Mental illness is nothing to be ashamed of, but stigma and bias shame us all — Bill Clinton
Mental health awareness is certainly making its rounds in the media these days, and while I am delighted to see it, myself and others working in the field know that we have so far to go as a society. So often, what we see on the streets is the result of tragic circumstances that have been left untreated for years, if not decades. Homelessness, addiction, poverty and street-level crime are all part of what contributes to the continued stigma of mental illness.
Blatant, serious gaps in service, funding and early intervention exist as huge obstacles to the betterment of mental health treatment. And with so many different opinions on treatment, that range from medication to meditation, no wonder we are in such a state. While the reality of mental illness can feel like a losing battle, it’s not. Hope gleams from every corner. In recent years, there has been an upsurge in awareness of illness, and with that came the commitment and movement for treatment. Certainly, we are seeing a time where the walls and barriers to services are being renegotiated and dismantled. But one of the core components that we are missing is the piece around connection and community.
The secret to human connection is in compassion: the warm feeling of care and concern that we feel when we notice that someone is suffering, followed by the desire to help. When we feel compassion, it is because we, too, know suffering, and the pain of another evokes the desire to nurture. Judgement, criticism and ridicule cannot co-exist with compassion. Compassion says, “me too,” rather than commenting, “pull yourself together.” It expresses, “that must be so hard,” instead of declaring, “why are you making these terrible decisions?” It asks, “what do you need in this moment?” as opposed to responding, “why can’t you be like everyone else?”
When I was doing my undergraduate degree in social work, I remember learning the “Plexiglass” theory. As budding therapists, who would soon be thrown face-first into the realities of a world that can be cruel to its inhabitants, we were told to simply pretend that between us (the aspiring social workers) and them (our down-and-out clients) a thick layer of Plexiglass existed. Apparently, this was the way to protect ourselves from getting too personally invested in our clients’ sadness.
I NEVER GOT THE PLEXIGLASS DOWN.
Five months after I joined the mental health and addictions field as a front-line social worker, I ran hiding back to graduate school in public policy. I wanted to make change. But most of all, my inability to remain unscathed after working 12 hours shifts in crisis mental health filled me with doubt. I couldn’t eat a sandwich following my work with a woman who had found her child dead by suicide. I also couldn’t drift off to a peaceful sleep after seeing another client with unmedicated schizophrenia, demanding to know if I was tapped, begging voices that I could not hear to stop yelling at her.
For years, I stayed away from the front lines, despite my draw to help those who were suffering. Instead, I poured my heart into climbing the corporate ladder, making programs for the early intervention of child and adolescent mental health and delivering training programs based on the research that I safely devoured.
It wasn’t until my own mental health crisis rocked my world years later that I began to experience life on the other side of the Plexiglass. After leaving a marriage that broke both my heart and the side of my face, I experienced a sadness so profound, it was palpable. The ceaseless anxiety I endured stole my sleep, and the most basic of decisions felt like I was deciding between cutting the red or blue wire. I began to shrink inside of myself, feeling isolated from everyone and everything. The shame of my personal failures played on repeat at every moment of rest.
IT WAS DEBILITATING.
That year, I moved through life desperately trying not to let my sadness take me under. I avoided friends because I felt that, comparatively, I had failed at both life and my own happiness. Despite having what I had always considered an innately cheerful disposition, I began to see everything as though I had “sad” glasses on. The world seemed ruthless and merciless. I was trapped and unmotivated. I saw myself as cut off from the rest of the world and after noticing that this was dragging on (and on, and on), I decided that this was looking a whole lot like depression. I took the first step and asked for help.
It had been a long time since I’d been on the receiving end of counselling, and I couldn’t help but notice how much things had changed since the days of the Plexiglass. My therapist was kind and warm, and she shared parts of her own life with me. I felt validated and connected, and her assurance (and reassurance) began to inspire hope that I could rebuild my life — which I did. It took time, but I began to heal. I returned to frontline mental health counselling, though this time I did not bring my Plexiglass with me.
I BROUGHT MY HUMANITY.
The past 5 years of my 13 in mental health have shown me that while recovery from mental illness is not only possible, it’s achievable for everyone. But the secrecy, stigma and shame that surrounds mental health perpetuates its severity. I want to be exceedingly clear: recovery is different for everyone. One person might find that recovery means getting over anxiety about driving, while for someone else, it may entail going to the mall.
The other lesson I’ve learned? In some way or another, we are all, at different times, dealing with our own version of mental health problems. All of us. Yes. The person sitting beside you reading this? Them too. The person at work who seems perfect? Yep. Even Beyoncé.
ALL. OF. US.
