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05 Jul 2023

Rachel Kelly: Navigating mental health, the NHS crisis and the power of poetry in “You’ll Never Walk Alone”

We had the chance to talk with acclaimed author, mental health advocate, and SANE Ambassador Rachel Kelly, during her latest visit to our offices where she delved into the pressing issue of the NHS mental health crisis and shared invaluable insights on her personal journey, the transformative power of poetry, and her latest book, “You’ll Never Walk Alone,” a beacon of hope for those facing mental health challenges.

I didn’t think of others at all. Only when I began to get better did I want to share my experience and the reality of severe mental illness, how it could happen to anyone, and why charities like SANE are lifesavers to those who were desperate like me.

When you were at your lowest, did you ever envisage a way out and that today, as now a keynote speaker, bestselling writer and mental health advocate, you are sharing your experiences to help others and encourage debate about mental ill-health?

No. At the height of my depressive episodes, I only thought about myself. I was utterly preoccupied with how unwell I felt – I was in screaming agony, in a fetal curl in bed, holding onto my husband or mother or a nurse or whoever was nearby… it felt as if I was falling into a bottomless pit of darkness and if I didn’t hold on, I would die. Another analogy – it felt as if I was on a plane which was going to crash… as if an emergency landing had been announced and I was hanging on for dear life. The feelings were terrifying and continuous. My heart raced; I felt nauseous; and my thoughts were darker and darker and darker … it felt as if taking my own life would be a relief. It all sounds dramatic, and it was… so no, at that point I didn’t think of others at all. Only when I began to get better did I want to share my experience and the reality of severe mental illness, how it could happen to anyone, and why charities like SANE are lifesavers to those who were desperate like me.

Are we going to have to radically reappraise how we approach mental wellbeing more broadly, given that the level of demand raises the possibility of the NHS never being able to solve the growing mental health crisis?

Yes. The sheer volume of people who believe they are suffering from mental health problems, with 8.6 million people now taking antidepressants, means that the NHS is overwhelmed with some who may be worried, rather than those who really need psychiatric help.

It’s tricky. Of course, many are facing psychological difficulties especially now with the cost-of-living crisis. Plenty of doctors will argue that far from over-medicalising problems, we are not providing enough support. It’s true: certain age groups don’t get enough help. Take middle-aged men aged between 45 to 64. Though they are most at risk of dying by suicide (and have been since around 2010) they suffer in silence, say doctors like Dr James Arkell, consultant psychiatrist at the Cleveland Clinic and the Nightingale Hospital. Typically these men still suffer from the stigma of suffering from a mental illness and there are barriers to them getting help.

But I do have concerns that we are in a muddle about what really is a ‘mental illness and nervous disorder’ and are confusing everyday anxiety with serious conditions like schizophrenia and psychosis, areas where SANE is doing such important research work. Sometimes we are treating mental health as a medical problem, when in fact it is far more of a social challenge.

This view is a long way from how we thought of mental illness in the 1970s. The perception then was that a few unfortunate people had something wrong with their brain chemistry. The answer was to lock them away and give them pills. Mental illness was for doctors and the NHS to deal with.

Almost no one believes that now. The new paradigm is that we all have mental health, just as we all have physical health, and we affect each other’s wellbeing. Our day-to-day mental fitness depends hugely on our environment and immediate experiences.

This new understanding naturally leads to different answers to the psychological problems. We need a two-pronged approach, and neither answer is about supplying more medical help or more demands on the NHS. The first applies to all of us; the second is more targeted.

Take the first, more universal approach to feeling better. Here the aim is for all of us to do a better job at supporting ourselves and feeling more connected to one another. To create a more sympathetic environment for anyone who is struggling, especially in the workplace, and to increase the amount of social prescribing.

A second approach to reaching those who really need help is to provide much more targeted medical NHS relief for specific communities who are vulnerable, such as minorities and the aforementioned middle-aged men. Sir Michael Marmot’s recent research has focussed on how much harder Covid has been for the wellbeing of the economically disadvantaged. Solutions are much harder to deliver to these groups, all of whom suffer disproportionately from poor mental health.

