A talk given for the Open University’s Special Interest Group on Inclusivity
You’ll learn a lot if you ask someone why a problem is important. The first thing you’ll learn if you ask the question to many different people is that it often feels like they’re answering completely different questions. Understanding why that happens is the first step in figuring out how to fix the problem. Take climate change. Ask people why it’s important to stop the climate crisis and you might find, even ignoring the sceptics and deniers, two large sets of answers that bear little relation to each other.
One set will go something like “because if we don’t stop climate change, many species will die, parts of the earth will become uninhabitable, and we’ll soon end up in an irreversible cycle that will steal all hope and possibility from future generations.”
And the other set will go something like, “97% of scientists agree that climate change is real and anthropogenic; greenhouse gas levels mean that if we don’t act now, average temperatures by the end of the century will rise beyond the critical 2 degrees.”
In many ways these are the same argument put differently. In the first instance, the facts of the situation are taken for granted so the emphasis is on the moral case. In the second instance, the moral case is taken for granted so the emphasis is placed on pointing out that the facts mean that moral case pertains to our current situation.
Think of the underlying dynamics like this – as the person putting the case for change, you know that you need the institution or person you want to make the change to agree with you on both facts and values. In order to have a hope of achieving change, you will usually start with the assumption that either facts or values provide you with some common ground – and you’ll focus your argument on the other side of the coin. I will, accordingly, look at both sides of the coin.
Of course, most of us who’ve been involved in activism know there are also times when we have nothing in common with those who need to change. In those cases, we quickly learn that trying to go either the facts or the values route leads to frustration. Instead, you develop a special kind of pragmatism that seeks to produce the outcomes you need by working out the values of the people you are talking to and appealing to those. This is what gives rise to what we might call the business case approach. No matter how much we don’t think that this should be necessary, and that basing human outcomes on business motives is a horrific situation, it is too often necessary in order to secure the primary goal of making lives better. For that reason, I’ll be talking about the business case for taking mental illness and problem debt seriously in this talk. I am very happy to discuss the ethical knots you may find yourself tied in by doing this and how to feel comfortable with it – a lot of which comes down to having a network of peer support and mentoring around you.
So let me start with some figures. For many of us they will feel very familiar. For those who don’t live this from the inside, they can be really shocking. Shocking enough, I hope, to make people want to do something to change them. The basic figures show that the relationship between poor mental health and problem debt goes, insidiously, both ways. People experiencing mental health difficulties are three and a half more times likely to be in problem debt than those who are not. And 46% of those in problem debt were likely to have mental health problems – compared to the 1 in 4 figure we are so used to.
But the reach of this interrelated pair of problems goes far beyond what is happening in people’s lives right now, and that is why tackling it is so important. A recent report by the Money and Mental Health Policy Institute’s Income Commission found that the lifelong income gap related to poor mental health was at a staggering level.
The median annual income for someone with poor mental health is £8400 less than their peers. Put another way, if you have anxiety or depression you will earn 68p for every pound your peers do.
The message is clear and stark. If you are in financial difficulty as a student you are more likely to also then experience poor mental health – and that will lead to an income gap throughout your life that has a further detrimental effect on your mental health – and so on. And if you have poor mental health as a student, it will affect your finances not just during student life but for the rest of your life.
That’s quite enough for now, as the saying goes, that’s not about me.
I always knew, growing up, what I wanted to be. Like many people my age, I was a young child when Cosmos was first on TV. I got the book for my 9th birthday, and had read it cover to cover by the end of the day. Unlike many who were equally inspired, I didn’t want to be an astronaut. I wanted to be Carl Sagan. I learned before too long there was a name for the kind of thing he was – public intellectual. It sounds really rather awful as a phrase now, but it meant something very specific to me.
I dreamed of my voice bringing a blend of hope and wonder over the receding image of a pale blue dot, entering the hearts and homes of a new generation maybe one of whom would one day remember and start down a road that would lead to a better future.
I never received practical advice on how I would do this. It was always just assumed that I would. If I was ever told anything by those guiding my future it was simply, “You’re clever. You’ll be fine. Just work hard.”
