Evening Standard Article

Why our cultural trend of not discussing mental health needs to stop
We need to stop saying ‘I’m fine’, says Kate Leaver

Every day, all over the world, people are answering the question “How are you?” with a casual, non-committal “I’m fine”. Like a chorus of mundanity: “I’m fine”, “I’m fine”, “I’m fine”. We say it as a matter of habit and, especially, when we’re anything but fine. It’s the easiest way to stop follow-up questions and the simplest way to signal to the world that you’ve got your shit together. It’s also the fastest way to shut down any genuine conversation about how we really are.

On average, we say “I’m fine” 14 times a week, but only 19 per cent of us actually mean it. That’s a twice-daily lie for most of us – all because we’ve lost the ability or the desire to be sincere with one another. The Mental Health Foundation conducted a survey of 2,000 British people and found that 85 per cent of us have lied in answer to the question “How are you?” and 75 per cent feel uncomfortable talking about our emotions. Almost a third of those surveyed said they often lie about how they are feeling to other people, while one in 10 went as far as to say they always lie about their emotional state.

What’s perhaps even more interesting, to me, is our intention when we ask the question. We no longer want to know, genuinely, how someone is – or at least, we’ve reached a stage where the enquiry has lost its meaning. 59 per cent of people told the survey that they don’t even expect a truthful response to the question “How are you?” – which makes it about as interrogative as saying “Hello”. It’s become a greeting; a call-and-response ritual we perform several times a day with people we know, people we love and people we meet.

“This cultural trend of not discussing mental health has a real impact,” says Mark Rowland, director of fundraising and communications at the Mental Health Foundation. “It’s the fear of being discriminated against or the fear of not being safe that stops people from talking about it. We have a disclosure problem in this country and we must address it.”

To do so, Mark says, we have to question why we’re so insistent on being ‘fine’ all the damn time. That starts – like so many cultural shifts – with amping up our compassion.

“If a friend or loved one says they’re fine, I would say it’s about asking how they are with more persistence and compassion,” says Mark. “It’s about understanding that when they say they’re fine, they might not be. You might not know the cause of their distress but it’s important to know that they could be suffering. We’ve got to keep asking the question ‘How are you?’ until people feel safe to give their real answers. Friends have to communicate to each other that it’s OK, that it’s safe to talk about mental health and that as a friend, you’d welcome that conversation.”

Now, sure, there are times when saying “I’m fine” is, well, fine. It can be a good, efficient shield in a professional situation and it can maintain your privacy among strangers. But it’s a dire situation if we’re lying to our friends, family, partners and parents. And we are. The survey showed that we are three times more likely to lie to our mothers about how we are than to our fathers. Imagine the disingenuous phone calls across Britain as grown adults in distress reassure their mothers that they’re “fine, Mum”. We’re actively protecting our own mothers from our problems rather than disclosing that we’re unhappy, unhealthy, or unsafe. It’s a nationwide coping mechanism and it’s shutting down meaningful conversation about mental health.

Psychologist Dr Abigael San says that we should push past the social convention of saying “I’m fine” as much as we can. “It’s really important to be open with your emotions. It’s extremely unhealthy not to be. If you keep everything to yourself, you stay within that circumstance you’re in without a sounding board for whether what you’re going through is normal. You can’t verify what you’re feeling, if you’re not talking about it with other people. You’re stuck with what you think and tell yourself. Stating our feelings is about validating them.”

 

Rolling out the “I’m fine” response is convenient and time-efficient. And we’re not always in a mood to sit down and have a candid conversation about our emotions. That’s cool, says Dr San. But the frequency with which we lie about our wellbeing is frightening. What does it say about us if we can’t – or won’t, or don’t know how to – speak about ourselves honestly? Surely it’s contributing to a culture of fear around mental health if we cannot bring ourselves to say to a friend, “You know what, I’m not doing that well at the moment”. It’s isolating and lonely to maintain a façade of always being ‘fine’. The answer, I guess, is to find someone, even one person, with whom you’re comfortable being honest.

“It depends who you’re interacting with, doesn’t it?” says Dr San. “It’s going to be different talking to a friend, or a romantic partner or a work colleague. Really, it’s about sensing when something might be wrong. Are they quieter than usual? Does their face match their answer when they say they’re alright? It’s about listening and noticing when their behaviour changes. It’s about compassion, listening and gently pointing out differences in behaviour. It’s the same with people you’re not as close to. With a work colleague or stranger or acquaintance, it might be less comfortable, but equally necessary. Start by gently pointing out what you observe. Again, they may say words (‘I’m fine’) but what is their face saying? What is their behaviour saying?”

So until we find a way to answer the question “How are you?” more honestly, we have to work on developing a sixth sense: the ability to tell when something’s not quite right with someone. Now that we know how frequently “I’m fine” is a lie, perhaps we can be more alert to other people’s possible distress. It’s only with this kind of compassion that we have any hope of changing the conversation around mental health.