Tokenism In Mental Health Awareness

Written for QLD Mental Health Week 2020

Saturday 10th October is World Mental Health Day and I feel a little conflicted about highlighting it. There are a lot of positives to having dedicated days or weeks to draw our attention to mental health. But I also believe we need to approach these awareness days with a little caution. It’s too easy to post or repost something related to the topic, tick the box of doing good and move on with our days.

Ironically these tokenistic efforts are becoming more common as awareness around mental ill health grows, especially when we don’t have to move beyond the comfort of our keyboards to feel as though we are achieving change. Of course it is good that there is more awareness, tolerance and marginally less stigma surrounding mental ill health than there was fifty or even twenty years ago. But we have to make sure we don’t replace the old insensitivities with their more modern counterparts.

I have written about my dislike of RUOK day before RUOK Day: Full Disclosure and this year I heard another perspective that reenforced my reasons for disliking this day. When I am well, my psychiatrist appointments usually consist of me requesting scripts for any medications I am running low on, a brief check in with how I’m going and then we chat about the state of the world, my advocacy work, his psychiatry work. This year one of my appointments happened to fall around RUOK day and we talked about the pros and cons of this day. I expressed my opinion and my psychiatrist referenced one of his patients coming in on RUOK day in distress because they were bombarded by people they knew asking them if they were ok. People they didn’t hear from for the rest of the year. People who were probably well intentioned, but using them as the token mentally ill person in their lives, to tick the box of having asked: RUOK?

Awareness around mental ill health should not be confined to one day or one week of the year. Episodes of mental illness flare unpredictably and feel as though they will never end. This feeling is fed by the fact that no one can tell you when it will end. There are good days and worse days. There are days when the risk of it turning into a terminal illness skyrockets. Someone may have a spectacularly good day on RUOK day, a calm and uneventful mental health week, but be suicidal sometime in April or on Christmas day, when it is all too easy to be under the impression that we showed our support for those among us living with mental illness back in mental health week, and Christmas day is busy and by April we are into Caesarean awareness month and IBS awareness month.

 So what can we do to be meaningfully aware of the impact mental ill health has on those of us who live with it, and what can we do to support them for more than a day or a week of the year?

Everyone who lives with mental illness is different and everyone’s experience is different even if they live with the same diagnosis. So, I don’t speak for everyone.

For me – I don’t need to be asked how I am. I have enough insight into my Bipolar 1 Disorder to know when I need to seek help. I am fortunate to have good support systems in place, so I don’t tend to feel lonely or isolated.

For me it is all about the language people use. Hearing or seeing stigmatising language either in the media, on social media, or spoken, punches me in the gut. When I am confronted with words like nuts, crazy, lunatic, psycho, mental institution, – the list is long – it belittles me. It strips away the facts of my life, my healthy functional relationships, my personality, my university degrees, my profession, my interests, my sense of humour and it reduces me to a hellish caricature of who the misinformed masses believe someone mentally ill is.

So, think about how you write and speak around me. If you hear or see someone else perpetuating stigmatising language around mental illness, call it out. Do so politely, but raise awareness of it. I do it as often as I can, but I also get tired of being told to shut up, get over it, or that I am overreacting.

Perhaps the most helpful thing you can do for someone in your life who lives with mental ill health is not to automatically ask them how they are, but to ask them what you can do to make them feel valued and supported all year round. They may answer: ‘Ask me how I am’ in which case you are doing it meaningfully and mindfully, not because it is a certain day of the year.

All that said, Happy World Mental Health Day everyone. In honour of it also being Queensland Mental Health Week from 10th-18th Oct I am aiming to drop a few additional posts in Thought Food this week.

Look after yourselves and each other!

You may also like to check out:

RUOK Day: Full Disclosure

Mind Your Language Katy Perry

Don’t Call Conspiracy Theorists Crazy

My 2018 World Mental Health Day

Inked20181010_192225_LI

How was your World Mental Health Day? Mine happened to be pretty shit.

It doesn’t really matter, because mental illness doesn’t respect particular days, especially those deemed meaningful by human beings. I’ve spent enough birthdays, Christmases, and anniversaries in hospital with a mental illness to lend weight to this theory.

Paying homage to mental health (ours or others) on a designated day seems like a nice idea on the surface, but I’m not convinced it does a lot. I suspect it makes people who don’t suffer a mental illness feel good if they remember it or mark it. But is this just another version of tokenism? Does it really make any difference to the lives of people living with mental illness every day of the year?

A very smart woman who ran the SANE Peer Ambassador training workshops I attended recently made the excellent point that we don’t have World Physical Health Day.

And that is because every single day is World Physical Health Day. It would be far better to reach a point in history where caring for ourselves and being sympathetic towards those around us with mental illness is as matter of fact as caring for our physical health. We shouldn’t need World Mental Health Day.

Here’s what today looked like for me:

10 am

‘You look flat’

There is only one person I trust to make this assessment, and it’s the one who spoke to me. My psychiatrist. He and I have known each other and worked together for just over twelve years now. And I have trusted him with my life many times.

For the last four days I have felt flat. It started with a sluggish Sunday. But everyone has those. Right? I am exhausted. That’s ok, understandable. It’s been a stressful couple of months. However, in the space of those few days ‘I’m exhausted’ morphed into: ‘I am exhausted by life.’

I have been on this runaway train often enough to know that feeling exhausted by life is the last stop before suicidal ideations set in. And that is where it turns into not ok. By yesterday, when I made the appointment with my psychiatrist, I was feeling worthless. Black thoughts crept in and crowded out the positive, the motivated, the real me.

Thankfully I have the insight to recognise these feelings and thoughts as imposters. These are symptoms of depression setting in. They have been waiting in the wings for their moment. My Bipolar Disorder is here to collect, on all the stress and sleep deprivation I had no say over in the last few months.

In the past I went to war against these thoughts and feelings. So naïve to think I could somehow out think or out feel them. Such a rookie error. As is waiting to see how it will all play out. That tends to land me in hospital for months at a time. So, after four sluggish days, feeling flat, off, down, irritable, and with my memory and concentration beginning to fray I walked into my psychiatrist’s consulting room this morning. That’s when he proclaimed, before asking me a single question, that I looked flat. And I felt relieved, because I knew I’d been right to come.

I listed my symptoms. He looked at my chart. Then, reminiscent of a pilot attempting to correct a plane out of a nose dive, he said:

‘Let’s increase the Lexapro by 10mg and halve your Lithium dose until your mood comes back up. As soon as your mood lifts, go straight back onto the full dose of Lithium. And keep your appointment for next Friday.’

‘Good. Let’s try that.’

Then we speak of the heavy truth between us:

‘And if I crash before then….’

‘Then you will call me and come into hospital.’

Neither of us want that. Neither of us want the months in hospital possibly having ECT, because I’ve become catatonic. Yet we both know it’s still a possibility.

So, in honour of World Mental Health Day 2018 – here are my thoughts on what will get me well again:

Insight. Communication. Early intervention with a medication adjustment. Fingers crossed. And luck…so much fucking luck…

Making Sense Of It

Treatment

What Does Someone With A Mental Illness Look Like?

Sick Not Selfish

Wedding Breakfast Spoiled

Lessons For A Control Freak