So I’m 14 years old and it’s about 5 months since the suicide of my friend Katy Swann. It’s September, national suicide prevention awareness month. I’ve helped organize to get a speaker to come to my high school to talk about suicide prevention. I’ve introduced her and have returned to my seat in the auditorium. The speaker asks the audience the question, “What do you think keeps a suicidal person from seeking help?”
The girl sitting in the seat in front of me asks, “Why don’t they just go to God?”
Outside of the many problems with the assumptions behind this question, to use a well-overused phrase of the English language, if I had a nickel for every time that a conversation about my mental health started with the words “Why don’t you just -,” I would have enough money to pay off my college loans by now. At this stage of my life my typical response is, “Being a reasonably intelligent person, if it was just that simple, don’t you think I would have done that by now?”
Questions about my faith are particularly painful. I have actually had someone look me in the eye and say that I have anxiety and depression because I “don’t trust Jesus enough.” Coming out of an evangelical background I have read numerous testimonies since childhood about the seemingly immediate healing powers of salvation. People addicted to alcohol and other drugs that walk away cold turkey. People broken by years of abuse suddenly finding peace. And yes, people with severe mental illness, including testimonies of people that claimed to have had schizophrenia and bipolar depression, that were cured immediately by the power of belief. As an adolescent, reading and listening to these testimonies cut deeply. I always wondered what was wrong with me, why God hadn’t healed me. Especially since my mental health issues started after I joined the Church. This experience forms a large part of why I eventually walked away from the Church (but that’s another story for another day).
I’ve learned since all this that my experience is far from unique. It fits the pattern of stigma and discrimination that people living with mental illness often experience. A research study in 2004 by Patrick Watson and Amy Corrigan found that there are three main attitudes in the United States about mental illness: 1) people with mental illness are violent and should be feared; 2) people with mental illness are irresponsible and their decisions should be made for them; and 3) people with mental illness are childlike and need to be cared for. All of these attitudes are harmful to people living with mental illness because they erase our agency and limit our existence to that of a patient that must be cared for or a societal burden that must be carried. I can speak from experience when I say that they are felt deeply and keep many from seeking treatment.
Stigma and discrimination show up in all aspects of life including social and cultural interactions and political and economic policy. In this two-part series, I will break down how discrimination shows up in these areas and why it is problematic and harmful. In part one I will focus on social and cultural interactions, focusing on language and public visibility of mental illness. In part two, I will focus on political and economic policy, including access to services and resources, gun control policy, and the impact of mental illness on special populations.
Part One: Social and Cultural Interactions
Our social and cultural interactions contain some of the most insidious forms of stigma and discrimination. Our language forms a feedback loop of stigmatization: revealing our underlying biases about mental illness while shaping how with think about the people living with the conditions. Public visibility, facilitated by media, is an extension of this feedback loop, shaping and reinforcing biases present in the language. Both are under our control.
Look, I’m a suicide survivor and I still mess up and make ill-placed jokes about killing myself. Making a joke out of mental illness is a part of the English lexicon and it’s a difficult thing to stop because language is just part of us. Speaking seems so natural that we often don’t think to analyze what we’re saying. But we should.
What we say is a window into what our society feels and believes. Saying “that’s so retarded” might seem like another way of saying that something is stupid or unfair, but at the deepest level we are making clear our lack of empathy for those with intellectual and developmental disabilities. This is because by making this statement we are equating the worth of a person living with one of these conditions to the value we place on a situation or object that we dislike which, in translation, is not all that much. We are saying that we value them so little that we throw around a word that is meant to insult their condition as another form of an insult. (I know where the word retarded came from, but that doesn’t change the fact that in the twenty-first century it is another word for stupid.)
The same is true when we throw around words like OCD or depression or phrases like “I could have killed myself.” At the heart of the matter, when we throw around words like this what we are really saying is that we don’t take these conditions or situations seriously. Obsessive Compulsive Disorder and depression are real and, sometimes, disabling conditions that millions of people experience. Suicide is the second leading cause of death for 18-34 year olds and the first leading cause of death for 45-65 year olds. They should be taken very seriously.
Think about it this way: we would never make a joke about cancer, type 1 diabetes, or dying in a drunk-driving accident. We would say that the jokes were inappropriate because these are legitimate, life-threatening illnesses and situations. Use that same logic when talking about mental illness.
