Left Behind: Missing Voices From Mental Health Awareness Narratives

By Elliot Mears

May was Mental Health Awareness Month and as on World Mental Health Day and other similar dates, social media was awash with posts about breaking down stigma and reaching out. Individuals and organisations affirmed that ‘it’s okay not to be okay’ and the like, lists of helplines circulated; all of this is valuable, but I can’t help feeling a little disillusioned with it all. The focus of most campaigning I see is on anxiety and depression, I’ve even seen ‘mental illness’ and ‘anxiety and depression’ used interchangeably. I suppose it makes sense to centre the conversation on some of the most common disorders. I think part of the reason stigma around anxiety and depression has reduced more than it has for other conditions is that they’re easier for others to understand - everyone at some stage will feel anxious or low in response to something. It’s much easier for someone with no experience of mental illness to imagine what it might be like to live with an anxiety disorder than say psychosis, because they will already know what it feels like to be anxious. Whilst the progress we’ve made as a society when it comes to understanding those with mild and moderate anxiety and depression is great - those who are more severely unwell or have more stigmatised diagnoses and symptoms are being left behind.

If we are to build a society where mental illness is not stigmatised, we are going to have to confront the reality that mental illness can be ugly. Whilst a lot of the time our struggles are invisible, a lot of the time they are not. I quite literally wear my struggles on my sleeve in the form of self harm scars and I am stared at, asked to cover up, shamed and have been shouted at in the street. We can preach about reaching out as much as we like but are we going to be understanding when a friend comes to us with a ‘scary’ symptom like hallucinations? Are we going to be there for a friend if they are sectioned? Or diagnosed with psychosis or a personality disorder? Are we going to reach out if a friend becomes severely unwell? All too often the answer is no. People are kept at arm's length when they are seen to be ‘too mental’.

Very little of this comes from people actively having bad intentions but stigma is still so pervasive when it comes to severe mental illness and the accompanying experiences. A lot of this, in my opinion, comes down to the fear of the unknown and misrepresentation; if you know nothing about psychosis aside from references to ‘psychotic killers’ in popular culture, of course you’re going to react with fear when someone in your life develops psychosis. If your only knowledge of OCD comes from its use as a synonym for tidy and jokes which trivialise the illness, of course you aren’t going to understand how distressing and life limiting the condition can be. If your only knowledge of psychiatric hospitals comes from horror films depicting asylums of a bygone era, straightjackets and dangerous caricatures of their patients, it makes sense that you won’t know how to support a friend on an inpatient unit.

We have to do a better job at educating ourselves and each other, we have to unlearn the myths about mental illness we have unconsciously absorbed in order to create a society where those affected by mental illness can live without shame and judgement and we are better equipped to support one another.

As well as listening to the experiences of those suffering with more severe or stigmatised conditions and trying to fill the gaps in our knowledge - it’s also important to notice and address the ways stigma works its way into our everyday lives. How many times have you heard someone say ‘I’m so OCD’ when they mean tidy or particular? How many times have you heard a particularly bothersome ex called ‘psycho’? There’s also an intersection with misogyny there as it’s far more frequently applied to women. How many times have you heard someone described as ‘psychotic’ when they mean violent or obsessive? How many times have you been part of conversations in hushed tones about how a friend of a friend ‘went crazy’? All of this perpetuates dangerous misconceptions and makes it harder for those suffering to speak up and talk about their experiences. Often, the same people who will preach about reaching out and self care on mental health awareness days do these things without realising they are part of the problem. I am asking you to make a conscious effort to notice when these kinds of things occur and call them out, this doesn’t have to mean starting an argument. For example, if someone says they’re ‘very OCD’ about x thing, try saying something along the lines of ‘do you mean you’re particular or fussy? OCD is a serious mental health condition and very different to liking your things neat’.

Another thing to be aware of if you’re living in the UK is that telling people to reach out for help without acknowledging how cripplingly underfunded mental health services are and campaigning to change that feels very empty for a lot of us. Every single person I know who has accessed or tried to access mental health services has been let down by the system at some stage. Resources are so scarce that people are all too often ‘not ill enough’ until they are in serious danger. If we are to create a world in which people with mental health problems feel able to reach out for help we have to ensure that the health service will be in a position to support them when they do.

In summary - we need to do better. Posting a pretty inspirational quote a few times a year is not enough, we have to do the work to make change and some of that will be uncomfortable. We need to do better because there are more jokes about OCD than productive dialogues about it. We need to do better because people still feel the need to hide their scars for fear of judgement. We need to do better because there are as many online forums of people claiming to be ‘victims’ of people with BPD as there are support forums. We need to do better because the government does not consider adequately funding mental health services a priority. We need to do better because people are still suffering in silence out of shame. We need to do better because psychosis is still a horror trope. We really need to do better.