When words fail

Exclusionary ‘mental-health’ messaging doesn’t work

Illustration by Gabrielle Funk

In a guest essay for the New York Times, author Rachel Aviv describes reporting on clinics for people experiencing the early stages of psychosis and meeting “many young patients who were struggling to express what was happening to their minds.”

In many cases, these people “described their condition as disabling, but it was still so new that it had not remade their identities and social worlds.” When Aviv asked one unnamed patient to explain her symptoms, she told her “there was no language. She said ‘It’s like trying to explain what a bark sounds like to someone who’s never heard of a dog.’”

Another woman who had recently been diagnosed with schizophrenia recorded her symptoms in a journal. “She began making up phrases,” Aviv writes. “She was struggling with ‘electrical sensations’ and the sense that ‘words were alive.’ She became preoccupied by what she described as the ‘overwhelming strangeness of the world.’”

As patients received treatment at these clinics, “expert explanations replaced their idiosyncratic attempts to make sense of the world.” Instead, they used terms like “brain disease” and “chemical imbalance,” described how a hippocampus could fire too often and instill panic.

It can be a challenge to obtain diagnoses and learn clinical language. In Canada, only about 20 per cent of young people who require mental-health services receive adequate treatment. Even with this knowledge, it can be difficult to articulate exactly how different illnesses, disorders and episodes feel.

These experiences can be severe, excruciating, unfamiliar, but people’s inability to express themselves may also be due to how communities discuss mental states in general.

Phrases like “we all have mental health” are plastered across the internet, from a Seattle Public Library resource guide to the official Jersey Shore Instagram account. These platitudes, along with calls for people to “reach out” for help, seem to circulate whenever tragedy strikes, as was the case when celebrity dancer tWitch died by suicide last December, or during so-called awareness events like Bell Let’s Talk Day.

“Ordinarily, the word ‘health’ implies an absence of illness,” clinical psychologist Dr. Huw Green writes, also for the New York Times. He describes how “mental health” is often colloquially used as an umbrella term that simultaneously encompasses “both states of wellness and distress.”

In other words, it’s essentially meaningless. “The term ‘mental health’ is a euphemism,” Green writes, “and euphemisms are what we use when we want to obscure something ... (this language) has simply moved our attention away from the very people who face the most stigma.”

The official announcement for this year’s Bell Let’s Talk Day uses the phrase “mental health” nearly 50 times but only briefly references anxiety, suicide and overdose deaths – without discussing other issues. As Scott Martin writes for Passage, “The people who suffer from more ostracized conditions are, ironically, too taboo for Bell’s campaign.”

And despite countless “anti-stigma” campaigns like Bell’s, most people author Philip Moscovitch has interviewed about psychosis “don’t want to use their real names, for fear of the personal and professional consequences.”

Even when people have the language to describe their experiences, it’s often impossible to use – at least not openly. “Asking people with a mental illness to reduce stigma by telling their stories potentially exposes them to more discrimination,” Moscovitch writes for the Globe and Mail.

It’s a catch-22 that will never be solved with feed-worthy Instagram graphics, punchy hashtags and euphemistic, sanitized language. Let’s talk about that.

A former sports broadcaster, Danielle Doiron is now a writer, editor and educator. Find them in Winnipeg, Philadelphia and, occasionally, on the airwaves.

Published in Volume 77, Number 15 of The Uniter (January 19, 2023)

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