But I never understood *how* to “just work hard”. I could spent days at a time staring at a page or a ceiling or a mark on my desk for hours at a time as if it was the only thing in the world, aware of nothing but the thumping noise in my head and a cloak of fog cutting me off from a world where I knew time was passing without me, futures were being shaped in which I played no part, plans were being made that were slowly writing me out of my dreams. And I could do nothing.
And then there were the weeks at a time my brain was abuzz with a cocktail of energy and grandiosity that scattered itself gloriously like a glitterball parrying laser beams, filling my horizons with fabulous distractions.
And in the moments when I had the clarity to reflect the only names I had to give to these things were the ones that had been handed to me in primary school: laziness and naughtiness.
Yet still I seemed to be marshalling resources well, though I had no idea how quickly I was depleting them, and by 2000, I was well into my doctorate.
And then after 6 months too terrified to open my post or leave my telephone switched on, one minute hiding rocking in the corner of a darkened room the next spending any penny I could find in a desperate attempt to rescue my academic life by simply buying more books and more books and more books still, I was, in every way, spent. My status as a student lapsed, and the bank wanted back, at once, every penny it had ever loaned me.
Although I’d had bipolar disorder for over a decade, what I experienced was one summer in which the door closed on my future.
Any moments since when I have been well enough to think about resuming my studies, the burden of debt has still been there. I am lucky – I am not so ill I can’t work. But neither am I well enough to have been able to get the pieces of paper that would enable me to get a job where I could earn enough to start studying again and get those bits of paper – it’s a Catch-22 so many people know so well. And the result is the only way to use my brain or do the kind of communication of ideas I always dreamed of is to do it on top of the job that just about services the debt. And the result is that I continue to break, at fairly regular intervals, and each time I break it is slightly harder to build back to a slightly lower level than before.
My story could be many people’s stories, but what it illustrates is how deeply intertwined poor mental health and financial difficulty are – and just how long a shadow that relationship can cast when it affects you as a student. So these two issues are intertwined and can’t be treated separately. But they are not just problems in our personal life. They are particular problems for higher education. And not just because students are more likely to experience problem debt and poor mental health – but because of the impact of this insidious relationship within the HE setting.
I want to take a moment to think about a reason why it matters so much that we tackle this problem in higher education setting. Just what is it that causes financial hardship and poor mental health to have such a large and long impact on students? The answer is that both debt and poor mental health strip our resources, and in particular strip us of the ability to perform at our best – at the very time when performing at our best will have the biggest impact on our life – if we don’t get a degree there are doors that will be permanently closed to us (a hint that one thing we need to change is how we go about recruiting people to key positions, and stopping the demand for bits of paper that come with a one time only chance).
The best explanation of how this works can be found in Eldar Shafir & Sendhil Mullainathan’s book Scarcity. Their work focuses on the impact poverty can have on people’s lives and the decisions we make by, in effect, using up crucial bandwidth that, if we had sufficient money to meet our needs, we could use for other things that would greatly benefit our lives. It’s no coincidence their work has become a key element of the arguments of many of us in the basic unconditional income movement.
But scarcity is wider than just a money issue. It is about every thing that makes life harder for some people than others. And that added difficulty compounds to the point where it lowers people’s ability to do anything else. And it has the greatest impact at the limits of our potential. Not tackling debt and poor mental health is making it harder for some than others not only to fulfil their personal potential at any given moment, but to obtain a CV that will open doors for the rest of their lives – and even where they are able to keep up academically, the extra resources that takes may cut short the other things people rely on to stand out.
And some, like me, will end up leaving academia altogether, and having doors closed permanently as a result that have nothing to do with their ability and everything to do with not tackling finance and mental ill health.
The negative impact goes beyond individual lives, and this is where we get to the business case. We need, as a society, and as a world, disabled perspectives as a matter of urgency. We need disabled people and our ideas at the heart of policy and research, for a very simple reason. We are, in so many ways, staring at the edge of a cliff of our own making. And the abled, neurotypical choices and leaders that took us to the edge are most likely to carry on right over.
And yet, those of us on the outside have different lives. Not because “we are all different” as the ableds love to say. But because our perspectives are not the same. Our answers are not the same. Damn it my questions barely rub shoulders with other people’s. Our lives make different shapes; we occupy different spaces. And it is this difference that offers hope.
