Jersey’s growing mental health problem
Has a leap in the use of antidepressants revealed the hidden pressures of living in Jersey?
By Ollie Taylor
There are many positives to living on the beautiful island of Jersey but a Freedom of Information request by ITV News last month revealed a more hidden side to the island. Making headlines, it showed that both the number of patients and the number of prescriptions for antidepressants in Jersey rose by 48 per cent between 2010 and 2016.
This follows a 2016 Jersey Health Profile report that showed Jersey residents have higher anxiety scores than people in England with more than one in three Islanders categorised as having high anxiety compared to just one in five in England. A 2016 report from the Safeguarding Partnership Board also found Jersey had a “relatively high suicide rate” compared to the UK. Despite efforts, Jersey also continues to have one of the highest rates of alcohol consumption in Europe.
So why are many Islanders feeling this way? Although the causes of mental health problems are varied and complex, there are indicators that may help explain why some Islanders are taking more antidepressants and over a third are experiencing high levels of anxiety.
Inequality
One of the greatest changes over the last five years, as confirmed in the Jersey Statistics 2014/2015 Income Distribution Report, has been the rise in inequality on the Island. A third of pensioners, a third of children and over half of single parent families are now living in relative poverty. Between 2010 and 2015 the spending power of the bottom fifth of Islanders declined by 17 per cent and the poorest 10th by a massive 36 per cent.
A 2009 World Health Organisation report found that even relatively small differences in levels of inequality can have very significant effects on mental health. It concluded that individual and collective mental health and wellbeing depends on reducing the gap between rich and poor. In the 2016 “My Jersey Survey” the only outright negative majority (53%), and also the lowest ranked outcome, was for the statement: “Islanders can independently afford a decent standard of living”.
The Income Distribution Report showed that as well as pensioners, it is women and children that are bearing the brunt of the growing inequality on the Island. Recent studies have shown that emotional health — the biggest determinant of the wellbeing of the future adult — is affected partly by family income, but most of all by the mother’s mental health.
With the majority of single parents being mothers, and half in poverty, the pressure of trying to maintain a stable family on lower paid (especially compared to men), and increasingly insecure work, is one of the most stressful things a person can go through in life. This may explain why one in ten children in Jersey are now suffering from some form of mental illness, with local health practitioner Yolanda Sáez Castelló reportedly treating children as young as three for stress.
Jersey’s minimum wage has also now fallen behind the UK, Guernsey and Isle of Man despite the very high cost of living. Considering the links between poverty, inequality and mental health, any States member that votes against raising the minimum wage shouldn’t be allowed to discuss mental health or stress without first clarifying where they stand on the issue of inequality and pay.
Competition
In the States economic strategy, the ‘Medium Term Financial Plan’, competition and competitiveness is mentioned twenty-five times and in a speech to the Institute of Directors last year, Chief Minister Ian Gorst said: “we should all welcome efforts to promote a more competitive economy”. The mantra of competition is regularly used as justification for a range of government policies, such as the current zero/ten tax regime.
Sociologist William Davies writes in his illuminating book “The Happiness Industry: How the Government and Big Business Sold Us Well-Being” that evidence from social epidemiology indicates how unhappiness and depression are concentrated in highly unequal societies, with strongly materialist, competitive values. The function of any competition is naturally to produce an unequal outcome, winners and losers. This competitive, business orientated mindset of market metaphors, metrics and practices now permeates much of Jersey life.
One area competition is having a big impact on mental health is in education. Only last month the States of Jersey Chief Education Officer, Justin Donovan said:
“The UK is our main competitor...We want to beat them and we want to be well ahead of them. In certain indicators we are ahead of them and we are not close to be ahead of our statistical neighbours”
The application of competitive market metrics and ratings means students are increasingly being assessed solely on their ability to pass tests and exams. In turn, teachers are being assessed on their ability to have their students pass them, creating a stressful and pressurised environment for both teachers and students. Local charity ChildLine revealed that there was a 200 per cent increase in exam stress counselling for the year 2014. Between 2014 and 2015 the time taken off by teachers with stress, anxiety or depression had doubled to nearly 950.
Due to the rising costs of higher education, there is also an added stress and pressure on families to acquire necessary funding to allow their children a chance to obtain a higher education and provide greater opportunity for an increasingly competitive job market. The impacts of such pressures are covered in my previous article here.
As Davies writes: “The need to entrench ‘competitiveness’ as the defining culture of businesses, cities, schools and entire nations, so as to out-do international rivals, is the mantra of the post-Thatcher era. A science of winning, be it in business, sport or just in life, now brings together former sportsmen, business gurus and statisticians to extend lessons from sport into politics, from warfare into business strategy, and from life coaching into schools.”
It also rings true that in a more competitive society mental illness would be considered a sign of weakness, a failure to operate at the necessary high levels required of winners. As founder of Sanctus, James Routledge explained of his own battles with stress, panic attacks and sleepless nights: “I didn’t want to admit weakness or vulnerability”.
This attitude towards mental health may explain why in the Jersey 2016 Opinions and Lifestyle Survey only a quarter of people surveyed believed that people are caring and sympathetic towards those with mental health problems, with nearly a third stating that they wouldn’t want other people knowing that they had a mental health problem at all. Especially understandable in a small and enclosed community like Jersey.
From our economy, to businesses, to education, to our consumerist lifestyles, we are constantly being put into a position of competition with each other, with the pressure of failure and its consequences ever in the backs of our minds.
