This evening I am at Glasgow University making a speech about mental health at the invitation of the Royal Philosophical Society of Glasgow. I have posted the speech below, and as you will see I have some strong connections with the university, two of which have particular relevance to the debate about mental health. On government mental health policy and strategy, such as they exist, I fear that we are making real progress in terms of attitudes, but going backwards when it comes to services.
When Theresa May was Prime Minister, she listed mental health as one of the “burning injustices” she was determined to address. Three Prime Ministers and a disastrous Brexit deal later, the injustice burns brighter than ever for all too many people.
Her Health Secretary was a man some of you may have seen on TV recently, first in the celebrity jungle, and now hawking round his so-called pandemic diaries, which read from the first line (I didn’t get much further) like they have been written long after the days they claim to record. ‘Standing in my kitchen in Suffolk after a quiet New Year’s Eve, I scanned my newspaper for clues as to what might be lurking around the corner.’ Yes of course you did, Matt. Not at all written in the manner of a history-rewriting, self-aggrandising piece of PR BS aimed at getting a decent serialisation deal out of the Mail.
Back when he was Mrs May’s Health Secretary, pre-COVID and his becoming a household name via “next slide please” briefings we felt compelled to watch because they concerned the health of us all, Matt Hancock also said that mental health was a priority. He invited me to speak at what he grandly titled “a global summit” on mental health. He introduced me to assorted ministers and others from around the world with very kind words, saying I had been talking about mental health before it became fashionable, “and isn’t it great we are talking about it so much more?”
Well, no, not really. I am frankly fed up of talking about it. Because four years on from that speech, in which he promised huge change not just in attitudes but services too, we are still having to make the same arguments and call for the same challenges to be met.
It means that much of what I say in Glasgow tonight will be familiar to anyone who has read my speeches on mental health before. Sometimes, however, that is the reality we have to confront when fighting for change, especially in such difficult political and economic times. You have to keep fighting.
Text as below
I have three very strong points of connection for tonight’s event, two rooted in family, one in friendship. My father Donald, who was born the son of a crofter one hundred years ago on the island of Tiree, became a veterinary surgeon thanks to his education here; my brother, also Donald, was both security officer and the Principal’s official piper, employed by the university for almost three decades, and you can see his portrait at the bottom of the stairs leading down from Bute Hall. And the friendship was with Charles Kennedy, whose life story and connection with this university, as graduate and former Rector, I am sure you all know well. All three, sadly, now dead. All three though continue to play a big part in my life. Charles and Donald in particular are fundamental to the theme of my speech, which is about the need to change the lens through which we view mental health and mental illness.
When my mother died, she left behind a poem which ended: “Those you love don’t go away; they walk beside you every day.”
When I walk, I often have little chats with departed family and friends.
‘Charles,’ I might say ‘a lot has happened since you left us.’
‘Such as?’ he asks.
‘Well, there are only 14 Lib Dem MPs.’
‘Oh dear. Is Nick Clegg still in charge?’
‘No. He is Mark Zuckerberg’s right-hand man.’
‘The Facebook guy? Dearie me!’
‘Yes, Nick is very rich now!’
‘And who is Labour leader? Ed Miliband stepped down not long before I died.’
‘Well, first it was Jeremy Corbyn .’
‘Jerrremy Corrrbyn???’ Few people could roll an r as expressively as ‘Charrr-els.’ … ‘Next you’ll be telling me Theresa May and Boris Johnson became Prime Minister.’
‘Well, funny you should say that, Charles.’
‘You’re not serious?’
‘Well, David Cameron called a referendum, he lost, and Theresa May became PM on the back of it. Then Johnson screwed her over, and he became PM. And since then … oh, you don’t want to know …’
‘So Scotland is independent?’
‘I’m afraid it was a referendum on Europe, Charles. A new word has been invented since you died. Brexit.’
‘That is terrible … I am assuming the rest of the world is in better shape?’
‘Well, not exactly, no.’
Charles had two great qualities that I value perhaps above all others in politics and life: moral courage; and wit. He knew the value of wit. ‘I’m a big fan of Puccini. Tosca is great because it has got the lot – murder, politics, sex, intrigue. It is like the House of Commons, only with good music.’
