The conversation we are not having about mental illness

Wednesday Letter #27

World Mental Health Day is tomorrow. If your response is “didn’t we just have that?” or some variation thereof, you’re likely not alone. It feels like there is a new mental health awareness campaign every other week.

For the record; World Mental Health Day is October 10th, World Suicide Prevention Day is September 10th and May is Mental Health Awareness Month. 

We talk a lot about mental health, but how much are we actually doing? 

According to the World Health Organisation (WHO) around 800,000 people die by suicide every year. The most recent figures for Ireland show that 437 people died as a result of suicide in 2016. Preliminary figures for 2017 and 2018 show that 392 people and 352 people died by suicide respectively. While these figures are decreasing, we are, on average, still losing one person a day to something which the World Federation for Mental Health (WFMH)—the founders of World Mental Health Day— deems entirely preventable

I think it is safe to say that there isn’t a family in Ireland untouched by either mental illness or suicide. 

Yet, for every campaign urging us to talk to someone we also have waiting lists full of people who have reached out but the help they need isn’t there. For every assertion that exercise will improve our mental health we have news that not all of the money allocated to mental health services in last year’s budget has been released to the HSE. For every mention of mindfulness there are children and teenagers being treated in adult mental health facilities. For every discussion about self-care we are failing people who have a dual diagnosis—an addiction and a mental illness—because neither our addiction services nor our mental health services are not equipped to properly meet their needs. 

Self-care, mindfulness and chatting to our friends and family will only take us so far. Individual action cannot completely replace a fully functioning mental health service. 

When we talk about mental health our focus is quite narrow. You know the story; a well known person shares their experience of anxiety or depression and how they overcame them. We rarely hear from people experiencing bipolar disorder, schizophrenia or other psychiatric illnesses. Even the voices we hear from about anxiety and depression often come from a place of wellness and the underlying message is I recovered, here is how and now it is your turn. 

As someone living with bipolar disorder it is difficult not to see this as anything other than respectability politics. We are OK discussing mental health, but don’t mention mental illness. And definitely don’t mention mental illnesses that involve relapses after periods of wellness. We are not capable of dealing with those messy and complex emotions. Look at how people react to Sinead O’Connor when her mental health issues fall outside the anxiety and depression norm. 

This is not about pitting one mental illness against another. There is value in discussing anxiety and depression, but when we make them the sum total of our mental health discourse we are doing everyone a disservice. We all have mental health and it is important to look after it. But when we draw a distinction between mental health, mental ill-health and mental illness we end up ‘othering’ people who do not fit neatly into our comfort zones. 

The stigma we have worked so hard to bust is still there. And it will remain so until we confront the true effects of mental illness in all its forms.

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