University of Birmingham

Lewis Capaldi's heartbreaking announcement following the Glastonbury festival and after his vocal problems that left him almost unable to sing his final songs sparked lots of discussion about mental health and chronic conditions.

People with mental and neurological conditions can face stigma - a negative attitude or judgment based on a characteristic that differentiates someone from the perceived norm. The stigma can be structural and come from the way the system deals with those conditions or comes from the society and the community where the person lives.

In many instances, people internalise the stigma - accepting the negative stereotypes or judgments that others have about their condition and apply them to themselves. This can make them feel ashamed, worthless, or hopeless. Internalised stigma can affect patients' self-esteem, relationships, and willingness to seek help or treatment. Conditions such as Tourette's syndrome can carry a lot of stigma - bringing lots of difficult emotions for patients, as control of symptoms can be difficult for them, and very often, others have difficulty understanding the symptoms.

Lewis Capaldi's reaction to what happened at Glastonbury Festival reminds us about the importance of attention to the stigma around mental and neurological conditions in society and how people affected by those conditions internalise the stigma. Capaldi apologised to the crowd for what happened and said he was annoyed with himself.

Shame and embarrassment are powerful emotions that can deeply impact an individual's psyche and social interactions. When one experiences shame, it is often accompanied by a sense of disgrace or guilt about one's actions, appearance, or perceived shortcomings. This emotion can be intensely personal, making individuals feel exposed and vulnerable as if their very essence is under scrutiny. Similarly, embarrassment arises from the discomfort caused by a public or perceived failure, resulting in self-consciousness and a desire to retreat from the spotlight. Both shame and embarrassment can manifest as physical reactions that may amplify the distress and can further impact the presence and performance of the person in public.

The model for working on mental health in society that researchers have widely suggested considers changes in both higher-order and individual levels. Changes at the higher-order levels target existing structures and reform in how the healthcare system addresses mental health and supports those in need.

With a drastic increase in life pressure in recent years following the COVID-19 pandemic and then the war in Ukraine, which increased the cost of living alongside other complications such as distance working and loneliness, the need for open discussion about mental health has become more pronounced.

With a model inspired by the way the healthcare system addressed the need for vaccines during the pandemic, the UK government announced a new level of investment in mental health, aiming at introducing innovative treatments and technologies to tackle mental health problems, especially in younger adults. The new initiative is called the Mental Health Mission (MHM) and will be delivered by the NIHR's Mental Health Translational Research Collaboration. Professor Rachel Upthegrove at the Institute for Mental Health at the University of Birmingham leads this network in collaboration with Professor John Geddes from the University of Oxford.

Our society is changing, and the Government's investment in mental health promises broader discussion around mental health care and individual emotional wellbeing. Discussing mental health will break barriers to discussing vulnerability and mental health issues. Emotions serve as powerful signals, reminding us of our humanity and the importance of social norms, but they can also be burdensome, hindering personal growth and self-acceptance.

Along with providing new treatments, a greater understanding of these issues and their normalisation would help people reduce the internalised stigma associated with these conditions. Removing associated stigma enables individuals to seek help and not be afraid of talking about the pressure on them, which can reduce the burden of their condition. It also adjusts society's expectations, removing pressure on people struggling with those complications.

Before the Glastonbury festival, Lewis Capaldi talked about the pressure of consecutive shows and how he needed to take time to look after himself. After the Glastonbury show, he said he might take a longer break. The reaction and support he received in the show and following his announcement suggests that increased awareness in public will pay its dues back to society and can be another step forward for better mental healthcare.