How Alastair Campbell is confronting Westminster’s mental health crisis

He is a divisive political figure, but Campbell’s candour about his own mental health has led MPs of all parties to seek his advice.

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When Alastair Campbell was 29 years old, he experienced what he describes today as “a full-on psychotic breakdown”. Depleted by long periods of heavy drinking and overwork, the then-journalist found himself in the lobby of a hotel in Scotland, confused and afraid. His head was “full of noise”; he heard voices, brass bands and orchestras; every street sign and fragment of conversation formed part of a horrifying test, one which he became convinced that he would not survive. He began to throw away his possessions, including his wallet and his passport. When two plain-clothes police officers noticed his erratic behaviour, Campbell was arrested for his own safety and then hospitalised.

Eight years later, Campbell was in Vaison-la-Romaine, an ancient town in the hills of Provence, when he was visited by Tony Blair, newly elected as leader of the Labour Party. It showed how much Blair wanted Campbell as his press secretary that he was prepared to follow him to his holiday home; Campbell remembers that he had already “said no about ten times. I took a month to say yes.” Before he did finally agree to the role that would make him instrumental to the fortunes of the party, Campbell told Blair: “‘I need to talk you through all the things in my character and in my life that could become a problem.’ I had done things in my past …silly things… and I said ‘I know you know about the breakdown, but the other thing you need to know is, it was really bad. And it was about cracking up under pressure’… And he said, ‘I’m not bothered if you’re not bothered’. And I said, ‘what if I’m still bothered?’ and he said: ‘I’m still not bothered’.”

Campbell remembers this exchange as an expression of support from his new boss; when he participated in the launch of the Time to Change campaign in 2007, it featured on the campaign’s first poster ads. But a more cynical view might read Blair’s comments more literally: that he really wasn’t bothered. He understood the risk that the most stressful job in politics might hold for Campbell’s mental health, and recruited him anyway.

“I’m not going to pretend that Tony was perfect on this stuff,” Campbell concedes, remembering that when Labour was in power, Blair “would regularly phone me, particularly on a Saturday or a Sunday, and he’d say ‘I’m really worried about you, you seem very down’, or ‘you really need to get a rest’. And I’d say ‘yeah, I know that’. And then he’d say ‘okay, good. Right, can you give Gordon a call about this, can you talk to Prescott about this, can you talk to Robin Cook about this, what are we doing about that interview in the Observer…’ and he’d give me about 20 things that he wanted me to do that morning.

“So on the one hand, theoretically, he was very understanding. But in practice, I don’t think he…” And then the press secretary’s instincts kick in, and Campbell changes tack. “I’m not criticising him for that, because he was the prime minister, and I think you’re entitled to expect that the people around you are going to work for you well.”

Campbell calls Westminster “a laboratory against good mental health”. The long hours and the artificial, high-pressure environment in which MPs work are, he says, not conducive to happiness and stability. “For all the fuss there was about expenses, most of them could make more money doing other things. The hours are crap. You get abuse. When the papers say ‘oh look, they’re off on holiday’, actually most of them are going to be working their balls off in their constituencies… The pressures are quite intense.

“I was talking to a Labour MP this morning. He’d been out in his constituency yesterday, and the mood was absolutely vile, he was getting a lot of abuse. This is not a very nice lifestyle at the moment.”

The pressure on MPs has been greatly increased by Brexit, he says, partly because the decision-making process has been so drawn out and partly because of Theresa May’s attitude, which he describes as “we’d be able to get it all done if it wasn’t for these terrible MPs.” This is dangerous rhetoric, he warns, because it opens the door to “Farage, doing his thing about ‘we’re going to put the fear of God into these people’, and ‘donning khaki’, and all this nonsense. After the Jo Cox murder, these politicians that have fanned this – they’re playing with fire.”

For all that he has divided opinion in the past, Campbell’s open discussion of his own mental health has led MPs “from all parties” to approach him for advice on dealing with anxiety, depression, stress and alcoholism. He was recently approached by a Conservative MP and former minister who he says “thought they were maybe on the edge of a breakdown, and didn’t know how to handle it. I put them in touch with somebody that I think they should see.” Another MP, he says, contacted him because “they were getting absolutely chronic anxiety. And they’d heard me talk about what anxiety actually is, as opposed to just feeling a bit nervous, and I was able to say, I know somebody who’s a specialist in dealing with adult anxiety. … I can think of people of all parties, now, that I’ve spoken to and put in touch with mental health experts.”

One politician whom Campbell tried repeatedly to persuade of the benefits of openness was his friend Charles Kennedy, the former Liberal Democrat leader who died in 2015, aged 55, from alcoholism. “Charles and I talked a lot about his drinking and about his mental health more generally. I tried to persuade him to be more open, but I understand why he didn’t want to be, because he was a party leader. He was worried about what the media would do, he was worried about what his opponents would do. He was worried that his constituents would think he’d done something wrong.”

