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How Should We Talk About Mental Health?
Ted.com; , 12/18/2013
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Mental health suffers from a major image problem. One in every four people experiences mental health issues 鈥 yet more than 40 percent of countries worldwide have no mental health policy. Across the board it seems like we have no idea how to talk about it respectfully and responsibly.
Stigma and discrimination are the two biggest obstacles to a productive public dialogue about mental health; indeed, the problem seems to be largely one of communication. So we asked seven mental health experts: How should we talk about mental health? How can informed and sensitive people do it right 鈥 and how can the media do it responsibly?
End the stigma
Easier said than done, of course. Says journalist听: 鈥淧eople still think that it鈥檚 shameful if they have a mental illness. They think it shows personal weakness. They think it shows a failing. If it鈥檚 their children who have mental illness, they think it reflects their failure as parents.鈥 This self-inflicted stigma can make it difficult for people to speak about even their own mental health problems. According to neuroscientist听, this is because when someone points to his wrist to tell you it鈥檚 broken, you can easily understand the problem, but that鈥檚 not the case when the issue is with the three-pound mass hidden inside someone鈥檚 skull. 鈥淭he minute you start talking about your mind, people get very anxious, because we associate that with being who we are, fundamentally with 鈥榰s鈥 鈥 us as a person, us as an individual, our thoughts, our fears, our hopes, our aspirations, our everything.鈥 Says mental health care advocate听, 鈥淔eeling miserable could in fact be seen as part of you or an extension of your social world, and applying a biomedical label is not always something that everyone with depression, for example, is comfortable with.鈥 Banishing the stigma attached to mental health issues can go a long way to facilitating genuinely useful conversations.
Avoid correlations between criminality and mental illness
People are too quick to dole out judgments on people who experience mental health problems, grouping them together when isolated incidents of violence or crime occur. Says听Caddick, 鈥淵ou get a major incident like Columbine or Virginia Tech and then the media asks, 鈥榃hy didn鈥檛 people know that he was bipolar?鈥 鈥榃as he schizophrenic?鈥 From there, some people think, 鈥榃ell, everybody with bipolar disease is likely to go out and shoot down a whole bunch of people in a school,鈥 or, 鈥楶eople who are schizophrenics shouldn鈥檛 be out on the street.鈥欌澨齋olomon听agrees that this correlation works against a productive conversation about mental health: 鈥淭he tendency to connect people鈥檚 crimes to mental illness diagnoses that are not in fact associated with criminality needs to go away. 鈥楾his person murdered everyone because he was depressed.鈥 You think, yes, you could sort of indicate here this person was depressed and he murdered everyone, but most people who are depressed do not murder everyone.鈥
But do correlate more between mental illness and suicide
According to the National Institute for Mental Health (NIMH), 90 percent of people who die by suicide have depression or other mental disorders, or substance-abuse disorders in conjunction with other mental disorders. Yet we don鈥檛 give this link its due. Says听Solomon, 鈥淛ust as the association between mental illness and crime is too strong, the connection between mental illness and suicide is too weak. So I feel like what I constantly read in the articles is that 鈥榮o-and-so killed himself because his business had gone bankrupt and his wife had left him.鈥 And I think, okay, those were the triggering circumstances, but he killed himself because he suffered from a mental illness that drove him to kill himself. He was terribly depressed.鈥
Avoid words like 鈥渃razy鈥 or 鈥減sycho鈥
Not surprisingly, nearly all the mental health experts we consulted were quick to decry playground slang like 鈥渕ental,鈥 鈥渟chizo,鈥 鈥渃razy,鈥 鈥渓oonie,鈥 or 鈥渘utter,鈥 stigmatizing words that become embedded in people鈥檚 minds from a young age. NIMH Director听听takes that one step further 鈥 he doesn鈥檛 like the category of 鈥渕ental health problems鈥 in general. He says, 鈥淪hould we call cancer a 鈥榗ell cycle problem鈥? Calling serious mental illness a 鈥榖ehavioral health problem鈥 is like calling cancer a 鈥榩ain problem.鈥欌 Comedian听, however, has a different point of view: 鈥淚 call people that are mentally disturbed, you know, I say they鈥檙e crazy. I think in the right tone, that鈥檚 not the problem. Let鈥檚 not get caught in the minutiae of it.鈥
If you feel comfortable talking about your own experience with mental health, by all means, do so
Self-advocacy can be very powerful. It reaches people who are going through similar experiences as well as the general public.听Solomon听believes that people equipped to share their experiences should do so: 鈥淭he most moving letter I ever received in a way was one that was only a sentence long, and it came from someone who didn鈥檛 sign his name. He just wrote me a postcard and said, 鈥業 was going to kill myself, but I read your book and changed my mind.鈥 And really, I thought, okay, if nobody else ever reads anything I鈥檝e written, I鈥檝e done some good in the world. It鈥檚 very important just to keep writing about these things, because I think there鈥檚 a trickle-down effect, and that the vocabulary that goes into serious books actually makes its way into the common experience 鈥 at least a little bit of it does 鈥 and makes it easier to talk about all of these things.鈥澨齋olomon,听Wax, as well as听, below, have all become public figures for mental health advocacy through sharing their own experiences.