Government here must play a role in helping the disadvantaged, sitting at home on their own. We desperately need more psychiatric beds and more NHS funding for these serious cases.

How has poetry played a part in your life?

I first got involved in how poetry can support our emotional wellbeing after I wrote a memoir, Black Rainbow: How words healed me – my journey through depression in 2014 about how poetry helped me through two serious episodes of depression, which was also when I first became involved with SANE as an ambassador for your amazing charity.

Since then, I’ve been running ‘Healing Words’ poetry workshops, for mental health charities and prisons, and in schools, and have discovered first-hand the lovely feeling of companionship which poetry can bring.

Poetry lets us connect with other people who have experienced similar sentiments. We’re not alone in our despair or delight.

When we have a poem by our side, whether tucked into a bag or on a bedside table, it feels like we’re being accompanied by a friend: an authorial arm is wrapped around our shoulders.

The workshops take place across four sessions. In each, we share poems which reflect the different ‘seasons’ of our mind, from the winter of discontent to the spring of hope, on to the summer of joy, and ending with more reflective poems with an autumnal feel. Unsurprisingly perhaps, given my belief in the power of poetry to help us feel more connected, I’ve called my new book which explains which poems might help and why You’ll Never Walk Alone: Poems for Life’s Ups and Downs.

Yes, you can share your feelings with friends, or a therapist if you’re lucky enough to have one. But that may not be possible, especially not at three in the morning when we can feel at our most isolated. In their place, the poetry (and occasional prose) in this book have been chosen as seasonal companions for the reader, reminders that someone else has been through the same ups and downs as you and found the words to express them just right.

I remember one woman starting to cry as she read Derek Walcott’s poem ‘Love after Love’ during a workshop held at my local hospital in West London. Fighting through tears, she eventually said, “I feel understood”. Everyone in the room knew just what she meant.

She had, in Walcott’s phrase, struggled to “love again the stranger who was yourself”. The poet’s invitation to “Sit. Feast on your life” was the nudge she needed, in language which spoke to her, to imagine loving herself in a way she had always found hard. Poetry had worked its magic, unlocking a feeling of inner connection, and in turn a connection to all of us sitting in the workshop. To paraphrase the poet Paul Celan, a poem is like a handshake: it creates bonds between us. Or as Scott Fitzgerald wrote of literature: “You discover that your longings are universal longings, that you’re not lonely and isolated from anyone. You belong.”

For many, the pandemic exacerbated feelings of not belonging, as did the lack of access to mental health resources. More happily, however, it also led to pockets of poetry sharing, whether online, in doctor’s surgeries, or in poetry workshops like mine.

What’s your favourite poem from your new book “You’ll never walk alone”?

Right now it’s ‘Wild Geese’ by Mary Oliver. I change what I find the most compelling poem in the book according to my mood. But Oliver really speaks to me right now. Here’s the poem, and below I’ve written about why I love it so much and why I turn to it in times of trouble.

You do not have to be good.
You do not have to walk on your knees
for a hundred miles through the desert, repenting.
You only have to let the soft animal of your body
love what it loves.

Tell me about despair, yours, and I will tell you mine.

Meanwhile the world goes on.

Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,
the mountains and the rivers.

Meanwhile the wild geese, high in the clean blue air,
are heading home again.

Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting –
over and over announcing your place
in the family of things.

As if in the middle of an intimate conversation between the poet and reader, the poem begins with what seems strange advice. Oliver urges us to unlearn one of the first lessons we are taught – to be good. In fact, we do not have to be good to be loved. Instead, all we need to do is reconnect with our essential loving, animal nature. All we must do is to ‘let’ this happen.

The intimacy between poet and reader is further heightened in Oliver’s promise that from now on we will trust each other sufficiently to open up, as we are equal in our humanity and our despair. ‘Tell me about despair, yours, and I will tell you mine’ shows how fiercely the poet wants to connect with her reader: this is the heart of the poem’s power – we are loving creatures, says Oliver.

