Now That We're Talking About Mental Illness, What Comes Next?

Photo by Matt Collamer

Efforts to get people talking openly about mental illnesses give visibility to people with mental health concerns. For some sufferers, it pulls them out when they didn’t even know that they needed to be pulled out towards help.

While motivated by charitable intentions and clearly beneficial for a great number of people, it is a first step of many and an open door to deeper understanding and respect. It also requires an appreciation that not every sufferer of any mental illness wants to talk about it and they may need you to stop asking them to. Feeling forced to talk about something I don’t want to talk about isn’t comfortable, worse still, it could also be an invasion of my privacy.

You see, mental illnesses and the suffering it causes can be quite intense. Society can pretend that everything will work out, but that is no more likely than for any other illness. If we understand mental illnesses to be illnesses, why would we think otherwise?

The Illness-Cure Model or the Disability-Accommodation Model

Talking is a strength, not a weakness. Movements in recent years to get people to talk openly about mental illnesses are good and meant to create more acknowledgement that people are suffering and share what we can do about it. It’s a start. It’s a platform. But, it can’t be the end point.

It is worth noting that sometimes the platform can perpetuate the stigma and undermine a deeper understanding. For starters, not everyone gets better the way you expect them to. Bob and Dawn got better, what’s wrong with Rick? When my girlfriend leaves me, I am sad and maybe I can cling to my friends and family and pull myself through. But if I am clinically depressed I can’t just buckle myself up to health. Sometimes people don’t understand that and the public discussion can entrench the stigma by making it look like I’m not trying hard enough, without realizing that my severe clinical depression stops me from functioning on a daily basis, forget about climbing mountains of change! I might still make additional attempts to harm myself. Are you okay with that? Are you able to witness the hidden side of my suffering or is it too uncomfortable for you ? If the public conversation says no, the stigma is further strengthened.

Photo by Stas Ovsky

The bias is perpetuated and a deeper understanding is undermined when we ignore how complex mental illnesses can be. When we talk about mental illnesses it can be the same as talking about having a cough - I may be fine but, then again, I might have lung cancer. On the surface I have a cough. But I may actually have something much more.

The stigma is strengthened when we fail to understand that someone with a mental illness may not be able to help themselves - may not know they even need help - BECAUSE of their illness. What if I am so low that I can’t get my thoughts together? If my will is not there, because of my illness, how do I get better? The disease has removed my motivation. I have no energy to put my feet on the floor and follow the path you hope I will follow. That’s ‘just depression’, now imagine if I have something on the psychosis spectrum. I don't have insight - I don’t even KNOW that I am ill! If I don’t know, why would I ask for help? I will continue suffering KNOWING that there are things in my world that I believe to be true whereas those around me tell me they are not. I withdraw more, suffer in silence more. So I will not ask for help because, for me, this is my life.

When I am very ill and I don’t have insight into my condition, then the last thing I need is for people to hide behind the niceties of society - I need them to stand up and get me the help I need! I won’t ask for it. I don’t know that I need it.

If we ignore the severity of what mental illness does to us, then we are contributing to the stigma. There is a subset of people with a mental illness who have mild, moderate or severe suffering and might get better if they work hard at getting better and get the appropriate care they need. But there are also people who suffer more severely and there will be extensive periods in their lives when they won’t be better and can’t get the right treatment and sometimes even with appropriate treatments won’t feel better.

Because we have created a subset of sufferers, one group “doesn’t try hard enough”. Is that where our narrative leads us ?!

I am me! Not my illness!

Even though I might struggle with a mental illness, I am still a person. Someone in a wheelchair, someone fighting cancer, someone with heart disease - we are all people. Regardless of my challenge, what I need are the supports and resources to live the kind of life that suits me best.

If I have been through a severe mental illness and my abilities only allow me to wake in the morning and get some coffee and go for a walk, what makes society think that my life is less meaningful than theirs? The realities of my life are different than someone else’s. I determine what makes me satisfied in my life. How I should live should not be judged based on how you live or even “the average person” lives. I am not average. But I am a person.

I want some semblance of my life in my life.

The Next Step

Photo by Gus Moretta

The next step requires commitment. The next step is to talk about severe and persistent mental illnesses. Highly complex situations which require treatment from people trained in these fields. Experts.

Complex problems require complex solutions. Oversimplifying mental illness is not the answer. We will end stigma by understanding that there are needs based on what the suffering is. We need more appropriate resources directed toward people who have more severe mental health issues. For some of us we have to move away from the illness-cure model to the disability-accommodation model for severe mental illnesses.

Start Asking Questions

Become a productive member of society and raise your voice for a person who may not be able to speak up. I need to know that my community cares about me. That it is going to do everything it can to ensure I have some degree of stability in my life.

There has to be community ownership of services, better access to services, for those who are the most vulnerable. What services are available for serious mental health issues in your area? How many psychiatrists do you have? How many psychologists do you have? How much is enough? Once we start asking questions we will educate ourselves and speak up!

Would a community not get together if a park was required for children and dogs to play in? Would a community not get together if a shopping mall parking lot did not have wheelchair parking? Would a community not get together if there wasn’t adequate marking for a street crosswalk near a school? But what about me, when I have a severe mental illness ? If you care, ask questions and learn what it takes and what is needed to support me in my community and do what you can to work for those resources.

That’s the next step.

You might feel overwhelmed. Don’t. By openly talking about mental illnesses  you have taken the first step to understand something that has been behind closed doors for so long, it shows you have an open mind. One step at a time, you will learn how to help.

Do you really care? Yes you do. If you didn’t care you wouldn’t be at the end of this post. This is an important step you are taking in a journey in which we, you and I, are going to walk on together. You care. I care. More to come...