It is this containment, the impossibility for many politicians of being open about one’s innermost fears and compulsions in a game in which any sign of weakness is exploited by one’s rivals, that Campbell says Westminster must try to change. “It’s different for me,” Campbell concedes, “because I was never an MP – but I’ve got a very public profile, and I always say to them that I’ve never, ever, ever regretted being open, not for one second.”

In a conversation in Downing Street, Blair once told Campbell that being prime minister was “a conspiracy against normality… You can’t really have a normal life, if you’re surrounded by security 24/7. You can’t just nip out. Everybody recognises you, everybody thinks they know you. Everybody thinks they could do the job better than you.”

At a banquet in St Petersburg in 2000, Blair felt moved to explain to his host, Vladimir Putin, why Campbell had turned down several offers of vodka. The new Russian president turned to Campbell and said:
“I hope you redeem yourself with other sins.” It was a perceptive comment; Campbell’s addictions have changed, but the force that drives them has not. 

When we speak, Campbell is back in Vaison-la-Romaine, ostensibly on holiday, although he has been up since 5am, during which time he has written two newspaper articles (on behalf of other people) and a note planning the next stage of the People’s Vote campaign. “I am a workaholic,” he admits, “and I don’t think that will ever stop.” Campbell’s psychiatrist, David, and his partner, Fiona, refer to Campbell’s addictive nature as his “demon”. 

While he recognises the danger of giving in to his obsessive side – he observes that his psychiatrist is “probably a little bit worried” about the intensity with which he is working on the People’s Vote campaign – Campbell says that it is for him a matter of choosing the right things to be addicted to. In Downing Street he began running – “I realised that I could get addicted to it very quickly, which I did, but also that it could be very good for my mental health” – and ran to and from work every day. He classes his commitment to Burnley FC as a kind of addiction, a necessary “release… I could feel myself back in the real world for a couple of hours.” He has also found, after years of refusing medication, a drug that works for him. “If I’m being honest then I think it’s probably my latest addiction, this drug.”

But of all the things the demon wants, nothing compares to work. He describes the time after he left Downing Street in 2003 as a period “decompression” in which “I didn’t know what to do with my life. At the time I was quite profoundly suicidal, I was self-harming, in the form of beating myself up, physically. It was all a bit weird.” It took Campbell a long time to emerge from this “massive depression”, and when Gordon Brown began asking Campbell to return, he wrestled with the risk to his mental health. “And when I finally said okay, I’ll come back, I remember my psychiatrist said: ‘ah, the demon has won’.”

When the first volume of Campbell’s diaries was published, one early reader told him they’d got the feeling that Campbell was unhappy in government. His answer was “well, no. I wasn’t happy, and I wasn’t enjoying it. But I’m very, very happy that I did it.” While the MPs who approach him about their own mental health fear the stigma of being exposed, for Campbell it is a badge of honour. “Somebody once wrote about me ‘Alastair Campbell has had a successful career despite a history of mental health problems’. I wrote to the guy and I said, next time you write about me, think about saying that any success I’ve had has been in part because of a history of mental health problems. I get my resilience, my thick skin, from having survived. I think I’ve got a more empathetic understanding of people, because I do have a sense of what pain, real pain, feels like. I think if you know what it feels like to feel like absolute shit, and to feel like death might be preferable to life... it does give you a sense of other people’s pain. And my energy and creativity, I’ve got absolutely no doubt, comes from me having a determination to get good out of bad.”

Campbell’s first policy recommendation would be “a really major anti-stigma, anti-taboo campaign”, although he says this would need to be “matched by services” for the treatment and support of those who were led to seek help. Charities, businesses and others are already doing this work, he says, and better education and awareness about mental health “need not cost that much money”.

But good policy can only be made if it has clear goals, and Campbell warns that while health secretaries and ministers “all talk the talk about how we need to understand the importance of mental and physical health going together, and understanding when pressure becomes stress… their own lifestyles are absolutely run contrary to doing that in practice.”

In business, the arts and sciences, and the military, mental health treatment is seen as necessary and expected – “there’s not a top sportsman in the world now that doesn’t have some sort of psychological support,” Campbell points out – but Westminster continues to see questions of mental health and wellbeing as difficult to discuss in its own workplaces. The country that brought the world the principle of utility, which defined general happiness as the objective of government, has in recent years lost sight of this principle: “the combination of austerity followed by Brexit,” he argues, relentlessly on-message, is “the worst possible recipe for the mental wellbeing of the country.”

Alastair Campbell: Depression And Me will broadcast in May as part of the BBC’s Mental Health season

Will Dunn edits the New Statesman's regular policy supplement, Spotlight.