Far too often, mental illness is the elephant in the room; even when it’s clearly there, people are reluctant to acknowledge its existence, much less talk about it. There are an ever-increasing number of groups that have taken on the challenge of wrestling stigma to the ground, but how effective are their efforts? As a person living with mental illness, I have a vested interest in seeing anti-stigma efforts be as effective as possible.
There are organizations large and small involved in the stigma fight. Time to Change, #SickNotWeak, and the National Alliance on Mental Illness, based in the United Kingdom, Canada, and the United States respectively, are perhaps among the most widely known. Those active in the mental health community on social media are likely familiar with various other organizations, including the Buddy Project, I am 1 in 4, Stigma Fighters, and Stamp Out Stigma. Websites of groups like these typically offer the opportunity for those with mental illness to get involved and share our stories. There’s no question that there’s great value in that for both the people sharing and other sufferers who may be reading.
I wonder sometimes, though, about the impact on a broader scale. Are these anti-stigma campaigns preaching to the choir for the most part? Or is the message truly getting out?
There are some high-profile annual awareness/anti-stigma campaigns, but is some of their effect relatively superficial? There is Time to Change’s Time to Talk day, Bell Let’s Talk day, and the National Alliance on Mental Illness (NAMI) mental illness awareness week. The World Health Organization has World Mental Health Day. Yet pretty much any health condition has a day, a week, or a month, and that can lead to a sort of awareness fatigue where no specific condition is able to stand out from the crowded field.
Even when people do choose to engage in one-off awareness days, how much of an impact is it actually having? Sure, people can feel good about tweeting something in support, but does that necessarily correspond to changes in attitudes or behaviours? It’s easy for someone to tweet that people should talk about mental illness, but unless that changes how they respond to a friend who discloses that they’re struggling with an illness, it hasn’t done a whole lot of good.
Stigma is not necessarily due to a lack of awareness or knowledge, in which case awareness-focused campaigns aren’t hitting the target. The most significant stigma I’ve experienced in relation to my mental illness was at work, and I’m a mental health nurse. The managers who seemed to view me as unpredictable and potentially dangerous knew a great deal about mental illness, and they were very used to seeing it… among the patients. For me as a nurse to have a mental illness, and heaven forbid to speak up about it, went entirely against expected norms.
It would be easy to use my story to argue that people should keep quiet in the workplace about mental illness. Yet I believe that it’s all the more reason that we do need to support people in speaking up. Stigma exists when there is a line drawn between “us” and “them”, when the “other” is minimized and dehumanized. To counter those kinds of attitudes, we need to be loud rather than quiet, and show that there really is no “them” because mental illness truly can happen to any of us.
Stigma research shows that the best way to combat stigma is for people to actually have contact with those living with mental illness. There’s no shortage of us out there with mental illness, but people need to feel empowered to speak up and disclose their illnesses. Of course, as individuals people are often reluctant to do that due to fear of stigma.
That could be where the anti-stigma campaigns come in. Maybe it’s less important the effect they have on society on a broader scale, and more important that they give people living with mental illness the confidence to share their stories. If someone writes about their story on the Time to Change website, for example, perhaps most of the people who read that story will also have a mental illness. Yet if that person then finds the courage to talk to their family, friends, and coworkers about their illness, that will bring all of those people a step closer to realizing that there is no “us” and “them” when it comes to mental illness. That counts for a whole lot more than a token supportive tweet on Time to Talk day.
So, if the elephant in the room could speak, that could be a chorus of me and the other one in four who experience mental illness raising our voices and saying we are here, we live with mental illness, and we’re not going anywhere. Stigma thrives in silence, so we need to roar.