Hope when the world is "going to hell in a hand-basket"
Ever heard the phrase “it’s all going to hell in a handbasket”? It’s an old way of describing impending disaster, supposedly from the days when miners were lowered into shafts in baskets—often with explosives. It’s dangerous, risky, and usually doesn’t end well.
Anyway, I overheard someone saying this in relation to mental health the other day – and was ‘slightly distracted’ about what this meant for those of us doing mental health research in this space. With mental health statistics climbing and systems breaking down, it’s hard not to feel like we’re all in that basket, headed for a rough landing. Tangentially, I also thought - what type of handbasket would I take? Did it need to be fireproof? Was it a pre-approved carry-on size only or big enough to take mates with me? Was this a one-way ticket? Or return but with a scorched ass?
Many of us have been a bit burned recently. Despite working hard, there has been a rapid increase in depressive symptoms, anxiety and distress for young people in the last 10 years (Sutcliffe et al., 2023; Fleming et al., 2022). The latest Cure Kids State of Child Health report found that hospitalisations for mental health concerns had doubled in the past two decades, and we have some of the highest youth suicide rates in the world. Māori, Pacific, disabled, and LGBTQI+ youth are hit hardest (Cure Kids, 2022; Child and Youth Mortality Review Committee, 2021) (Roy et al., 2021; Fleming, 202).
To make it worse, recent coalition health reforms have reversed much-needed equity approaches, and now the system feels paralysed, lacking the leadership and urgency needed to face this crisis. It’s easy to feel cynical when there’s so much need, with so few people to do the mahi and limited resources and options.
Typically, the first response to poor mental health is to throw more counselling and therapy at it. Sure, we need to respond to urgent distress, but I get frustrated when we think this is the only solution. Many people don’t seek help, and if they do, they often don’t get what they need, especially if they don’t fit the service criterion to access care. Help-seeking relies on people asking for help, but for many, it’s impossible.
An anonymous quote I came across sums it up: “I’m fully submerged in water, and everyone keeps asking if I need help. Can’t they see? I can’t speak underwater; I can’t even breathe.”
Education is the next go-to, but it’s not a magic bullet either. Once again, health promotion and mental health education are vital skills for life - most of us will experience mental health concerns at some stage. But some school-based mental health programs might actually do more harm than good (Johnson et al., 2021; Therriault et al., 2023). Understanding what is helpful and what is not, and for whom – is essential if we want to effectively decrease the increasing levels of distress in our communities. We need evidence-based, culturally safe, and local solutions tailored to our unique communities, especially for Māori.
Sadly, there are no quick fixes here. The causes of the increasing levels of distress are complex, with young people having multiple, cumulative, overwhelming stressors and life events that impact their wellbeing. Our existing interventions often arrive too late—when they’re already at the bottom of the cliff. But what if we could stop them from falling over in the first place? What if we could stem the tide of distress by creating environments that keep our children and young people well? There are ways forward (Fleming et al., 2024). This is what keeps me hopeful.
I want us to take a moment and look around at all the people who really make a difference in our communities. As a Māori researcher working in child and adolescent mental health, I see brilliance and ideas everywhere. When I take my tamariki to Kura, and I hear them all speaking te reo Māori, performing kapa haka proudly, I see wellbeing. When I take them to sports, I see all of the teacher and parent heroes that give our children opportunities to thrive. When I see clinicians trying to do things differently, I see innovation and resistance. When I see artists speaking truth in powerful performances, I see resistance and creativity. When I see Masters and PhD students trying to make a difference through their research, I see hope. Everywhere.
The systems might be tough to shift right now, but I see you all trying to make a difference.
Get your handbaskets out, put your best fire-proof knickers on and, keep asking questions, keep being curious, keep having ideas, keep trying to make things incrementally better – this is the power of research.
