Why is mental health awareness important?

This year we have chosen to focus our campaigns around the theme of why mental health awareness is important to you.

To many individuals who struggle with serious mental health conditions, this question may have a relatively simple answer: awareness plays a large part in reducing the stigma surrounding mental health. On the face of it, this appears to be a fairly simple response; however, in order to understand this statement we need to ask ourselves what is meant by ‘stigma’. What forms does stigma take? Who is responsible for stigmatising the mentally ill community? Why is it important to reduce stigma? The answers to these questions are not so simple and are dependent on a variety of different factors.

What is meant by stigma?

An overwhelmingly complex question, there can never be a black and white answer to this. Webster’s new world dictionary offers this definition: “Stigma is a perceived negative attribute that causes someone to devalue or think less of the whole person”. It’s not a bad attempt at an explanation, but the truth is that the answer will depend on who you ask. My personal experience of stigma is a lack of understanding or willingness to understand the complex difficulties experienced by those with mental health conditions. In general, most individuals you speak to will say that they have felt like they cannot freely speak about their experience mental health difficulties to others without judgement, or fear of ostracisation. Indeed, the Anti-Bullying Alliance (2017) states that those with mental health issues are more likely to be bullied, while the British Association for Psychopharmacology (2011) reported that nine out of ten mental health service users experienced some form of stigma.

What forms does stigma take?

Answer: how long is a piece of string? In truth, there are so many ways this takes that I could create an endless list, but for now I will have to make do with a shortened edition of some aspects that I have experienced or worried about myself. (NB: there is no particular order to the list below).

1. Being told that you are attention seeking and making it up.

2. Being told that mental health issues don’t exist and you’re a liar

3. Being told ‘It’s just a phase’

4. Being told you’re/thought of as ‘crazy’, ‘a freak’, many other derogatory slurs and being physically bullied besides

5. Being judged

6. Being ostracised

7. Being pitied

8. Being laughed at

9. Being seen as weak

10. Losing friends and family

11. Being told it’s your own fault

12. Being told it’s all in your head

It has taken me many years but I am finally at the point where I can stand up for myself and will readily debate with friends, family, and strangers about all the reasons why these aspects of stigma derive from a lack of education on mental health and how holding these stereotypes is damaging to the mental health community. Many are not so fortunate and still face many of these stigmas, and may well believe in them themselves.

The price of the stigma is clear; it means that people are afraid to speak out and seek help for serious issues. As a result, their mental health declines to the point of the extreme, resulting in either, more serious interventions needed - which is more time-consuming, costly and harder to access - or, they have to be sectioned, a serious problem in itself, often found to result in institutionalisation and will ruin people’s lives to the point where they cannot return to normality. People may have to rely on benefits and the welfare state because they cannot hold down a job, or, worst case scenario, they will end their lives. While these examples are at the extreme end of the spectrum, they are nevertheless a reality faced by many people across the world. The research shows that in most circumstances, early intervention results in a better prognosis, less reliance of pharmaceutical, and other serious interventions. That being said, for the more serious conditions, it is sometimes impossible to manage solely through promotion of good well being - though it certainly helps - schizophrenia, bipolar, and major depressive disorder are normally only successfully treated through the use of pharmaceutical interventions, alongside other therapies such as CBT.

So, who is responsible for perpetuating the stigma?

Truthfully, we all are, no matter how well educated and understanding we are of mental

health we all inadvertently say little phrases that misrepresent mental health. For example, “ugh, that’s so depressing”, or “I’m so OCD”. The general use of those terms is not helpful when it comes to people discussing their true meaning. Saying, “that’s so depressing” implies that the small everyday sad stories or incidents are akin to a bout of major depression. Though, major depression looks vastly different, physical ailments, loss or gain of weight, lethargy, crying for no reason, and sometimes having intrusive thoughts of self-harm or suicide, to name but a few. Saying, “I’m so OCD” when you are referring to little habits such as being particularly neat or preferring things done in a certain manner, is simply misinformed. OCD as a clinical condition is characterised by intrusive thoughts that re-occur and are distressing, which sometimes results in compulsive behaviours, but is by no means simply having to wash your hands 5 times each time you wash. Many individuals with OCD and other disorders such as anxiety or depression will tell you that they would much rather deal with the depression and anxiety than OCD. It is incredibly distressing and impacts on almost every aspect of daily life, depending on the individual.

That being said, using these phrases is not the only cause of stigma. The media misrepresents and encourages the stigma in many ways. Not only by writing in these sorts of phrases, but by labelling characters as ‘crazy’ or ‘mad’ when they are written as Schizophrenic or Bipolar, for example. But also, there is a complete misrepresentation of these conditions in their portrayal, a recent popular TV example being Netflix’s Thirteen Reasons Why. This show needs little more than a look at its plot to understand what is wrong here. A young teenage girl struggles with home life and school and decides to kill herself, leaving behind a box of tapes for her classmates to find and figure out her reasons why later on. Most people think immediately of depression when they think of suicide and the implication here is that she is depressed. To justify such an extreme step the writers decided to write her as a troubled teenager who isn’t the most popular and whose parents are getting divorced. This perpetuates the stereotype that depressed people are just teenagers going through a rough patch. This stereotype is damaging in so many ways; firstly, depression is not solely a middle class white teenage girl problem, anyone can have it, though there is a genetic link. It does not discriminate on a class, race or on a gender basis. Nor is depression a problem limited to teenagers, though it is important to note that due to hormonal changes it is definitely true that young adults are more likely to develop depression at this point in life, but these people are also usually biologically prone to depression and the hormones act as a trigger. Furthermore, although more girls/women seek help for mental illness, professionals estimate that sufferers are split evenly between men and women, with 75% of complete suicides being undertaken by men. This show trivialises the realities of depression and encourages those who have not been educated in mental health to believe that this is what depression is. Thirteen Reasons Why is just one recent example in a wealth of films, TV shows and other media outlets which provides severe misinformation on the reality of mental illness. I simply use it here to indicate how misunderstood we are as a community, even with so many people speaking about mental health today.

I want to leave you with this; educate yourselves, talk to others and open up the conversation. Talk about mental health in all its forms, find out about schizophrenia, learn why it is not split personality disorder and tell others. Catch yourself saying phrases that may perpetuate the stereotype, and ask what did you mean by that? And ask yourself, why is mental health awareness important to me?