How disastrous an impact has the butcher of Leningrad, Vladimir Putin, had on our collective mental health? Not as big as he’d have liked, is probably the most encouraging answer we can offer. But there is no doubt that – in a variety of different ways – he and his henchmen in Russia have cast a new kind of black cloud over the prospect of life, love and happiness across the world, since they launched their so called ‘Special Military Operation’ in Ukraine in February of this year.

When the invasion began, for many a mounting feeling of daily dread became inescapable. The more the Russian forces advanced, the worse it got. This, it became clear, wasn’t just about seizing territory, though that was part of the plan. The invasion, it turned out, was the first large-scale attempt at a new form of hybrid warfare, the aim of which was not just to annex parts of Ukraine, but to drive up energy prices, fracture the EU, break NATO and inflict the widest possible damage on democratic countries and systems by forcing Ukrainian citizens across the borders into Europe, thereby creating an unprecedented Euro refugee crisis.

Which is why every morning was approached with a freshly minted feeling of anxiety. What new horrors would be revealed? Rape of women as an instrument of war? Check. Mass murder of citizens? Check. Airstrikes on schools? You bet. And all the while the Kremlin denied that a war was happening at all.

In a sense, of course, no level of butchery is really new after Hiroshima. And yet, the sense of foreboding we feel now is of a different order. The news is on all the time. Updates happen by the minute. They ping into our phones non-stop. The headlines are followed by social media bellowing. And we have to wade through the information overload to decipher which propaganda machine is behind what, before we can come to any reliable conclusions.

Add to that toxic mix a similar, ongoing blitzkrieg of bad news on the climate crisis, the soaring cost of living, the rise of the far right and the imminent collapse of democracy and there is good reason for us all to fall into a deep funk of depression. Which is why, more than ever, we need to build our reserves. Stay positive. Be kind. Maintain solidarity. And generally become part of the solution rather than the problem.

In one respect, over the past few weeks, the tide started to turn. There has, at least, been good news coming out of Kiev. Ukraine has successfully regained vital territory. The Russian army is clearly in disarray. Vladimir Putin is looking ever more isolated and incompetent. The likelihood of an ultimate, ignominious defeat on the battlefield is growing. But we are not out of the woods yet. Far from it. Because, as the Russian army is pushed back and Putin’s problems mount, the danger that – in desperation – he will use nuclear weapons increases.

It could be a vicious winter.

HIGHEST IN THE WORLD

With all of that as backdrop, people seem to agree that there is currently an epidemic of mental health problems worldwide. It’s a proposition that’s worth examining.

People have a tendency always to think that things are getting worse. That the good old days were better. That we are all going to hell in a hand-cart. That we have lost our sense of values. That crime is rampant now. And so on. Fortunately, when we look at the statistics here in Ireland, we see that things are not so bleak.

For example, the truth is that there was a steep decline in the number of criminal offences recorded in Ireland between 2008 and 2013. Offences subsequently fell to their lowest level in two decades in 2016, and – having crept up slightly over the following three years – fell again in 2020 and 2021.

Where mental health is concerned, there may be a similar story. During the 1950s, the level of ‘mental hospital’ usage in Ireland was the highest in the world, with a rate of 710 beds per 100,000 of population. In second place, incidentally, was the (old) USSR, with 617 per 100,000. In Ireland, there were in excess of 20,000 individuals resident within mental hospitals on any single night, at a time when the population dipped as low as 2.8million. In other words, not far off 1% of the population was effectively incarcerated in psychiatric hospitals. It is an astonishing number.

And it was the Irish State and the Irish people who were responsible for this particularly unpleasant world record.

“The remarkable growth of mental hospitals (in Ireland) had little or nothing to do with the mental state of the individuals who were institutionalised,” Damien Brennan, Assistant Professor at the School of Nursing and Midwifery in Trinity College, wrote in 2014. “There was no epidemic of ‘mental illness’ in Ireland, rather this institutional confinement occurred in response to social forces such as poverty and family dynamics along with the actions of the individuals and professional groups who directly carried out the act of committal. A host of social problems were ‘managed’ in these institutions, with many individuals living out a large portion of their lives in these harsh places of confinement.”

Nothing is ever as simple as it seems. But, of course, many Irish people did have mental health issues. Suicide was common, though totally unacknowledged, because it was regarded as a mortal sin by the Roman Catholic Church. Within a short space of time, between the end of the 1970s and the mid-‘80s, within  my own family and immediate cousins, there were four suicides. I saw enough of psychiatric hospitals in that era to know that ending up in one might just feel like a fate worse than death.

Things have indisputably changed in that regard. What used to be called ‘loony bins’ are now called mental health services. Where it used to be dank and dour, a place like St. Patrick’s University Hospital in Dublin is now bright, clean and well tended. And yet the problems linger. In 2018, an OECD report ranked Ireland 3rd worst out of 36 European countries for mental health problems. An alarming 18.5% of the Irish population were recorded as having a mental health illness, including anxiety, bipolar disorder, depression, or alcohol/drug use in 2016.

Inevitably, that situation has been exacerbated by the toxic impact of social media...

Molly Russell

INCREASINGLY EXTREME

Molly Russell was just fourteen years of age when she died by suicide.

Fourteen years of age.

It is an extraordinary, heart-wrenching thought. The kind of thing that makes you want to howl in anguish.

