Beyond stigma lies dehumanization
While “mental health matters,” we still devalue mentally ill people every day
It’s taken this long, but the Bell Let’s Talk initiative rolling around this year is finally reaching the point where it doesn’t pass for real advocacy anymore. Instead, most people see it for the corporate smokescreen it is; more and more people are starting to care about the way Bell has a direct link to actually worsening the mental health of vulnerable people, like incarcerated people needing to contact their families by phone, for example. Some of the real work “for mental health” related to Bell has probably been from people protesting outside of its offices this year, in terms of the material effect it may have on supports in a person’s life. I’ll admit that when I was a teenager feeling unseen and isolated, initiatives promoted by companies on social media like this did appeal to me, too – I felt like there were people out there who cared about my struggles and wanted to do something for people like me. But as sad as it is, no company entity wants you to thrive in any meaningful personal way. Mental health “stigma-busting” has almost become an industry now, with brands like UnderstandUs and “wellness” products using anxiety and depression to build a customer base. It’s definitely insidious, and no part of me feels represented by it. I don’t think I’ve ever had a meaningful conversation about mental illness under Bell’s banner.
All of this acknowledged, I do want to talk about mental illness this week, and I also want to be intentional about calling it that. The phrase “mental health” as it’s used in initiatives of Bell’s kind is very vague, wide-reaching, and applicable to nearly anyone. We all have “mental health” just like we all have physical health, and yes, taking care of both is important (while nearly impossible under the double conditions of the pandemic and the sorry state of worker’s rights and protections). But as I expanded on in another op-ed, “conversations about mental health” (conversations that rarely go anywhere) often work to obscure the active and dangerous marginalization of mentally ill people.
I have witnessed many people, not just at this time of year but almost day-to-day, tout themselves as “mental health advocates” while regularly subscribing to ideas about mentally ill people that lead to institutional violence. I have become familiar with the type of “mental health advocacy” where the telltale signs of anxiety and depression are thoughtfully and thoroughly outlined, but where psychosis is incredibly poorly understood or utterly out of the scope of discussion. It is clear that many people believe there are two kinds of “mental health issues”: the kinds that make you a troubled but otherwise ordinary person, and the kinds that make you, as I have been called, “a nutcase.” Throughout my life, I saw this most clearly in mental health professionals who were hesitant to believe me about my own symptoms because I expressed them “too well.” The implications there, when it comes to the assumptions and bias going into so much critical treatment, make me distrustful of anyone claiming to be an authority on these things. Some “mental health problems” are worth a corporate campaign – and even that is useless – but some seem to be worth nothing at all.
Earlier this year, my uncle died. He lived with schizophrenia, and often struggled to find a place to live because of the conflicts he would get into when he became paranoid. Much of the time, it was only our family that could offer him material support; sometimes even social workers and doctors would refuse to work with him. When he had a heart attack, still coping with his illness while in and out of homelessness, it took over a day for us to know what had happened. I can only imagine how it must feel for a person to die alone, failed by the society meant to address their needs. What’s more, I can only imagine what it’s like to be seen as a lost cause to those whose job it is to help you thrive. I am now reaching an age, with some possibility for family inheritance, where it becomes more likely for schizophrenia to present in me. I worry much less about life with that illness, which I know is possible and entirely manageable with the right support, than I do about the way I would be viewed and treated by others with that diagnosis.
The word “stigma” does not really capture the depth and severity of the cultural associations that have been made with mentally ill people over history. When it comes to something like anxiety or depression, it seems like a reasonable term. Yes, we have false ideas about what these conditions are, but we still recognize that they’re mental health problems with a variety of causes and treatments. It’s a very different situation when it comes to psychiatric terms like “narcissist,” “mania,” “psychotic,” or “sociopath.” It isn’t only that people don’t understand what these words mean, but that these words themselves are also directly derived from negative cultural ideas we have about people who we’ve labeled “insane” or “disordered.” The history of these tropes is completely dehumanizing, and it actually hasn’t really gone away with history – as a fan of the horror genre, I don’t have to look very far to see an “insane asylum” or psychiatric ward presented as the worst of humanity, nor is it difficult to find a movie where a person’s illness alone is viewed as monstrosity (see Split, Ratched, American Horror Story: Asylum). It also becomes clear very quickly that this construction of monstrosity is intimately tied with other structures of oppression: anti-Blackness, transmisogyny, and ableism against physically disabled people or those with physical differences.
While you’re grappling with the relative uselessness of Bell Let’s Talk this year, I want you to think about some of the ways you may have internalized ideas about mentally ill people that dehumanize and characterize them as inherently “evil,” “abusive,” “tragic,” “difficult” or impossible to understand. Do you, like so many people did this year, insist on diagnosing Trump with narcissistic personality disorder to somehow drive home that he’s a bad person – not considering that people with NPD are largely survivors of abuse, as capable of good deeds and responsibility as anyone else? If you find a mental illness “fascinating,” would you befriend and respect a person who lives with those symptoms every day – not only when they “appear normal” (when they hide their symptoms from you), but when they are fully themselves? Do you view it as a mental health issue when people experience police violence because of their symptoms — do you see the police and the carceral logic of institutions as mental health problems? Do you support mentally ill coworkers and classmates in a meaningful way (beyond pleasantries, with real material supports) when their illness makes it difficult for them to survive? Challenge yourself with these things. No one should ever have to seek help and be made to feel like a monster.