He appreciated the wit of others, and had some wonderful tales of life on the campaign trail, my favourite of which was a woman on whose door he knocked, to be told ‘I’m sorry dear, but I am blow-drying the cat.’
It was funny to watch the vox pops in Fort William after his death. Virtually everyone said ‘oh yes, I always voted for Charles.’ Amazing he lost that last election really! But he would have seen the funny side of that too. There was pain in his defeat, but no bitterness. I never once heard him express bitterness about his ousting as Lib Dem leader either. He knew his colleagues had a point. They knew – and he knew they knew – that unless he cracked his drink problem, a bigger problem was coming their way.
When he died, there were many who said that had it not been for his drinking, Charles could have been a truly great politician. To me it was like saying Churchill could have been even greater but for his Black Dog and his tendency to drown it in Scotch; Abraham Lincoln would have been even greater without his ‘melancholia’; Clinton would have had a near perfect Presidential reputation had he not had a Kennedy-esque sex drive – that is JFK not Charles.
Charles was respected because of the political qualities that saw him rise so young and so far; but loved because people sensed his vulnerability and, through it, his humanity.
We have to learn to understand and accept that alcoholism is a disease not a lifestyle choice. Of course every time we raise a glass, that is our choice. But nobody chooses to have a disease. Some get it, some don’t. Charles got it badly, and that is why he is not here now, why we miss him, miss his voice in the debate on the direction of our country.
And for me, though I don’t do God, when drink does take someone, I do have a strong sense of ‘there but for the grace of God go I.’ Anyone who has had a troubled relationship with alcohol knows that this is the way you must think of it – it is a relationship. Not drinking, that is a relationship too.
I am not sure, once Charles’ drinking started to become a problem – and for both drinker and friends it is almost impossible to know when exactly that happens – he ever really got on top of the relationship. He did go for periods without a drink. He did have short periods of rehab and get dried out. But if this disease is in you, will power alone, or other people telling you it is obvious what you need to do – ‘just don’t do it’ – will not fix it. You need to find a new way of looking at the world, and living your life. That can be harder if your life is in the public eye, every move you make subject to analysis and attack.
When I was in hospital post psychosis in the mid-80s, I was led by a wonderful Paisley psychiatrist named Ernest Bennie to the insight that unless I resolved to stop drinking I would likely be back in such places again and again. Though I was in the intense pain that follows a breakdown, and heading for a depression that would stay with me for a long time, something clicked in me and I knew my life had to change. Also, I was in journalism not politics then, so when I got back to work I felt I could be open about my problems and even in the macho, hard drinking environment of Fleet St most colleagues were brilliant with me.
I think Charles felt that if he had admitted to a possible problem when on the rise, he might never have reached the top. And, though there is more kindness in politics than people might realize, it was not unreasonable to worry about what his colleagues would say and do, how the media would respond and whether it would unleash a torrent of coverage that would hurt his family, and of course how his constituents would react. Scotland has a somewhat troubled relationship with alcohol (the relationship notion applies to countries as well as people). But there is also a strand of Scottish opinion that deeply disapproves of alcohol and might not be overly sympathetic. So he thought, certainly.
Also, could he do the things he was going to need to do to be able to say, genuinely, he had sorted that relationship with booze? Too many of our conversations on the subject were laced with the little tales and tactics I knew so well from my own drinking days – ‘not had a drink so far today, barely touched it at the weekend, did fine on TV last night, I’m feeling good.’
This is the opposite, it seems to me, to what people do when the relationship with a partner is going wrong and they can only see the bad side, not the person they fell in love with. When alcohol is the partner, you look for the bits that tell you everything is ok when the evidence to the contrary is staring you in the face every time you look in the mirror or to the bottom of a glass.
I did get Charles to agree to go to a place I know in the Scottish Borders, Castle Craig. He said he was up for it. But by the time I went back to him with dates and rates, he had other things to deal with, reasons to put it off – a sick father in need of help, an important speech to make, a meeting here at the University, a planning meeting for the next election. And so it went on.