Don鈥檛 define a person by his/her mental illnesses
Just as a tumor need not define a person, the same goes for mental illness. Although the line between mental health and the 鈥渞est鈥 of a person is somewhat blurry, experts say the distinction is necessary. Says听Insel: 鈥淲e need to talk about mental disorders the way we talk about other medical disorders. We generally don鈥檛 let having a medical illness define a person鈥檚 identity, yet we are very cautious about revealing mental illness because it will somehow define a person鈥檚 competence or even suggest dangerousness.鈥澨鼵addick听agrees: 鈥淭here鈥檚 a lot of things that go on in the brain, and just because one thing goes wrong doesn鈥檛 mean that everything鈥檚 going wrong.鈥
Separate the person from the problem
Continuing from the last,听Insel听and听Patel听both recommend avoiding language that identifies people only by their mental health problems. Says听Insel, speak of 鈥渟omeone with schizophrenia,鈥 not 鈥渢he schizophrenic.鈥 (Although, he points out, people with autism do often ask to be referred to as 鈥渁utistic.鈥) Making this distinction clear, says听Patel, honors and respects the individual. 鈥淲hat you鈥檙e really saying is, this is something that鈥檚 not part of a person; it鈥檚 something the person is suffering from or is living with, and it鈥檚 a different thing from the person.鈥
Sometimes the problem isn鈥檛 that we鈥檙e using the wrong words, but that we鈥檙e not talking at all
Sometimes it just starts with speaking up. In听Solomon鈥檚听words: 鈥淲ittgenstein said, 鈥楢ll I know is what I have words for.鈥 And I think that if you don鈥檛 have the words for it, you can鈥檛 explain to somebody else what your need is. To some degree, you can鈥檛 even explain to yourself what your need is. And so you can鈥檛 get better.鈥 But, as suicide prevention advocate听Chris Le听knows well, there are challenges to talking about suicide and depression. Organizations aiming to raise awareness about depression and suicide have to wrangle with suicide contagion, or copycat suicides that can be sparked by media attention, especially in young people. Le, though, feels strongly that promoting dialogue ultimately helps. One simple solution, he says, is to keep it personal: 鈥淩each out to your friends. If you鈥檙e down, talk to somebody, because remember that one time that your friend was down, and you talked to them, and they felt a little better? So reach out, support people, talk about your emotions and get comfortable with them.鈥
Recognize the amazing contributions of people with mental health differences
Says autism activist听Temple Grandin: 鈥淚f it weren鈥檛 for a little bit of autism, we wouldn鈥檛 have any phones to talk on.鈥 She describes the tech community as filled with autistic pioneers. 鈥淓instein definitely was; he had no language until age three. How about Steve Jobs? I鈥檒l only mention the dead ones by name. The live ones, you鈥檒l have to look them up on the Internet.鈥 Of depression, Grandin says: 鈥淭he organizations involved with depression need to be emphasizing how many really creative people, people whose books we love, whose movies we love, their arts, have had a lot of problems with depression. See, a little bit of those genetics makes you sensitive, makes you emotional, makes you sensitive 鈥 and that makes you creative in a certain way.鈥
Humor helps
Humor, some say, is the best medicine for your brain. Says comedian听Wax: 鈥淚f you surround [your message] with comedy, you have an entr茅e into their psyche. People love novelty, so for me it鈥檚 sort of foreplay: I鈥檓 softening them up, and then you can deliver as dark as you want. But if you whine, if you whine about being a woman or being black, good luck. Everybody smells it. But it鈥檚 true. People are liberated by laughing at themselves.鈥
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