Which can only mean that if we have all experienced tough times or lingering distressing emotions, we should all be helping each other, or coming “clean” when we are struggling. Except that we don’t.
I’m a research gal, so let’s take a look at the facts. According to the Canadian Mental Health Association, by the age of 40, 50% of the Canadian population will have had or have a mental illness or mental health problem. In any one year, 1 in 5 Canadians will personally experience a mental health problem or illness. The staggering rate at which youth (14-24) have a mental health disorder is 10%-20% — the highest prevalence of disabling illness worldwide. While 70% of mental illnesses begin during childhood or adolescence, only 1 out of every 5 children who need mental health services will receive them. In Canada alone, 11 people die by suicide each day, with suicide being the second leading cause of death for youth aged 15-24. Our First Nations youth are 5 to 6 times more likely than the national average to die by suicide.
And then, there’s addiction. A 2012 study found that over the course of a lifetime, 1 in 3 Canadians met the criteria for a substance-related disorder. People with mental illness are twice as likely to have a concurrent substance abuse problem, and people who have a diagnosis of schizophrenia as well as a substance use problem could be as high as 50%. In Ontario alone, the annual cost of alcohol-related health care services is estimated to be a whopping $5 billion.
One might think that with the research painting what I would still consider to be a fairly conservative picture of the extent of mental illness and addiction (after all, we can only count the individuals who report these problems), we would be open to lending a hand as much as possible. The sad reality is that the stigma of mental illness and addiction — while making great strides each day — remains one of the biggest barriers in
receiving help.
It seems almost inconceivable that a societal issue could be this widespread, but not be openly discussed. Yet every day, in my office, scores of people talk about their feelings of crippling unworthiness, worry that won’t let up, emotions that flood them… and then, they tell me that I am the first person they’ve told. Or, that only one other person knows, but doesn’t know the extent of how they are feeling. Many times, the individual’s spouse won’t even know.
Although 50% of Canadians would feel comfortable discussing mental health concerns with family or friends, it is lower than the 68% that would do so for diabetes. Nearly half (46%) of Canadians felt that people use mental illness as an excuse for bad behaviour, and while 58% said that they would socialize with a friend who had a mental illness, only 26% would socialize with a friend who had a drug addiction.
Research seems to all be saying that people want to be asked about their struggles. So, what are we to do? We are afraid of talking about “darker” feelings, scared to be seen as weak or making excuses. Consequently, we hold things in. On the other hand, we want to be asked, comforted and helped through our tough times. On the flip side, we are uncomfortable with the concept of mental illness and addiction so we ignore it, or turn away from it. Sound confusing? It is. We want to help, but we don’t know how to.
Feedback that I hear from family members and friends is that they don’t know what to say to their loved ones who experience mental health troubles. They are worried about saying the wrong thing, or feel so uncomfortable discussing feelings that they say nothing at all. Other times, I have been told that the fear of not being able to effectively help a person struggling with their mental health is the biggest block of all. People want to help — they just worry that they can’t, or could even make things worse.
Remember that people who need help can look a whole lot like people who don’t need help. If you’ve noticed that a friend has gone silent, seems angry, is cancelling plans or makes constant jokes about being a failure, I would say that there is information for you there. When people ask me how to help someone who is struggling, I ask them to think about what they might need when the chips are down. Usually, we need to be heard and validated. We need to be listened to, and know that our pain is seen. Asking someone with genuine concern and carving out time for them to speak to you about their life is a great gift that you give to others. You do not have to fix anyone else’s life or their personality, for that matter. You do not need to have the answers. Allowing someone the opportunity to be heard and to feel valued can do a lot of good for their mental health.
“But what if someone says something really scary, like they are thinking about hurting themselves?”
This is serious, and you should treat it as such. You should also remember that you are not responsible for fixing this issue — but you can take actions to ensure someone’s personal safety. If someone confides in you that they have been thinking about suicide, you can encourage them to attend their nearest mental health walk-in clinic (London has a 24-hour mental health walk-in at 648 Huron Street), or take them to the emergency room.
Humans are a species that depend on each other for our very existence. We cannot survive without one another and we are interconnected at our core. In his illuminating TED talk, Jonathan Hari, a journalist who studied addiction treatment in Portugal, states, “the opposite of addiction isn’t sobriety; the opposite of addiction is connection.” Similarly, author and speaker Andrew Solomon claims, “the opposite of depression is not happiness; it is vitality.” I would agree with both of these viewpoints to varying degrees. What mental illness cannot withstand is communication, connection, meaningful activity and hope, and we cannot do these things without each other.
Written By Jordan Thomas
BSW, MPA, MSW, RSW
Nourish Counselling Services
www.nourishcounselling.com