Disempowerment
Disempowerment is also an integral part of how depression, stress and anxiety arise. Social, political and economic changes in Jersey have led to a growing number of people to feel they have less power, authority, or influence over their busy lives.
A major contributing factor in this has been the rising cost of both renting and owning property in Jersey. Meaning more people are living in ever smaller, poorer quality accommodation and in some cases, with siblings having to share rooms. High costs have meant that 73 per cent of those living in qualified rental, and 53 per cent living in non-qualified rental, are now currently classified as living in rental stress — where costs are high relative to household income. Subsequently, leaving Jersey becomes another luxury many cannot afford.
According to the Chief Executive of the Ipsos Mori Issues Index — that tracks changes in UK attitudes — housing anxiety has now risen to the highest level in over 40 years, especially among the young and Londoners. Jersey has similar house prices to London so it is conceivable that similar anxieties are being experienced here. Furthermore, even where individuals are “lucky” enough to afford property, the current high house prices means that such individuals become locked into years of mortgage debt with large portions of their monthly income being used to pay it off.
This in turn forces people to maintain jobs that they would potentially otherwise leave due to the pressure of having to service these debts, not to mention the additional costs of those with children to look after. With such a single dominant industry driving the Jersey economy there is also a lack of job diversity and opportunities. Meaning those who want to study or are qualified in different fields may feel forced to either leave the island or choose the more available career that affords them the necessary high wages for housing costs and the ability to start a family life.
Studies have also shown that there are strong links between high levels of stress and declines in work productivity. Badly designed jobs and lack of proper recognition in the workplace are clear contributors to poor mental health. Jersey statistics showed in their last economic report that, despite a rise in the number of workers and an increase in pay, productivity declined in the financial services sector between 2014 and 2015. How much was stress a factor at play in this decline?
Job dissatisfaction and high levels of stress are also reflected in the amount of sick days taken by employees. According to the 2016 Jersey Opinions and Lifestyle Survey, ten per cent of the working population had taken time off for stress in 2015, with no difference between the proportions of males and females. Over half (53%) of workers that had taken time off for work-related stress or anxiety reported taking at least six days. Half (49%) of male workers reported taking more than 10 days off for work-related stress/anxiety compared to less than a third (31%) for women.
From a political perspective, Jersey’s Better Life Index report scored Jersey the lowest for civic engagement out of all 36 OECD countries, and not without good reason. Despite strong civic engagement over the Jersey Referendum and the petition against the implementation of a Goods and Services Tax “GST”, both were ignored by the States of Jersey.
The public's voting decision for “Option B” in the referendum was dismissed, as was a 19,000 strong petition — roughly 20 per cent of the population — against GST. This could only have been taken by the public as a message that, on the major issues such as tax and political reform, the States are unwilling to listen to the public. These, along with other more structural issues such as a gerrymandered electoral system, vague manifestos, lack of clear policies and accountability and politicians reneging after getting into office have all led to people feeling increasingly disempowered, with civic engagement now being at an all time low.
States of Jersey: helping or hurting?
Rising inequality, an increasingly competitive society and a growing lack of self-determination over our lives, all create an environment that compounds the negative life events we all experience in life from time to time. Whether it be physical illness, losing a loved one, failing a test, or going into debt. Jersey has become a place where, for many, it means operating at higher stress levels which in turn makes it far easier to suffer from mental health problems like depression, anxiety or stress.
But it’s also clear that States of Jersey policies have contributed to the growing mental health problem on the island. Passing deliberate austerity measures that have seen cuts to benefits and income support. Social Security have ensured those suffering from more serious and debilitating mental health issues are denied financial assistance due to their narrow requirements of what constitutes a disability.
The States drive for full employment has meant financial assistance will only be offered on the condition that employment is being sought. As anyone who has ever had the experience of a job interview knows well, it can be an extremely stressful event. Forcing those with mental ill-health problems to go through such a process without proper assessment can only be considered punitive and counterproductive, inevitably leading some to simply drop off the radar.
Other government issues have included substandard accommodation for those suffering from mental ill-health. Young people experiencing a crisis being locked up in police cells, advising those contemplating suicide to go to A&E, as well as inadequate mental health guidance and information on the States website, all demonstrate a failure to give the matter the attention and seriousness it deserves.
However, that is not to say there hasn’t been progress either. People are becoming more aware of mental health and it is being taken more seriously with a number of recent moves to address the problem. The States launched a complete review of mental health services at the end of 2015. The establishment of the Jersey Recovery College (part-funded by the States Mental Health Strategy), and a “health hub” to improve stress and depression care as well as high profile individuals bravely coming forward to speak of their mental ill-health problems show admirable and much needed progress.
If the States are serious about dealing with mental ill-health then a concerted effort is needed from politicians and policy makers to alleviate economic and social inequalities and ensure any growth is inclusive. Yes, competition can be beneficial and productive, but not when it’s forced into so many areas of our lives and at the expense of our mental health, especially our children's.
We need open communication on the issue, and to start promoting a culture of empathy and kindness towards those with mental health problems, treating them with the same understanding we do other types of illnesses. There’s no reason why any of this cannot be achieved, especially when it’s in all of our interests to do so.
For further information, support and practical help on mental health in Jersey, please click here.
This article is dedicated in loving memory of Malcolm Waddell (10th July 1981–4th January 2010)