Molly, from Harrow in North London, was described by her father Ian Russell as someone who was “full of love and hope and happiness, a young person full of promise and opportunity and potential.” She was interested in music, fashion, jewellery and Harry Potter. She had been given the lead role in the school show. But, he said, the family had noticed a change in the young school-girl over what became the last 12 months of her life. She had become more withdrawn. She spent more time alone in her room.

Her parents were sufficiently concerned to talk to her about it. Molly told them that it was just a phase she was going through. When she was with her family she seemed to be in good spirits. To them, she was – as Ian put it – “a positive, bright happy young lady, who was indeed destined to do good.” They put whatever choppy waters she was navigating down to the kind of normal teenage mood swings that we are all familiar with. They kept on keeping on, as families do.

And then...

On 20 November 2017, Molly’s parents were confronted with anybody’s worst nightmare. It was her mother Janet who found Molly in her bedroom, when she went to waken her at 7am. Molly was dead.

The inquest into Molly’s death finally took place, almost five years later, at the North London Coroner’s Court recently. At the end of the hearing, in what has been described by the National Society for the Prevention of Cruelty to Children in the UK as a landmark ruling, the court established that Molly had died from an act of self-harm while suffering from depression and what was summarised as “the negative effects of online content.”  In his ruling, the coroner Andrew Walker said that images on social media had “romanticised acts of self-harm.”

The reality, it turns out, is that – by bombarding her with hints, nudges and alerts – social media platforms had turned an initial curiosity into a dangerous obsession.

During the six months before her death, on Instagram, Molly had saved, liked or shared 2,100 pieces of content related to suicide, self-harm and depression. That is an average of well over 10 a day, every single day. Among the items viewed by Molly was what was described by The Guardian as “a montage of graphic videos containing clips relating to suicide, depression and self-harm set to music.” On Instagram alone, Molly watched 138 videos containing suicide and self-harm content.

The note that the 14 year-old left for her family contained quotes from a depression-related Instagram post she had viewed. The barrister for the Russell family described this as Instagram literally giving Molly ideas. Molly’s father Ian said that – when he read it retrospectively – the relentless nature of the content Molly had been fed had a profound, adverse effect on his own mental health.

It was graphic, disturbing, horrible. And it was pushed to an impressionable and increasingly troubled 14 year-old. People who understand self-harm, and in particular suicide, talk about a ‘copycat’ effect. When young people hear, read about or see examples of suicides, they are more likely to carry through those actions. It has been called suicide contagion. And ‘contagion’ is exactly what social media and tech companies aim for: the phrase ‘going viral’ is confirmation.

It is important to understand just how relentless – and invasive – the impact of social media really is, in particular where mental health issues are concerned. The algorithms are designed to spot what you search for or look at – and feed you more of the same. That applies to anorexia. It applies to self-harm. It applies to far right conspiracy theories. It even applies to suicide. The tendency is for the recommendations thrown up by the algorithms to become increasingly extreme, making people more likely to go further down the rabbit hole, to spend more time online. In this way, the social media companies prey on people’s vulnerabilities and exploit them mercilessly to generate advertising revenue.

Molly Russell was active also on Pinterest, where she was sent emails offering her “10 depression pins you might like.” Similarly, Ian Russell found a high number of disturbing posts relating to anxiety, depression, self-harm and suicide on Molly’s YouTube account.

“It’s a ghetto of the online world that once you fall into it, the algorithm means you can’t escape it and it keeps recommending more content,” Ian Russell said.

“You can’t escape it,” he repeated.

After the inquest, Ian Russell directly accused social media companies of exploitation. “It’s time to protect our young people,” he said, “instead of allowing platforms to prioritise their profits by monetising their misery.”

MALOVELENT INTENT

It isn’t only in the most tragic individual cases like Molly’s that appalling damage is done, by the utterly cynical way in which social media operates. Some of us have known this for a long time. We have tried to prod governments and regulators into action. We have pointed to the fact that the democratic process itself is under threat from the more or less free rein given to dark and malevolent forces, who spend money on advertising with the specific purpose of spreading lies, propaganda and disinformation.

You might be able to debate the scale of the impact of social media in different scenarios. However, we can say confidently that – to bring it back to Vladimir Putin – Russia set about a campaign of covert interference in both the Brexit referendum in June 2016, and the election of Donald Trump later that same year. That social media was one of the Kremlin’s methods of choice. And that they got the results they wanted.

It is just one branch of a wider campaign of cyber warfare being pursued by Russia and its affiliates. In relation to the election of Donald Trump, we know that the Internet Research Agency in Saint Petersburg created thousands of fake social media accounts that planned or promoted events in support of Trump. Between 2013 and 2017, they targeted voters in the USA and reached millions of social media users, spreading fake news and lies, designed to damage Hillary Clinton’s campaign. Meanwhile Russian military intelligence infiltrated the Democratic Party’s information systems and hacked emails. An investigation, led by the former director of the FBI, Special Counsel Robert Mueller, concluded that Russian interference in the democratic process in the United States, in the 2016 election, was sweeping and systematic and violated US criminal law. Trump won. And the far right insurrection of 6 January 2021 was the result.

Of course, this isn’t just about the malevolent intent of Vladimir Putin’s Russia. It is about the way in which any sick and twisted monster with access to funds can fuck with people’s minds – and with their sanity – via the internet and risk killing them in the process. And about how social media companies are complicit in this, accepting dark money on a non-stop, round-the-clock basis, totally protected against any fallout by the absence of serious regulation and their own willingness to hide behind the veneer of ‘freedom of speech’.

No wonder a Mental Health Special Issue of Hot Press feels timely...