If we are going to survive the 21st century we must solve a whole raft of complex problems of our own making, from climate change to transhumanism, food security to how to control general AI. Yet for all our determination as a world to solve them we remain determined to do so through the same ways of thinking, the same ways of finding answers, the same ways of investing, the same ways of hiring, the same ways of apportioning research grants, the same ways of allotting credit, the same ways of experimenting that led to the problems in the first place. That is why the different perspectives disabled people bring are so important. That is the business case for ensuring as many of us get as successfully into and through higher education as possible and come out not burned out not indebted not sicker than we went in but ready, and enabled, to fulfil our potential.
So when it comes to higher education we need better protection of mental health, better accessibility for disabled students, and better financial support – and providing that even on a low level will have massive long-term benefits for those involved and for society.
So finally, what does this mean in practice? First, this is why we must ditch the idea of leaning in and resilience – it’s not just because we need to focus on the structural rather than the individual – it’s because it’s essential for a university’s mission for academic excellence, and the wider goal of maximising impact.
A key thing universities can do is to stop confusing wellbeing and wellness with how they provide for those who are sick. Yes, it’s vitally important to keep well people well and stop them falling into the cycle of poor mental health and problem debt. But that is a different thing from providing properly for those who are already ill to cut off that cycle in its step. It’s a different thing in practice because sometimes what those of us who are sick need can be the opposite of what those who are well need. It’s also, and let me be blunt – a different thing when it comes to budgets. Too often wellbeing programmes eat up equality and disability budgets. They should never do that. Spending money that disabled students need on keeping basically well students well needs to stop.
And on a similar subject, invest in your disabled and sick staff. Just as autistic children go on, we hope, to become autistic adults only to find services they relied on swept away when they need them most, so disablked students will, if all goes well, sometimes become disabled academics. They are less likely to if they know that doing so will see them unsupported. Yet the disparities in budgets for, say counselling, between students and staff in higher education can be eye watering
In practical terms what can universities do aside from this kind of spending? Make sure people don’t have to pay stuff up front; make sure advisers proactively point to sources of funding; make sure people aren’t excluded by lack of funds; make sure OTHER needs are overcatered so that resource use is minimised there, meaning that the damage from debt is less – for example understand the impact on people’s personal life of having to work more hours and be really flexible – and make sure you consider accessibility of everything from your forms to your lectures so friction overall is reduced
Most of all, don’t treat financial hardship and poor mental health as separate issues. A decade ago I worked on a project with Mind, the Financial Conduct Authority, and the Royal College of Psychiatrists called In the Red. The output was a short, clear leaflet provided to every healthcare worker in the country explaining how patients presenting with mental health difficulties might also have financial problems, and giving a hole list of places to signpost people for financial help (I worked on similar problems with the likes of Citizens Advice to make sure those coming with problem debt were given information about mental health service). What we need in higher education is at least this level of joined up thinking so that when students come forward with one issue authorities are aware that they may have the other and able to advise accordingly,
But we also need to understand the impact that these issues can have on people’s wider and longer term prospects, and we need our universities to put measures in place to ensure that frictions are removed at every possible opportunity and in all context to mitigate the wider impact of these very specific problems.
- Money and Mental Health Policy Institute “Mind the Income Gap”
- Seeking to Improve Wellbeing in Universities may have a Damaging Effect on Applicants with a Mental Illness, Dan Holloway for the Higher Education Policy Institute
The following all offer debt advice and specialise in debt advice for people who have mental health problems
Step Change – https://www.stepchange.org
National Debt Line https://nationaldebtline.org/
Mental Health and Money Advice – https://www.mentalhealthandmoneyadvice.org/
Money Advice Trust https://www.moneyadvicetrust.org/
Mind also has a list of contact, some of which are for specific issues https://www.mind.org.uk/information-support/tips-for-everyday-living/money-and-mental-health/money-and-mental-health/#FindProfessionalAdviceAndSupport
You can find a huge amount of information and advocacy for policy change through the Money and Mental Health Policy Institute https://www.moneyandmentalhealth.org/
Other Resources I mentioned
Shafir and Mullainathan, ScarcityFinally Knowing Me – on late diagnosis autism and ADHD https://finallyknowingme.wordpress.com/