Where Mental Health Advocacy Fails

Living with #depression is hard. But journaling helps. I take care of my #mentalhealth. 

An Instagram post such as this one unsurprisingly receives comments filled with sympathy applauding the user’s “strength” in such a situation. But a few alterations to the scene yields the opposite result. Instead of an Instagram post, a homeless individual experiencing PTSD and major depression is pleading on the highway for money. This creates a different commentary: 

“It’s her own fault!” 

“If she stopped spending her money on drugs, she’d be better off.”

“She should just get a job!”

The search for #mentalhealth on Instagram yields 2.5 million posts. Individuals are capitalizing on mental health, whether that be through social media posts or contributing toward an industry consisting of stress balls and bullet journals. That, in turn, reduces mental health to a commodity, whether it be a yoga class or art therapy routine

This isn’t always a bad thing. Individuals have found mental relief and peace through healthier living practices. But there exists a double standard in which we alternate between praising individuals for openly discussing their mental illnesses while criticizing factors that exacerbate their health. This sympathetic lens of praising individuals for confronting their mental illnesses does not apply to people of color. It does not apply to the LGBTQ community. Marginalized communities continue to disproportionately bear the burdens of mental illnesses without the culture of support that is now emerging.

A few statistics: approximately half of all trans individuals attempt suicide. According to NAMI, the LGTBQ community faces higher rates of suicide ideation and substance abuse. Nearly half of all homeless individuals in shelters experience severe mental illnesses and/or substance disorders. Multipleacademic papers have concluded that African Americans face worse treatment from therapists and are more likely to experience travesties associated with mental illnesses, such as incarceration.

History provides insight as to how this issue began. The United States has a documented narrative in punishing mentally ill individuals. From sterilizing the “feeble-minded” (hence disproportionately targeting people of color) and lobotomizing mentally ill individuals, institutional violence has long been established against people with mental illnesses. In the 1980s, the federal administration initiated a massive spending cut, shutting down hospitals and welfare programs. During this period of time, mass incarceration and homelessness skyrocketed. Let us not even delve into the inequities of the USA healthcare system that prevents marginalized communities from seeking care.  

With respect to mental health, the medical model currently used by many doctors is fundamentally flawed. Treating a mental illness as a physical condition that will ultimately be cured ignores the fact that we, as a population, have a limited knowledge of mental health. It also erases a history of violence perpetuated by the state.  

Structural changes are lacking, despite the statistics suggesting urgency. Today, federal and state governments continue to prosecute substance abuse. Homeless individuals are fined for sleeping on the street. Factors strongly associated with mental illnesses are being criminalized—our government is criminalizing mental illness. But we’re not actively targeting the social determinants that intersect with mental health, the factors that can dictate an individual’s mental well being more than a stress ball. Examples include: sexuality, substance abuse, housing security, access to food. All of these were factors listed in the Universal Declaration of Human Rights. All of them are considered inherent entitlements. Yet today, they are nothing more than judgment calls. 

The current news cycle reflects this phenomenon: California’s housing crisis is exemplary of governmental failure to target mental health determinants. Despite the plethora of academic research linking housing status and security to mental health, the California State legislature and US federal government are not passing enough measures to contain the homelessness epidemic. While substance abuse has been classified as a mental health issue, Congress has yet to enact funding to combat the opioid epidemic. 

In the end, state and federal governments can pass legislation increasing the number of therapists and psychiatric institutions, but that will only do so much.  The conversations surrounding mental health need to be both interdisciplinary and structural if we wish to address the crux of the issue. A shift in lifestyle routines, as featured on Instagram or via a new product on Amazon, may provide individuals with increased mental wellbeing. But it does not address mental health as a population health issue.

This requires giving everyone a seat at the table. We need to address institutional failures and make changes for everyone. We need to have the uncomfortable conversations mental health necessitates if we wish to target it directly.  But perhaps most of all, we need to draft policy—not social media posts— that protects the most vulnerable populations.

This post was written by Deepika Dilip. Interested in writing about mental health? Become a Subconscious Contributor and publish your content to thousands of readers.