Charles was in my phone as ‘Charles K’ and I got a text from ‘him,’ saying that he had died and could I call on this phone to speak to Carole. Carole McDonald, his friend and partner. She had been worried about him after speaking on the phone, had driven up to see him and he was dead. She said ‘I know he would have wanted you to know before it started to leak out.’ I think I knew why. To help with the announcement, yes. But also, he would have wanted me to be among the first to know that his relationship with alcohol was at an end, over. And he would want me to use that to keep my own relationship with alcohol on the straight and narrow.
He is often at my side now, along with others I have known who have fallen victim to this awful disease, and he will be urging me to push the urge aside, and also to keep heading up with the family to the most beautiful place on earth, the Highlands, where now he rests in peace, in the little cemetery at Clunes, where Fiona and I make an annual pilgrimage and I play on the pipes the lament that was played at his funeral.
His memory also pushes me on to campaign for change, and fight for a new relationship between our culture and alcohol, one which has to be led by politicians understanding that unless we face up to the damage being wreaked across families and communities, wrecking our NHS, filling our courts and prisons, then there will be many more Charles Kennedys to come. Not so well known, not so talented maybe. But victims like him of a disease we all too often fail to see as one. And it is not enough for politicians to say ‘isn’t it great that we are all talking about mental health in a way we never used to?’ Because no, it’s not, unless the services that match the need are there to help the people who need them. I sometimes worry governments use the awareness and anti-stigma campaigns, welcome though they are, as a substitute for rather than an accompaniment to the services. On stigma, we are going forwards. On services, in many parts of the UK, we are going backwards.
The reason I knew about Castle Craig, and felt it would be right for him, was because it was where my son Calum sorted out his troubled relationship with alcohol and, an AA regular, he has not touched drink for almost ten years. But I often wonder what we would have done if we had not been able to pay, as many alcoholics and their families cannot.
Castle Craig is a place where mainly British alcoholics mingle with mainly Dutch drug addicts, the latter sent there at public expense by a government which understands not just that addiction is an illness, but that long-term savings can be made for the State if we invest in treating it as such, even for the hardest cases. Some will relapse. But many do not. And when those that don’t are able to rebuild their lives, become healthy productive citizens again, we all gain from that. I wish our own government was as enlightened. Change the lens. Addiction is an illness. Needs to be treated properly as such.
So now, my brother Donald. Another who died too young, just 62. In the eulogy I gave at his funeral, I thanked this university specifically. Let me tell you why because this too is relevant to how we take a different look not just as government but as employers, who are so important in this field.
At his farewell party just over a year before he died, retiring early because of breathing problems, Donald announced proudly that among the students he piped out at graduations ‘I did seven thousand two hundred doctors.’ Yep, I said, and you’ve seen quite a few of them since. Because he had schizophrenia, and plenty of crisis periods in his life when he needed medical help.
But the reason I singled out Glasgow University for praise, and the reason I so readily accepted the invitation to speak here today, is because here he was never seen as ‘a schizophrenic.’ He was an employee, who had schizophrenia. Big difference. He did not define himself by his illness, and nor did the university. So thank you. His work was so important to his well being. He liked being in a team, in security. He liked the status that went with his position as piper. He liked ritual. He liked performing. He liked being something. And he loved his music.
The last time Donald ever played the pipes was alongside me, at Charles’ memorial service, in this very building. Donald didn’t look well. He was struggling for breath even before we started. I said to him ‘listen; I can do this on my own.’ ‘No,’ he said, ‘I’ll do it. I liked Charlie.’
We led the procession out of the service and into the quadrangle. But a third of the way round he had to stop to fight for breath and I finished alone. Donald never played again. To lose his work and then his piping to physical ill health, respiratory problems made worse by the medication he was on for so long, after doing so well for so long with his mental ill health, that was cruel.
One of his psychiatrists once said to me ‘Donald is my greatest success story. Holds down his job. Owns his own flat. Drives himself around. Has a passion for his music. Has lots of friends. Has a positive attitude almost all the time.’
That last bit was certainly true. He would say: ‘I got given a bit of a crap deal, but you’ve got to make the best of it.’ It helped that, especially latterly, he did do God and his faith was certainly a comfort.