An additional problem to consider about language is that the way we talk and joke about mental illness is highly gendered. Women are far more likely to be called crazy or emotional. In general, women’s emotions and complaints are not taken as seriously, but women face a particularly nasty catch-22 when it comes to their mental health. Women are far more likely to be diagnosed with a mental illness while at the same time having their symptoms taken less seriously. Read the flip side of this: men tend to be less diagnosed when they should be and their symptoms are often ignored or missed. Once again, misogyny hurts everyone.
In short, check your language. Ask yourself before you speak: “Would I say this about another health condition?” “Would I say this about another way of dying?” “Would I say this about a man if the situation was the same?” Language sets the tone for how we will perceive something. If the tone is hostile, people are far less likely to engage, especially if a person fears that they will be seen in a less respectful or empathetic way for engaging honestly. If all else fails, remember what Thumper says: “If you don’t have nothin’ nice to say, don’t say nothin’ at all.”
I can only speak for myself in this situation, but every time someone reports another mass shooting my first thought is, Please don’t let this person have a diagnosed mental health condition. As sick as it seems, I would much rather the person just be evil. It’s because every time something like this happens, it drives the conversation about mental health that much farther away from the public consciousness.
People living with mental illness have a similar problem to the Muslim and African American communities; the only times we tend to make the news is after a violent incident. This feeds directly into the mistaken belief that most people with mental illness are dangerous. Because of the stigma that exists around mental illness, people living with these conditions tend not to make their conditions known. This frequently means that most peoples’ only contact with someone living with mental illness is what they learn on the news. In reality, a person living with mental illness is far more likely to be the victim of violent crime than the perpetrator.
But fear and the perception of danger, real or imagined, are powerful. This is where public representation is problematic. A person having a mental health crisis is more likely to encounter the police than a healthcare worker. If the perception of a police officer is that a person with mental illness is dangerous, they are far more likely to resort to violence than nonviolent, conflict resolution techniques.
In addition to prejudicial media coverage, people living with mental illness are also affected by prejudice in consumer media (think movies, television shows, books, etc.). When characters with mental illness are included, they are almost exclusively white, heterosexual, and male. This erases the experiences of mental illness of people of color, the LGBTQIA community, and women. At the time of writing this blog, I can only think of two movies that feature (straight) women with mental illness and one that features a homeless black man as protagonists off the top of my head: Silver Linings Playbook, The Forest, and The Soloist. The Soloist is the only of these movies that is based on the life of a real person living with mental illness, cellist Nathaniel Ayers.
Additionally, scripts about people living with mental illness are typically limited to the horror, science fiction, and thriller genres. Think about these titles: Legion (An FX Original Series), Split, The Visit, Fight Club, Shutter Island, Psycho, The Silence of the Lambs, Bates Motel, American Horror Story, The Machinist, The Accountant, An American Psycho, Donnie Darko . With the exception of The Visit, all exclusively feature a straight white male as their protagonist. All fall under the three genres listed above. What is problematic about the use of these genres to depict the stories of mental illness is that these genres tend to rely on violence and unrealistic (read: not based on evidence) portrayals of mental illness, feeding the fears and misconceptions that most Americans have about people living with mental illness.
SPOILER WARNING! Let’s break down Psycho, Alfred Hitchcock’s famous 1960 film, as an example. Let me say that Psycho is one of my favorite films and a great work of art, but that doesn’t mean that it isn’t a problematic work. of its portrayal of mental illness. To begin, the protagonist and murderer, Norman Bates, is a white, heterosexual male. He is also afflicted with what, at the time, would be called multiple or split personality disorder. Today it would be called dissociative identity disorder.
Dissociative identity disorder (DID) is a common trope in horror films, television shows, and novels, but it is rare in the “real” world: only 2% of the population experience any kind of dissociate disorder. DID only affects around 1% of the population. Ironically, women are more likely to experience a dissociative disorder. The disorder is identified by the Diagnostic and Statistical Manual of Mental Disorders by a person alternating between personalities. The personalities often have unique names, characteristics, mannerisms, and voices. The person experiencing the disorder often feels like the voices are trying to take control of them. The disorder often develops as a way to cope with trauma and abuse.
