I’m happy 😀
I didn’t express that very clearly, I suppose. (Out of practice 😐 )
What I mean is, if I am happy does that mean I am well? Is is possible to be happy and (mentally) ill at the same time?
Yes, of course it is!
I might be manic — getting irrational enjoyment from nothing much.
I might be psychotic — imagining happy circumstances that do not really exist.
I might have dementia — thinking I live in a happy time in my past.
And these are just some extreme examples. Lots of people who are mentally ill, or perhaps in the process of recovery, are just happy in the ordinary sense at times.
Looking at it the opposite way, suppose I am sad or worried. (And indeed I have been sad and worried at times, but not right now.) Does that mean I am mentally ill?
I might be grieving over a loss, struggling with some difficulty, or temporarily sad for no apparent reason. None of these things is a mental illness.
Where am I?
Does it matter where I am when I am sad or worried? Apparently it does.
If I am sad or worried in Oxfordshire, the authorities there will be concerned. Someone in the NHS in Oxfordshire, or more likely a whole committee of people in the NHS in Oxfordshire, seems to think it is their job to ensure that people do not go around looking sad or worried there.
They have placed advertisements at bus stops to try and stamp it out.
Turn a frown upside down
The Turn a frown upside down campaign advises passers-by to do things to make themselves smile:
Don’t stress out. Your friends will
give you something to laugh about.
Why not try giving someone else a hand?
You could both end up laughing.
Try something new. Join a free course,
group or club. It could be a real laugh.
This kind of nannying by officials seems very much a throwback to New Labour, and indeed even the smile they have used is eerily reminiscent of our last Prime Minister’s infamous attempts at smiling. But the serious issue that it raises is: what does the NHS think it is doing wasting money on this kind of fatuous advertising?
Newspaper reports put the cost at £40,000, which could have paid for dozens of mentally ill people to be permanently cured with CBT. Instead, this branch of the National Health Service spent the money on a grandiose gesture that has nothing to do with health at all.
The idea that frowning is a mental health issue is complete nonsense. The idea that doing things that might make you smile has any influence on mental illness is childish superstition. There must be something else entirely behind this advertising campaign.
Advertising expert Rory Sutherland, giving a talk entitled Sweat the small stuff at TEDSalon in London earlier this year, put his finger on the cause of this wasteful idiocy. People with large budgets, he points out, want to spend their budgets on large gestures (5:09):
Our own sense of self-aggrandisement feels that big important problems need to have big important — and, most of all, expensive — solutions attached to them…
So what happens in an institution is: the very person who has the power to solve the problem also has a very, very large budget. And once you have a very, very large budget you actually look for expensive things to spend it on. What is completely lacking is a class of people who have immense amounts of power but no money at all. And it’s those people I’d quite like to create, in the world going forward.
That’s what I would like to see in the NHS. Currently, the NHS is awash with money in the hands of bureaucrats who have no idea how to spend it wisely. Those people’s budgets need to be cut. The NHS would actually improve the service it delivers.
Here’s the entire talk:
Sutherland’s main point is that intoxication with grand gestures means that the little details that actually matter, “the small stuff”, gets completely ignored. No one wants to fix all the little things that go wrong.
And that’s what we see in the NHS. Little things going wrong all the time, with many of the little things that go wrong causing something else to go wrong — tangled chain reactions of incompetence and confusion.
So Sutherland proposes that institutions should deliberately focus on important detail. In this diagram, it’s the stuff where the question mark is (11:20):
…there’s a fourth thing, and the fundamental problem is that we don’t actually have a word for this stuff. We don’t know what to call it. And actually, we don’t spend nearly enough money looking for those things, looking for those tiny things that may or may not work, but which if they do work, can have a success absolutely out of proportion to their expense, their effort, and the disruption they cause.
My suggestion for the name is catalysis, defined (appropriately enough, by AskOxford.com) as:
the acceleration of a chemical reaction by a catalyst
So what would make me even happier than I am now would be to see the NHS’s ability to waste money severely curtailed. Instead of all that waste, the people who currently spend their time thinking up grandiose schemes would be given the power to just make things work, but no budget.
Their job would become removing blockages, simplifying systems, allowing things to happen, accelerating reactions. And in particular, they would allow the NHS to get back to basics again, to get back to being a health service.