“I have a mental illness”, is not a phrase people say lightly. It certainly shouldn’t be. But the reasons in today’s world are not that mental illness can be horrifying and life threatening, but rather that there is an incredible weight of stigma in the world. If a terrorist attack happens “that person must be crazy”. If a politician does something we disapprove of “he must be crazy”.
So, what about all those people in the world who have real, sometimes harrowing, mental illness? Should they just “pick themselves up, and get better”? Is it really that easy? My answer is no, it is not. Mental illnesses are often complex and confusing and there is much more to it than just “deciding to be better”. Mental Illness can in many cases originate from a person’s past and how the mind deals with that, perhaps it is ingrained trauma, perhaps something from childhood, perhaps it is reactive and stems from stress at work—everyone is different. It is something that should always be taken on a case-by-case basis. Never though, have I heard of people “deciding to be better” and just magically they are better.
On the other hand, once you have decided you want to be better, is there help available? There are plenty of charities and spoke-people calling for people to “speak up” to have a conversation, to reach out, to start somewhere—Time to Talk and Heads Together come to mind. But in reality, the help is spread thin, underfunded and hard to get. One goes to their GP, who may or may not refer them to their local community mental health team (CMHT), who may or may not take you on, depending on their case-load and how much threat they view you to be in. That is if the GP takes you seriously in the first place.
I have had experiences along both lines—I have been faced with a GP who bluntly told me I did not have depression and I have also been put under the care of the CMHT. It varies, but whatever level it is at, it has to be pushed for, chased and to be honest when you have a mental illness the last thing you have energy for is chasing down your own self-care. In my current house, I waited over a year to be referred from my GP to the CMHT. I am now back with my GP only, and fear the day I am next in crisis and need to be referred again. Will the wait be as long? Will it be too little, too late?
I am lucky, I have had therapy with a lovely therapist who through a combination of mindfulness and immersion therapy got me to reassess how I viewed the essence of my mental health and how it manifests for me. (In my case, my depression and anxiety manifest as hallucinations of Ghosts and Monsters). To realize that it was my body’s way of saying “you are not coping well right now” rather than that I needed to die, imminently. To slowly learn to be compassionate to myself and realize that I am actually a nice person, even if I have a deeply ingrained belief that I shouldn’t be here. That part hasn’t changed yet and my therapist has left the service before my therapy was truly over or had dealt with everything it set out to—but I am still better than I was. I can progress from here.
Some people do not even have the choice of therapy. Or medication. Or help at all. Because stigma shuts the door on them and they either never ask for help, fearing the consequence or they ask for help and are denied. I am on medication, and have recently changed from one antidepressant to another; something my GP is guiding me through. I am lucky to have a caring and understanding GP at present. I can’t believe the contrast between previous GPs who just did not get or want to get mental health, and my current GP who tells me I can go there whenever I feel I need help.
I believe medication is needed in my case: it provides the foundation from which I can build my recovery. Without it, I am too at risk to even consider recovery. I do not believe medication is the be-all and end-all of treatment. I am a strong believer in attacking this illness from all angles and therefore therapy is just as important as medication. That is my point, though—mental illness is exactly that. It is an illness and should be treated as such, with just as much respect as physical illnesses.
If someone comes to you with a broken leg, you do not tell them to “get over it” or “pull yourself together”. You get them to see a doctor, to have an X-ray, to get a cast—which many people will happily sign with their hopes for quick healing. So why do we not yet have this for mental health? Why do people shy away from it as though it is taboo?
Yes, stigma has a lot to answer for, but the infrastructure and systems of GPs, CMHT, Accident and Emergency and other services needs an overhaul, and a lot more money put into it. It is suffering from years of budget cuts and the cultural view that it should somehow hide away at the back of the hospital out of sight (as it was, literally, in my old town).
This is illness at its hardest to face in today’s society. It is time people took a stand against that and said simply: enough is enough. We need parity of esteem, and now, not tomorrow. It is time mental illness is seen as just that: illness, which is mental.
About the Author
You can find Roiben on Twitter (@roiben).
Illustration by Zhang Xiao Bai.