Schizophrenia is a truly horrible illness. No crutches. No bandages. No scars. Invisible. All in the mind. People who have it often pariahs, shunned in the workplace, derided and abused on the streets. And because of the stigma, it’s at the wrong end of the queue for research so that those on a lifetime of anti-psychotics live on average 20 years less than the rest of us. Our Dad 82 when he died. Donald 62. Imagine if we knew that the drugs we take for asthma or diabetes shortened our life by 20 years, rather than kept us alive for longer. Would we accept that? Or might we move with the speed we moved to find a Covid vaccine, and find better treatments and better cures?
As well as my own experience of mental ill health, and that of friends and family, the other reason I feel my campaigns and communications background is useful in this area is because language is so important. A plea: never use the phrase “commit suicide” when we talk about someone who ends their own life, the ultimate in mental ill health. We commit sins and crimes. That is where the phrase comes from. It is neither sin nor, now, crime. So let’s stop referring to it as such.
Let’s stop referring to schizophrenia as a ‘split personality,’ that awful cliché, as awful as the way people use the word ‘schizophrenic’ when they mean there are two views of something, someone has good moods and bad, or your football team played well in the first half, and badly after half-time. It minimizes. It misunderstands. It stigmatizes. Schizophrenia is a severe illness in which the workings of your mind become separated from the reality around you. And it can be terrifying. Imagine a cacophony of voices in your head, screaming, telling you to do things you normally know you shouldn’t. Then imagine plugs and light switches, road signs and shop signs, talking to you. Imagine sitting in a pub or a train and thinking every single word being said and thought by everyone is about you. Imagine watching TV and thinking the same. And then imagine snakes coming out of the floor and wild cats charging through the ceilings. Donald had all that and more when he was in crisis. So imagine the strength of character it takes to deal with that in a way that had so many people love him so much, not out of sympathy – he didn’t want sympathy – but out of an appreciation of the real him, unclouded by illness.
Also to have had that and never say ‘it’s not fair’. I said it, for more than 40 years, from the first day my Dad and I saw him lying in a military psychiatric hospital, terrified, his eyes not the eyes I knew. ‘Not fair. Why Donald?’ I said it, he didn’t. Not then. Not ever. Not once.
Imagine being so keen to be in the Guards, doing well but then with this illness, his career terminated, the prestige of playing in the Scots Guards First Battalion Pipe Band gone. Did he ever say a single word against the Army? No. He talked of the Guards with fondness, always. It just ended badly and he got through it, got on with it, adapted, lived the best life that he could.
Resilience. Fortitude. Courage. Kindness. Not letting even a horrible illness destroy zest for life and love of people. Always looking for the positives.
He and Charles, and people who shared their struggles, they are the reason I campaign to change the lens on the way we think, talk and act in relation to mental health; to campaign to eradicate discrimination, to end the inequality of access, which means less than a fifth of those who would benefit from talking therapy get it; to deliver on maximum waiting times which have existed in theory but all too often are not met; to end disincentives in the system which mean mental health is the service most likely to be cut; to make the words in the NHS Constitution – parity between physical and mental health – actually mean something; to stop people being shunted around the country for treatment; to stop mentally ill kids being locked up in police cells, because through no fault of their own the police have become the mental health frontline; to accept that prisons are filled with people who should be in hospital not jail; to ask ourselves why mental illness is a research desert compared with physical illness; to urge the government to invest more in mental health today as a way of saving money tomorrow; to develop a preventative mental HEALTH service not, as we have now, a mental ILLNESS service, so stretched that a sick man, woman or child may have to be in absolute crisis before urgency is applied.
But also – if I can move to the final argument in my plea to change the lens – not just to speak up for the mentally ill as people who need support; but to speak up for the mentally ill as, often, major contributors to our life and times.
Anything I have achieved in my career I don’t feel that I have done so, as a Telegraph journalist once put it, “despite” a history of mental ill health; but in part because of it. The resilience that comes from building back from breakdown. The ability to deal with setback. A thick skin. Loyalty to others close to me, who have been loyal to me. The energy and creativity that comes from emerging from a depressive episode.
