Blog, Commentary

Talking is not enough

Bell Let’s Talk always makes me super uncomfortable for reasons I can never quite articulate. Part of it is because I dislike a company advertising for itself on the backs of advocacy for mental health awareness. I get that this campaign is more effective at raising awareness across the country than Bell just silently throwing a whole gob of money at CAMH, but the ads don’t have to be so damn branded. (Note: I have similar issues with the Dove Campaign co-opting feminism. You didn’t start the conversation, you’re just benefiting from it. Yes, I am a cynical asshole.)

Part of it is also the nagging sense that we’re missing something, and moreover, that the thing we’re missing is being further obscured by a focus on talking.

There are so many layers to mental health stigma. Diagnoses for depression and anxiety carry less stigma than diagnoses for schizophrenia and borderline personality disorder and bipolar disorder. Every overachiever with a halfway type-A personality makes claims of OCD without understanding how disruptive a disease it can be. Our cultural love affair with people with autism who are secretly geniuses in some special way obscures the needs of people with autism who do not have some exceptional skill, who deserve just as much support.

A person of colour diagnosed with mental health issues will face very different challenges than a white person diagnosed with the same, given a racist system that socializes us to perceive PoC as inherently more unstable. A fat person seeking help for mental health struggles will be told to lose weight. The continued medicalization and pathologization of gender dysphoria is just one of the ways that mental health diagnoses will be used to control the bodies of those society perceives as a threat. Not so long ago, homosexuality was considered a mental illness.

There are few resources available to someone who needs access to mental health services. Your average physician probably received very little training in dealing with mental health issues, most of that focused towards pharmacological “solutions”. You can check yourself into the emergency room if you actively have suicidal ideations and plans, but there is precious little support available to you after your three days are up. (Bless you, Gerstein Centre.) The availability of preventative, maintenance care rather than emergency care is even more dire. Most therapists are not covered by OHIP. Some will operate on a sliding scale or have pro bono sessions, but they are few and far between with waiting lists as long as their arm. The number of therapists who are trained to understand the intersection between mental health and oppression is even smaller.

The science itself is often politically motivated. (This may come as a surprise to you, but scientific study is rarely value-neutral.) Schizophrenia in the 20s and 30s was a diagnosis primarily given to middle-class housewives who were sad and withdrawn, until the diagnostic criteria changed in the 60s to include hostility and paranoia so it could be used to pathologize young black men in the civil rights movement. A diagnosis for borderline personality disorder has been said to be far more reflective of the physician’s attitude towards a patient than anything inherent in the patient, which explains its reputation as basically being sociopathy-lite. (It is far more accurately described as emotional PTSD.)

And I can’t even begin to enumerate the number of ways our society is just set up to be ableist. From the language we use to the systems and infrastructure we design, we’re not built to accommodate neuro-atypicality. Any atypicality, really.

There is less stigma today than there was ten, fifteen years ago. Fifty years ago. I don’t fear losing my job because I am writing this blog post.

But it’s not enough. It’s not enough. I can tell you that I’ve been depressed and anxious most of my life, that I’ve been officially diagnosed and on medication for the past half a decade, that I’ve frequently known more about my options for mental health treatment than the physician I was speaking to, that I’ve seen therapists who saved my life and therapists I thought barely deserving of their medical degree.

I can tell you that I’m willing to talk and desperate to help and that I will not judge you and that I understand the stigma you’re afraid of. Talking is so important. I’ve always been incredibly lucky and privileged that I’ve always had someone I could talk to. My friends are fucking fantastic.

But talking can’t give you access to the resources you need, because they don’t exist. It can’t guarantee you a doctor who will understand the problems you’re going through, who has the luxury of spending more than fifteen minutes with you. It can’t reform our affordable housing policies so that those who are unable to work can still have a roof over their heads. It can’t make our politicians understand the effects of poverty and oppression on mental health. It can’t table motions in parliament to change how OHIP funds mental health treatments. It can’t find you a place in a capitalist system that prizes our individual value only insofar as we can be predictably productive cogs in the system.

So, okay. I don’t know where I can go with this. Maybe talking is all I can do for now. So let’s talk. Let’s talk about community building. Let’s talk about how municipal political engagement is the best way of enacting change. Let’s talk about our one-size-fits-all work culture and education systems. Let’s talk about workaholism and alcoholism and self-medication. Let’s talk about our uneven social power dynamics, and minority threat, and microaggressions, and death by a thousand cuts. Let’s talk about toxic constructions of masculinity and how it perpetuates the falsehood that not asking for help is manly. Let’s talk about underfunded services in schools for neuroatypical kids who require extra assistance. Let’s talk about the problems inherent in the DSM and the politicization of mental health. Let’s talk about what scientific research gets funded, and by whom, and why, and how. Let’s talk about finding alternatives to institutionalization, of giving agency back to the individual. Let’s talk about supporting the very activists who are doing the advocacy on these and other important issues, of the mental health implications of activism fatigue.

Let’s talk about how one day a year isn’t enough.

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One thought on “Talking is not enough

  1. Malikah says:

    Love it, as usual. I’m writing my major paper (they won’t call it a thesis, heh) on mental illness/addiction/lack of access to services/the need for it to be one of the foundations of primary health care, but I’m having a hard time focusing my question because there’s just SO much to consider, and so much that’s wrong with our system. It doesn’t make sense that if 1/5 Canadians suffer from some sort of issue, services aren’t readily available from where we ought to be getting them. They introduced PAs and NPs in primary care because we’re overburdened with chronic disease, yet not much has been done in the way of supporting those who need help with mental illnesses. WTF. You’re absolutely right about Emergency departments not being equipped to handle them. They get turfed to Psych Emerg, discharged because they’re not acute enough for the overcapped inpatient unit- as if the 72 hour watch is enough. Its more like saying, “hey. We can’t help you. But we’ll see you the next time this happens!” Its bullshit. We know what the issue is, yet we won’t put money into the right places to actually make a change.

    I’m done ranting. Text me if you wanna chat further, i could use a brain to pick.

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