Keep calm and carry on: are we really coping with current events?

I intended to write this editorial about anxiety and how the recent shocks in the political landscape might affect those living with anxiety and depressive disorders – would the stress, fear and anger generated by these events exacerbate existing conditions and trigger new episodes in others? Aside from the unrest created by Trump’s ill-executed ‘Muslim ban’ and a very public war against facts (suddenly everyone from the Twitterati to Theresa May were using the ‘fake news’ mantra to deride anything they did not like), recent proposals by the Trump administration and Theresa May’s government aimed to strip funding from social care and medicine provision for millions of people. It felt like a perfect storm where increased anxiety and depression would not be able to be treated due to political and economic decisions made by those at the centre of this storm.

The past eighteen months had been a turbulent time in global politics: the twin shocks of Brexit and Trump, a new UK election barely two years after the first, the rise in support for far right ideologies and the establishment of an ersatz dictatorship in Turkey. Amid the chaos, the destruction of Syria and its citizens continued apace, fleeing refugees were being demonised and expertise derided as elitist establishment propaganda. A new post-truth language emerged: “snowflakes and cucks”, “alternative facts”, “fake news”. It felt as though anti-minority rhetoric was given a fresh voice under the guide of patriotism, and people were urged to ignore experts, commentators and vote for the promise to return to a sepia-tinted past which never really existed in the first place. For those caught up in the fury of these times – the EU citizens living in the UK, the undocumented migrants and ethnic minorities living in the States, those whose fear and anxiety deepens at every newspaper headline, it does not seem a stretch to imagine that recent events are detrimental to mental health conditions: Carol Landau, a professor at Brown university made the point that while global events are unlikely to create new instances of mental disorders, they are very likely to trigger or exacerbate episodes in those who are already suffering (Smith, 2017).

Just yesterday, however, a terrorist attack was perpetrated at Manchester Arena in a concert full of teenagers and pre-teens. This comes less than two months after the Westminster attack and is part of a recent spate across Europe where vehicles were used as weapons. Britons, as noted by many headlines in the aftermath of this recent attack and after 7/7, take pride in keeping calm and carrying on, the mantra on a million posters and mugs the length and breadth of the country. So we are experiencing more than increased anxiety due to the political climate, we are living entirely in a climate of fear, of vigilance, of eying people with rucksacks on the tube and wondering about their motives. And with the attacks, the turbulent political scene and economic threat to our healthcare services, are we really coping as well as we think we are?

According to the website Anxiety UK, approximately 13% of the adults in the UK will suffer some form of anxiety during their life (Anxiety UK, 2015). In addition, a 2002 WHO study found that 40% of disability across the world is due to depression and anxiety (Moussavi et al., 2007). These disorders range from uncomfortable and sustained feeling of unease to full-blown panic attacks which can cause frightening physical symptoms. In the wake of Brexit, there were a plethora of newspaper articles dealing with “political depression”; a horror that the wrong things were happening and the wrong people were going to do the wrong thing. Susie Orbach, reporting in the Guardian, noted that in each of her therapy sessions post-Brexit, her clients only wanted to talk about their “anger and despair” regarding the referendum (Orbach, 2016). Moussa et al. (2015) also explored the negative effect of political violence on children and in 2016, Childline reported that there was a 35% increase in children calling in with anxiety-related issues, with many of them citing distressing world events as part or all of the cause (Davies, 2016).

In the midst of the fear, anxiety and depression, stalks the spectre of unaffordable healthcare. For Americans, the proposed American Health Care Act would remove mental health as an essential healthcare benefit, and strip millions of dollars from Medicaid funding. For the British, the NHS is being driven to its knees by ideological austerity cuts and many are predicting that an American insurance model will eventually replace free and universal healthcare in the UK. These bleak predictions could see further reductions in mental health care at a time when the global environment is exacerbating these disorders and when studies such as Chui et al. (2017) have found unsurprisingly that long term and carefully planned interventions are crucial for survivors of disasters.

If those with mental health disorders are at increased risk, so too are their carers who are often family members who either have to give up work or stretch themselves thin to provide support for their relative. Studies note the current lack of formal support for these groups (McLaughlin et al., 2016; Onwumere & Kuipers, 2017), and further funding cuts would be disastrous for them.

There is no easy answer apart from the ideal: communities standing up for one another, space in schools for children to express their fears, increased healthcare funding and more money for mental health care and those who care for them. Some of the above exist, some are a pipe dream promised by a shadow government who may not prevail. Social and financial investment in our society is required to ensure increased stability, and physical and mental health but in this current political and social climate, it is unclear if this will ever be made available to those who need it the most.