I genuinely believe that if it had not been for my breakdown, and my insight into depression, I would not have been able to do the job I did for Labour, for as long as I did it, with the energy and commitment I had, nor take on all the things I do now. Why? Because of the yardstick the breakdown gave me for pressure. I still get depressive episodes, can feel anxious and stressed, but I find a quiet space and say to myself, ‘if the breakdown was nine out of ten bad, how bad is this?’ Perspective.
I am not recommending psychotic breakdowns for all. But I am saying that sometimes it is too simplistic to think of mental illness only in terms of pain. In many ways I believe mine made me what I am. I am proud to talk about it, because I am proud that I learned from it, and use it to this day. Get Good Out of Bad, one of my rules of life.
To me the most dreaded place on earth is ‘the comfort zone,’ my least favourite word ‘content.’ My mother was a content kind of person. Nothing wrong with that. It was all she ever wanted, to be happy in her life, to care for her family and for others. She would often ask me, why do you put yourself under so much pressure? The answer is, and she would shake her head as I said so, that pressure can create physical, emotional and psychological change which can help focus and sharpen the mind, give greater energy to the body, and improve performance at whatever it is you are trying to do. ‘You’re absolutely barmy,’ she would say. Indeed.
When King Lear was on at the National Theatre in London, I did a talk there on power and madness with Nassir Ghaemi, a professor of psychiatry in the US. He says that ‘normal’ people are naturally conformist. They go through education and career paths in which the goal is often to be liked and to achieve according to the norms of a previous generation, parents who want to keep them safe and secure, teachers who want to get them through standard exams. Ghaemi believes this ‘normality’ obsession discourages the development of skills needed to excel. Great achievement therefore requires something beyond normal.
Professor Ghaemi argues that innovation and creativity are ‘explicitly a reflection of mania’ and its four main features of mania: increased rapid thought, increased physical and mental activity, increased likelihood of risk-taking, increased confidence and self-esteem. When taken to excess, those characteristics can be dangerous, potentially deathly. But there can be enormous advantages in them when the mania is more or less under control. By definition, increased rapid thought and increased activity enable you to work harder, get more done, so provided the work is good and the decisions being made are the right ones, this should in theory lead to more success and achievement.
Ask cycling genius Dave Brailsford which other walk of life he has learned most from, and he doesn’t hesitate. ‘Psychiatry.’ He describes his hiring of psychiatrist Dr Steve Peters as ‘maybe my most important single act of innovation – definitely innovation, not marginal gains.’ He also said this – ‘There is definitely a link between hyper achievement, and being a slightly or even seriously unbalanced personality.’
When Brailsford came across him, Peters was dealing with psychopathic personalities at Rampton high-security psychiatric hospital. ‘I realised that a lot of the things he knew applied to our riders. I’m not saying they’re psychopaths, but what makes them special is that their minds don’t work in the same way as most people’s. They are extreme. Extreme ambition. Extreme talent. Extreme drive and ego. But there are risks with that too, risks to them as individuals, and risks to the team. They can be strong but they are also vulnerable, and Steve was brilliant at making the strong side stronger and the vulnerable side less vulnerable.’
To move from sport to politics, who is the greatest political figure of our lifetime? Many will say Nelson Mandela. For much of his life he was a labeled an extremist, not least by the UK government. He certainly had an extreme mindset. Is it ‘normal’ to be able to endure 27 years in jail and come out smiling and full of forgiveness? Is it normal to be able to cope with the torture of knowing you may never see your family and that they are being abused and hounded?
Who usually wins surveys on the Greatest Briton, or greatest Prime Minister? Winston Churchill. Who is the American president all American contenders – bar Trump of course – feel they have to laud as the greatest ever? Abraham Lincoln. Both were depressives – in Churchill’s case, of the manic variety.
Charles Darwin, Florence Nightingale and Marie Curie. All had what doctors today would define as mental illness. Imagine a world in which those five had never been able to fulfil their potential because their mental frailties were viewed as overwhelming obstacles. It would be a very different place. They were all major change-makers, their influence still with us today. Florence Nightingale, for example, single-handedly reinvented the basic concept of health care as well as challenging the idea that women could not be medical professionals. But she had a personality that today would be described as bipolar.
