Is there a problem in this sad old world that can’t be solved by physical jerks? I find myself muttering this, because wherever I go someone is coming up behind me, breathing heavily: a runner.

Some of my best friends are joggers – pushing themselves up hills, finishing marathons – it keeps depression and mood swings at bay and it’s free. It’s a good thing, but I cannot be alone in finding underwhelming the advice about looking after one’s mental health as if it is physical health.

For example, there is the Every Mind Matters campaign, an initiative from the NHS with a well-intentioned film featuring Prince Harry and Glenn Close. It has a “mind plan”, which gives you “top tips and advice”. I filled in the questionnaire and it told me to get off the bus a stop early, run up stairs, relax more and all that. Yes, lovely. As we go into winter, some people can barely get out of bed. Some of us feel lonely, hopeless and absolutely unmotivated. We should all talk more about our feelings – I get that – but something is askew here or at least being glossed over.

I would like to be less aware of acute mental illness. And suicide. And of the eating disorders and self-harm in so many schools. I would like not to see severely mentally ill people every day, but I do. They are sleeping on the street, gathering near hostels – abused and often abusive, clearly in torment. There is no care and no community. Do we not see these folks?

Anyone who has tried to get a bed for someone in acute distress will know they may end up being sent to another part of the country because there are none nearby. They will also be discharged way too quickly, often with a cocktail of medication and little follow-up support. They will often resurface in A&E.

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People with severe mental illness are not necessarily likable, or comprehensible. Stigma is still attached to schizophrenia and bipolar disorders. Those with these conditions may end up in prison, or as addicts, or on the streets. The economic cost of such illness is huge, the cost to loved ones even bigger.

Perhaps you will say this is a different issue, and there is a difference between serious illnesses and “wellbeing” – the new catch-all term. Does wellbeing include the pandemic of anxiety disorders in young people and the rate of male suicide? Don’t we need to be clearer about the bandied-about stat that one in six of us will have “a common mental health disorder”? Which disorder? The focus on anxiety and depression (as bad as they are) has led to this burgeoning discourse of self–help: we must all try to eat well, exercise, not become isolated – precisely the things we are unable to do when our mental health is poor. Or when we are actually poor.

The link between mental health, unemployment, bad housing and isolation is real. Those in contact with secondary mental health services have an employment rate 67.4 percentage points lower than the overall rate.

The mental health crisis is a societal problem. Individuals find little help when there are long waiting lists even for six weeks of cognitive behavioural therapy. Psychiatric care is severely underfunded.

But we must ask what it is about the way we live that makes so many of us ill. Alienation in the Marxist sense cannot explain the forms and complexity of so much mental ill health, but it is a huge factor, surely?

Likewise, delving into individual childhoods, or seeing it all as matter of serotonin uptake, is reductive. We need to understand what is happening now, in this culture of 24/7 performance on social media and workplace presenteeism. What is also insane is the constant instruction to be happy. When I was young that was for the Americans.

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Our malaise is not about individual pathologies. Self-care is never bad, but it can make it seem that, somehow, we are responsible for our own despair. Our failure here is collective – and we are failing the mentally ill in myriad ways. It is a delusion to think that people can jog their way out of serious distress, or that a bit of mindfulness is the answer, just as you can’t visualise your way out of cancer.

Awareness is cheap and comforting. What is much harder to understand is why so many of us are in pain.

Suzanne Moore is a Guardian columnist