctors.

I no longer have to engage with my own subjectivity: there’s no point in that because I’ve ‘got’ something. So, just as there’s no point in my trying to sort out my dodgy heart condition without seeing a heart doctor, so, if I have ‘mental health issues’, I must go straight to the mental health doctors. And there are plenty of people out there encouraging me to do so – that, indeed is why they are happy to promote the language. There are professional careers to be advanced and (forgive me for being the hardened, cynical old journalist) money to be made.

Language matters. It helps shape the way we pay attention to the world and therefore what we see there. As the old saying has it, ‘to a man with a hammer, everything is a nail’. If we turn ‘mental health’ into our favoured hammer, everything will become a mental illness nail. My question is: are we, as a society, in the process of forging such a hammer? My genuine answer is that I simply don’t know, but I do think it’s a question worth asking.

And the question came into my mind because of another news event this week. Prince Harry has got himself a new job. You’ll remember that when he still lived this side of the pond, he, his brother and his sister-in-law set up a mental health charity, in part further to erode the stigma of mental illness and to make seeking help for it even more acceptable than it has already become. They seemed the ideal people to do it. Surely we’d all agree that William and Harry could not have gone through the very public divorce of their parents and the sudden death of their mother without having suffered some very dark periods indeed. In the current lingo, they had ‘been there’, so who better to launch such a charity, and what better use of royal status and exposure than to promote mental health.

Now Harry has gone further. He’s got a job as an executive in a Silicon Valley life-coaching firm. He’s to become ‘chief impact officer’ with a San Francisco start-up called ‘BetterUp Inc’ (valued at around £1.25bn) and will have a full say in its ‘strategic’ decisions. He put out a statement in which he said that he wanted to 'lift up critical dialogues around mental health, build supportive and compassionate communities, and foster an environment for honest and vulnerable conversations'. He added: 'Self-optimisation is not about fixing something that's broken. It's about becoming the best version of ourselves, with whatever life throws at us - someone who is ready for the next challenge and can meet setbacks with courage, confidence and self-awareness.'

This impenetrable corporate-speak dimly rang bells for me. And then I realised: it’s straight out of the sincere, boosterish talk-book of the likes of Goldman Sachs. I hope they don’t want him to work 95 hours a week.

What do you think about the way we speak of mental health?

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