Ghaemi believes there is a strong link between depression and realism, which can contribute to leadership skills required in times of challenge and difficulty. ‘The thing about crisis is that the depressive imagines the worst and works to avoid it,’ he says. ‘The optimist believes they can handle the crisis and that everything will turn out fine.’ When Prime Minister Neville Chamberlain was pursuing a policy of appeasement, Churchill was constantly warning him about the danger of Hitler and the need for a stronger riposte. It was a steady message through the premierships of MacDonald, Stanley Baldwin and Chamberlain. Were his depressive instincts making him more realistic about the threat that Germany posed, and Chamberlain’s optimism blinding him to reality? Ghaemi, for one, believes so. He said the same about Tony Blair and George W Bush – both non-depressive optimists – with regard to Iraq, but perhaps that is something I will address another day.
Lincoln’s law partner William Herndon said of the President that “melancholy dripped from him with every step.” But he said Lincoln had an inner strength, “as tough and gnarled as seasoned hickory wood, and the increasing hostility that his outspoken politics provoked as the country drifted into war, seemed to bounce off him like peas from a peashooter against a wall”. Resilience through depression.
Charles Darwin, born on the exact same day as Lincoln by the way, February 12 1809, had chronic panic attacks that often left him in floods of tears; palpitations, skin inflammation, agoraphobia, blinding headaches and agonising stomach cramps. Over twenty-five years he consulted more than twenty doctors in a vain bid to find a cure. Darwin’s illnesses, however, accompanied a restless intellect that couldn’t accept the status quo and that was constantly asking ‘what if’.
Ghaemi believes that Martin Luther King became a great leader not despite being a manic-depressive, but because of it. The mania gave him energy and high self-esteem, which contributed to his charisma – important in any campaign leader – and forward-thinking – important in strategy. His depressive side and the qualities associated with depression – particularly understanding of human emotional pain – allowed him to be an exceptional and empathetic team leader.
The reason it’s important to understand all this is that a lot of stigma is still attached to anything that smacks of ‘abnormal’ mental activity. And that means that many organisations are missing out on having more potential winners in their midst. Sport is leading the way here, business second, politics third, when it should be the other way round.
Clearly the demands in sport are predominantly physical, and yet it is now seen as routine to have proper psychological support. In politics and business, by contrast, where the challenges are more mental than physical, no such attitude change has taken place. It is still considered to be an admission of weakness ever to suggest that you yourself are suffering any kind of mental strain.
Yet the stress under which political and business leaders work – the hours, the sheer volume and nature of issues they are having to deal with, the shocks and setbacks that come with the turf, thetime spent separated from family – are all likely to have a negative psychological impact. It would be far better to acknowledge this and work with it, but most leaders just plough on. Sadly, as regards the politician of whom I have spoken most this evening, we will never know if he might have benefited from the kind of support many top athletes take for granted.
So there we are. I hope I may have persuaded some of you to get involved in campaigning on this, because it is through campaigning that we can make change. And I hope one day we can look back and wonder – did we really accept medications that took 20 years off people’s lives? Did we really think the mentally ill were more likely to be violent than the general population when in truth they are more likely to be victims of violence? Did we really think it was OK to discriminate in the workplace on the grounds of someone admitting to a mental health problem, as still happens all too often today?
Maybe a bit of reverse discrimination would be better. I speak to a lot of businesses, the best of whom are filling the gap left by government, by genuinely looking after the mental health of their employees; and I argue, that if you have two identical CVs in front of you, same level of school qualifications, same degree, same kind of interests, but one has six missing months, and they admit it was because they had a breakdown, were in rehab, prison, whatever it might be … go for that one. Honesty, and resilience. Are these not qualities we are looking for in the people we hire?
So join in, campaign for change and one day, hopefully, we will have the parity between mental and physical health that today exists in the words of the NHS Constitution, but not in the practice of government or of the reality of healthcare. Only then will we be able to say we are a genuinely civilized country. Thank you