Norman Bates, whose alternate personality is that of his mother, is explained to have been abused by her as a child which aligns with the experience of many of those living with DID. However, what is atypical about Norman’s behavior is his violence. In general, people living with mental illness are rarely violent. This includes people living with DID. They are more likely to harm themselves than others.
In addition, while it is common for people experiencing DID to experience periods of lost memory and time when another personality, sometimes called an alter, when the alter is in control, there is little evidence to suggest that a person living with mental illness can be “lost” to the control of another personality, as Norman Bates is at the end of the film. In the vast majority of people living with DID, alters exist to hold onto the traumatic memories of abuse. The theory of most scientists is that abuse or trauma causes the mind to reconfigure into divided personalities that can manage stress and anxiety. Alters switch with the person experiencing DID in situations that trigger the past trauma, allowing a means of escape.
In this way, Hitchcock’s portrayal of DID is inaccurate. Norman Bates’ murderous rampage is not a typical of a person with DID, nor any person in general living with mental illness. In addition, Bates’ total transformation into his mother’s personality at the end of the film is not based on evidence of actual people living with the disorder or scientific study of the condition.
To summarize, check your media consumption. Are you exclusively consuming media that portrays people as violent or helpless? Are you exclusively consuming media that erases the experiences of women, people of color, and the LGBTQIA community? Do your research and seek out research that debunks myths about mental illness. Follow websites for organizations like NAMI (National Alliance on Mental Illness) and the NIMH (National Institute of Mental Health) that frequently publish a broad range of news about mental health. Seek out media that portrays mental illness realistically. Here’s a great article from NAMI about film portrayals of mental illness: http://www.nami.org/Blogs/NAMI-Blog/December-2015/7-of-the-Best-Movies-About-Mental-Health. Your media consumption is really one of the simplest ways that you can change the public portrayal of people living with mental illness. Money talks.
What can you do?
While the stigma and discrimination of our social and cultural interactions seem overwhelming, this is one of the parts of our lives over which we can exercise the most direct control. Here are ways that you can change the way you use language and consume media in order to reduce stigma and discrimination:
- Check your assumptions. First of all, just because you have never had an experience does not mean that someone else’s experience isn’t real. As evidenced by our use of language and consumption of media, Americans hold many skewed ideas about mental illness and mental health. The only assumption that you can make safely is that you don’t have all the information.
- People that have had a particular experience get to control the narrative about that experience. The best way to get more information about the experience of mental illness is to listen to the people who have actually that experience. Seek out blogs, novels, and media that accurately portray the experience of those living with mental illness. Better yet, consume media that is actually written and created by the people that have had these experiences.
- Practice empathy. It is easy to assume (see point number 1) that the reason skewed ideas about mental illness exist is because the people that experience it don’t tell their stories. Recognize that there are many reasons why people living with mental illness don’t talk about their experience. Forcing someone to speak is just as oppressive as forcing them, directly or indirectly, to remain silent.
- Get informed. It is not the responsibility of people living with mental illness to be your sole source of information about mental illness. Take responsibility and educate yourself. There are numerous resources that can help you understand the experience of mental illness. At the end of this blog I will relink last week’s blog post which contains a short list of some of these resources.
- Check your language. Take the time to analyze how you speak about mental illness. If your language is problematic, change it. Note humor is a great way to change peoples’ hearts and minds. Many people ask me, “Isn’t making jokes and using humor a way to make mental illness more acceptable.” Yes and no. Yes, if the humor is created by a person who has had the experience or a person that is extremely familiar with mental illness (example, the parent or friend of a person living with mental illness) and that humor moves the conversation about mental health forward. No, if mental illness just serves as an insult to a person or group of people or is based on erroneous assumptions about mental illness.
- In case you missed it the first time, consume media that accurately portrays mental illness as well as media that is written and created by people that experience mental illness. Seek out broader news media on sites such as NAMI and the NIMH. Don’t assume that the headlines tell the whole story. Don’t assume that you know the whole story. Be open to allow a person who has experienced mental illness to correct you if you are wrong.
Check in next week for part-two: Political and Economic policy and mental health.
As always, love and respect.
As promised, here’s the link to last week’s blog post, People Matter: