Mental health campaigns have been able to achieve a great deal in terms of reducing stigma and encouraging people to have honest conversations about their mental health. This has to be applauded. A culture of openness and non-judgement helps people living with mental health issues to feel less alienated, ashamed, and embarrassed about their suffering, and more likely to seek out treatment and support. There are, however, some issues I’ve noticed with certain aspects of mental health campaigns. I don’t want to paint mental health campaigns with a cynical brush – after all, the intentions behind these campaigns are undoubtedly good-natured. But if we want to diminish self-stigma and public stigma surrounding mental illness, then it’s essential that mental health campaigns are sensitive to nuance and accuracy.
When mental health campaigns strive to be down-to-earth, they can more effectively raise awareness. This will help sufferers, their loved ones, and the general public to gain a realistic perspective on various mental health conditions, and what support, management, and recovery entails. So, in the name of improving conversations around mental health, here are some particular instances when mental health campaigns go wrong.
Messages About Opening Up
Many mental health campaigns are focused around the pressing need for people with mental health issues to open up about them. And this is necessary. Keeping a tight lid on your emotional pain compounds suffering. Reticence about opening up can also, sadly, have fatal consequences, which is poignantly highlighted by the male suicide epidemic. Mental health campaigns, using hashtags like #ItsTimeToTalk and #ItsOkayToTalk, aim to combat this problem.
I’m sure these campaigns have helped to encourage many people to overcome shame and repression in relation to their mental health. However, I feel context is missing from the sentiment that we should just open up about our mental health issues. For example, it matters where, when, how, and to whom we reveal our mental suffering. If you feel desperate to talk to someone and do so at an inappropriate time or place, you may not instigate the conversation or response that will be helpful to you.
In addition, given the stigma and misconceptions connected to mental health conditions, having some tact about how you open up may be necessary. Revealing to someone every single unpleasant thought, feeling, or behaviour you experience in raw, exhaustive detail may be too much for someone to handle. I’m not suggesting, of course, you shouldn’t reach out to someone if you have to get something off your chest, only that issues can arise when you rely on others as your personal therapist or emotional blanket.
In this vein, then, the person you decide to open up to is also important. Revealing your mental health issues to a person on a first date, a complete stranger, or someone you don’t know you can trust could, on the one hand, catalyse a warm, heart-to-heart chat. On the other hand, it could also create an uncomfortable atmosphere or, worse yet, result in judgement, mockery, or rejection. This can be an acutely painful experience for someone living with a mental health condition.
The message to open up has to be nuanced. For courageous shows of vulnerability and pain to be met with genuine compassion, these conversations should take place in a safe environment, with caring and trustworthy people.
The Comparison Between Mental Health Issues and a Broken Leg
In many areas of life, including interpersonal relationships, the workplace, and the healthcare system, mental health conditions are not given equal weight to physical health problems. We feel comfortable calling in sick for work if we have flu but not during a bout of clinical depression. For this reason, many mental health campaigns are fighting for parity of esteem, which means valuing the seriousness of mental illnesses to the same degree as physical illnesses.
Many mental health campaigns will emphasise that we shouldn’t treat clinical depression any different to a broken leg. Of course, it may be more difficult to lend support and sympathy to a depressive than to someone with a broken leg since, in the case of the latter, we can see the problem – and in the case of the former, we can’t. Depression can be completely invisible to outsiders.
Nevertheless, comparing mental health issues to broken legs – or physical illnesses, like diabetes or cancer – is misplaced. Clinical depression is markedly different from a broken leg, and not just because depression is often hidden from view. For example, depression can make you extremely irritable, angry, short-tempered, moody, self-obsessed, withdrawn, inactive, and self-destructive. Let’s not pretend that it’s always as easy to show compassion, understanding, and support for a depressive as it is for someone with a broken leg or diabetes. Doing so often takes a certain degree of patience and empathy.
The Glamorisation of Mental Health Issues
Some mental health campaigns can be guilty, at times, of glamorising mental health issues. You often see this on social media, with share-worthy, platitudinal messages about mental health battles and recovery. The intentions behind these messages may be sincere; however, focusing on positive, uplifting sentiments may make a lot of sufferers feel worse, especially if their mental illness is particularly complex, messy, and ruinous. Being constantly inundated with motivational messages may come across as patronising, not quite grasping the severity of what you’re going through. Maybe some people are helped by trite quotes followed by trite hashtags. I personally tend to just find them irritating.
The glamorisation of mental health problems in mental health campaigns can take the form of messages about how help is out there and recovery is always possible. Which isn’t necessarily true. Poverty, personal debt, stretched mental health services, and unsupportive or judgemental family members can thwart serious attempts at recovery. Moreover, some people living with mental illness, unfortunately, don’t ever recover. We shouldn’t sugarcoat the facts. Schizophrenia, for example, is a lifelong condition for many patients.
Others may live with recurrent depression, perhaps experiencing periods of relief, yet still enduring the condition throughout their entire life. If the condition is treatment-resistant, then every approach tried has failed to work. This doesn’t mean recovery should be ruled out or given up on; although, we do have to come to terms with the unsettling truth that some people will only be able to manage or cope with their illness rather than banish it forever. The problem with many mental health campaigns is that they can portray a simplistic and unrealistic narrative about recovery. They give the impression that recovery is a smooth process, starting with a difficult episode, followed by one brave decision to get help, followed by a sort of spiritual awakening, leaving you fully functional and free from mental health issues for the rest of your life. Sadly, recovery often doesn’t conform to this romanticised ideal.
Generalising Mental Illness
Another common issue with mental health campaigns is that they often discuss mental illness with a broad brush as if all mental illnesses are the same. But this is mistaken. While all people experiencing mental illness are in a state of pain, the cause, nature, intensity, and impact of each mental illness are quite different. Bipolar disorder, borderline personality disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and schizophrenia are not the same. Some symptoms may overlap – and you can experience more than one disorder, which is known as comorbidity – but otherwise, we are talking about entirely separate illnesses.
We wouldn’t compare cancer with diabetes. Yet many mental health campaigns seem to be happy to lump all mental illnesses together. It is reassuring to see many mental health organisations dedicated to specific mental illnesses, in the same manner as physical illnesses. This approach will most likely better aid awareness raising than campaigns that view mental illness in a monolithic way, as if depression, bipolar, and anxiety are simply different flavours of this thing called ‘mental illness’. Awareness campaigns that focus on ‘mental illness’ rather than specific illnesses may appear all nice and positive. However, when you group all mental illnesses together, you fall short in terms of actually educating the public about mental illness and combating stigma.
These criticisms are only intended as constructive. I believe that by recognising these campaigning pitfalls and making changes, mental health campaigns will become highly effective at achieving their aims. At the same time, growing awareness is not enough. Mental health stigma will only truly be eliminated when actions reflect an increased understanding of mental health. This means actually living in a culture in which it is not awkward to talk about our mental suffering and where mental health treatment is as easily accessible as any other form of healthcare. We are moving in that sort of direction. For millions of people, however, progress isn’t happening fast enough.