Today is October the 10^th, World Mental Health Day.  I’m up early to make sure I get to my workplace in time to do my small part in setting up a morning tea arranged in support of World Mental Health Day.  Why does it mean so much to me?  Why am I a Peer Ambassador for SANE Australia?  Why do I think it’s important to be honest about my own journey with mental illness?

“1 in 5 Australians are affected by mental illness, yet many don’t seek help because of stigma.”

World Mental Health Day is about making a promise to shed a more positive light on mental health issues.  This blog post is about highlighting what stigma around mental illness is, the level of harm it causes, and how we can start to change that:  This may be one of the toughest posts I ever write, because it means being candidly honest about who I was, and how I thought, before I experienced mental illness.

I grew up in a household where mental illness was viewed as personal weakness, a sign of poor character, and a choice.  Beyond that, I grew up being fed various pieces of information that suggested mental illness was some kind of spiritual failing or demonic possession that could be ‘prayed away’; and, if it didn’t go away, then you hadn’t prayed the right way.  That was my foundation in terms of my view of mental illness – not a great starting point. 

To add to my own incredibly prejudicial views of mental illness, I came from a position of privilege:  My family never struggled to meet my basic (or even non-essential) needs.  Beyond a very basic understanding that some people don’t have access to the same opportunities and resources that I did, I had no appreciation of the impact of privilege, nor its absence, on people’s lives and how they turned out.  For me, empathy is a cognitive task; one that is made much harder when I have no comparable experience to the person I’m trying to empathise with.  Beyond my background of privilege and difference in ‘empathy processing’, another critical building block in my own foundation of prejudice against those who experience mental illness was the fact I have never had difficulty succeeding academically (which, up to the end of school, is very much a measure society uses to define an individual’s worth and success – something to be reflected on in another post).  

With that foundation and prejudice, I started medical school and began my journey to become a doctor.  I had the right intentions and so much compassion, but I also had no appreciation of how damaging my own assumptions and attitudes could be.  So, today, nearly 18 years after I started my medical degree, I’m sitting at my computer writing something I never would have imagined could have come from me.

“I’ve experienced mental illness.  At times it has been severe.  And, I am glad and grateful, for those experiences now being part of my journey.”

Wow.  Who would be grateful for experiencing any kind of illness or suffering?  Me.  I am.  I am grateful for the experiences that have provided me with the armoury of information I needed to challenge, and destroy, the strong foundation of stigma and prejudice that I held towards mental illness and the people it affects when I was a young adult.  I am grateful that I learnt those lessons in my young adulthood, before I could do too much harm by propagating stigma and prejudice further.  I am grateful that I have lived experience that allows me to highlight for others what stigma and prejudice really are, and what they do (and how we can stop them).  And, I am grateful for organisations like SANE Australia, who strive constantly to eliminate stigma and prejudice towards those with mental illness and who encourage those with lived experiences to be ‘Peer Ambassadors’.

I’ve recently reflected on my own lived experience of mental illness and the impact it has had on my life.  My medical career, and life in general, has been interrupted repeatedly, taken detours, and at times been completed halted, because of the mental illness I’ve encountered.  Through my reflections, I’ve come to a painful and alarming conclusion.

“Stigma and prejudice around mental illness have caused me far more harm and damage than the mental illness itself ever could have or did.”

I don’t say that to minimise the experience of mental illness:  The clinical experience of severe depression, anxiety, and suicide attempts has been profound.  The symptoms can be crippling and steal from you the time and energy you need to recover from them; it’s vicious, and painful.  But, it’s still nothing in comparison to the stigma and prejudice you face when you become ‘someone with a mental illness’.  

Stigma is the association of disgrace, failing and shame with a particular characteristic/experience.  Prejudice is the harm, injury, and negative action directed at a person or situation because they’ve got a particular history or characteristic.  

“Stigma and prejudice go hand-in-hand.  They come together to hurt and damage.  They support each other’s survival so they can live another day and continue on their destructive path.  They promote a mentality of ‘them and us’, they build false esteem for those who rely on them and they cut away at the self-worth of those they target.  Where stigma and prejudice are, empathy cannot be present.  When they leave, the people they’ve touched, their relationships, and their lives are damaged.  The biggest weakness that stigma and prejudice have is that they can’t survive without each other; they’re co-dependent.”

In my own journey I can identify clear instances where it has been the stigma and prejudice associated with my mental illness experiences that has harmed me (not the illness).  Stigma and prejudice have resulted in judgement and criticism (often unfounded).  Relying on them, people have made assumptions about my character, intentions, capability and worth.  People have made determinations about my future, without any consideration for time and the impact of effective treatment and intervention.  I’ve listened to stigma and prejudice, then based on their advice/impact made decisions for myself that have changed my life course.  Stigma and prejudice have served to make me less desirable in many contexts than those with serious criminal records.  They’ve led people to believe I am dangerous, not trustworthy, or otherwise unsafe.  They have given people permission to suggest I am less valuable (in many ways) than if I had not experienced mental illness.  They have chewed into the credibility and respect people extend to me.  And, most importantly, they have wounded relationships with friends and family, which has in turn served to sustain stigma and prejudice so they could survive another day.  These are all outcomes and challenges I’ve faced due to having experienced mental illness that have not been associated with my experience of physical illness/disability (which is not insignificant).

The shame that has been projected onto me as someone with a complex mental health history is something I have needed to actively combat.  It’s taken hard work and persistence to re-claim self-esteem, self-confidence, and self-respect that stigma and prejudice stole from me.  It’s taken courage to stand up and tell others that I am not willing to be shamed, nor prejudiced, for having experienced the mental illness that I have:  It’s a tough gig standing up and honestly telling people what you’ve experienced, but also telling them you’re not ashamed of it, and you won’t embrace any shame they project onto you.  

With these realisations comes responsibility.  Sometimes we don’t realise when we act/speak in a way that fuels the survival of stigma and prejudice.  You cannot go through life assuming that simply because you don’t mean to support stigma and prejudice that you therefore will succeed in not propagating them; it has to be a conscious decision, you need to monitor your thoughts and actions for the very food sources that stigma and prejudice rely on.  Here’s my little checklist that you can use to identify when you’re feeding the toxic, co-dependent, entities known as stigma and prejudice.

1. Are you thinking differently about someone’s word, actions, abilities etc because you know they have, or have had, a mental illness?  Would you think that way about them if they had a physical disability?
2. Are you fearful of a someone because you have knowledge of their mental illness, or suspect mental illness?
3. Have you allowed yourself to believe that you are more controlled, or more successful, than someone you know with a mental illness?
4. Do you attribute any blame onto a person with mental illness for their situation (homelessness, financial troubles, lack of academic success etc)?
5. Do you view the person you know as someone who has experience mental illness as ‘potentially mentally unstable/unwell’ even after they have recovered?
6. Have you ever considered not giving someone an opportunity, or not giving their opinion as much weight as someone else, because they have (or have had) a mental illness?

The biggest litmus test to see if you’ve been impacted by stigma and prejudice towards those who experience mental illness is this question.

“If you were diagnosed with a mental illness tomorrow, and needed treatment/therapy, would you be less comfortable telling your friends, family, colleagues, employer or anyone else than if that illness was physical?”

It’s everyone’s responsibility to breakdown stigma and prejudice towards those with mental illness.  With 1 in 5 Australians experiencing mental illness at some point in their lifetime, we are all going to come across someone who has been impacted; and, one day you may be that person.  

Happy World Mental Health Day…