We can mirror nature’s own sense of being unperturbed. (Note the ‘clear pebbles’ of rain: an arresting image given the solidity of stone compared to the translucence of water.) The natural world unfolds anyway, not because it has been told it must or should. This sense of freedom is conjured in the metaphor of the wild geese of the poem’s title. We too can fly free; we too can be kindred spirits to each other, calling to each other, just as the geese do. We are a part of something bigger, an affinity that nonetheless acknowledges mutual pain suggested in the word ‘harsh’. Oliver’s message is powerful for not being sentimental: we too can head home, back into nature, both in our lifetimes and perhaps after our deaths.

Our place in ‘the family of things’ may even be our final home, just as the geese are perhaps heading home to their last resting place. I often find myself imagining the spirit of my late mother as a bird, finally flying free after the horrors of cancer and chemotherapy. She might even be one of Oliver’s wild geese, ‘high in the clean blue air’, her place assured in the family of things.

You have overcome great challenges in your life and use those to help and inspire others which is wonderful. How do you manage your mental health with such a busy life?

Good question! I don’t always. I use a toolbox approach. Some of the tools are about slowing down and draw on an ancient Buddhist approach to life that incorporates meditation and breathing exercised and which the West has rebranded as ‘mindfulness’. Learning to pause has helped me become more conscious of the world around me and made me more aware of the seasons.

Other tools reflect the nutritional and physiological tips I rely on. The body and mind are so profoundly interlinked that in order to take good care of one, it’s important not to neglect the other. I’ve written about the importance of nutrition in my Happy Kitchen: Good Mood Food book.

And of course poetry helps me! Poems require our full attention in order to unpack their meaning and enter into a different world. By focusing on the poets’ words I can silence the endless chatter in my head.

My advice is to create your own toolbox of the strategies you find most helpful. I recommend you cherry-pick from a variety of approaches to put together a selection that is personal to you.

The pursuit of happiness is about connecting more deeply with yourself, not attempting to be like anybody else.

What’s your go-to food when you are feeling low?

Probably fish. I know it’s expensive, and it’s best to choose sustainably sourced fish, but fish contain omega 3s or ‘healthy fats’, which are crucial to support good brain health. Many of us don’t eat nearly enough fish… which means we are deficient in omega 3s, but also in Vitamins A, D & K and essential minerals such as iron, zinc, and iodine.

Probably therefore, the most important change in the last 100 years that is causing the current epidemic of mental ill health, is the overall deterioration in our diet, of which low fish consumption is one example.

ADHD, anxiety, anorexia, autism, depression, obesity, obsessional compulsive disorder, antisocial personality disorder and crime have all seen massive increases over the last century.

While many argue that the reason for our mental health epidemic is the stress of modern life, our deteriorating diet is a more important factor. Our brain’s large size was made possible by our evolutionary relationship to fish; fish were not only our main source of protein and calories, but also they gave us important vitamins and minerals, and, crucially, omega 3 long chain polyunsaturated fatty acids, such as docosahexaenoic acid (DHA).

Other changes to our diet have also contributed to our mental health problems, so when I’m low I don’t just add in more fish to my diet, but also try and cut back on sugary treats which is hard as I associate them with cheering myself up.

Consumption of sugars and high fructose syrup has rocketed, whilst activity which might have used up all those extra calories has plummeted; hence obesity and its attendants, diabetes and hypertension have also risen inexorably.

The government needs to stress the importance of diet to the nation’s mental health and recommend we all eat more oily fish: My mother’s belief that fish is good for the brain turns out to have been absolutely right.

And changing our diet is one way we can help ourselves without recourse to psychiatrists or therapists. We can choose what we eat and cook. For me taking responsibility in this way for my own mental health was a step on the road to recovery.

Do you have any ideas for your next book?

I’m working on it! I’m currently interested in trying to help young people, given the special challenges they are facing post Covid, and to help their parents too. If we get mental health right among teenagers, we will have far fewer problems among adults. 50% of mental health problems are established by age 14 and 75% by age 24. 10% of children and young people (aged 5 to 16 years) have a clinically diagnosable mental problem, yet many children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age, according to the Mental Health Foundation.

Follow Rachel Kelly on Instagram @rachelfkelly for more tips & poetry to stay calm & well.

Order Rachel Kelly’s book “You’ll Never Walk Alone” here.

Learn more about Rachel Kelly on her website.

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