By Jim Melanson
I’ve read a lot about mental illness lately, because I am mentally ill. In this reading, I’ve noticed there seems to be a wide disparity in the language used for this topic. There are those who say they don’t have mentally illness, but rather, they have mental health issues. I’ve read where others insist they are not mentally ill, but rather, they are people with lived experience of mental health care. The most ridiculous term that I’ve read so far is “neurodiverse”[i].
I am not: a psychiatric survivor; a mental health consumer, a person labeled with psychosocial disability; a person with a psychiatric history; a mental health client; a mental health peer; a person with psychiatric vulnerabilities; psychiatrized; a person in mental health care who is on the sharp end of the needle; a person who experiences problems in living; a person with lived experience in the extremes of human experience1.
I am not a label. I am a human being with mental illnesses.
With so much effort being expended by people to distance themselves from the mental illness label, is it any wonder that those of us with mental illness are still being marginalized and stigmatized? While I agree that language can be very important, there comes a point where positive verbiage becomes marginalizing and deceptive.
There are words of course that are offensive. As an example, I would probably be offended if you were to say that I was: a nut-job, a lunatic, off my rocker, a sandwich short of a picnic, or bonkers. But I might not, depending on the situation and context.
What I am not, however, is a person with mental health issues. I think that mental health[ii] is great. It’s wonderful when people are mentally healthy. I work towards mental health every day with the help of a great medical team and medication. In a policy paper on Mental Health Promotion and Mental Illness, GermAnn and Ardiles say[iii]:
“Stemming the tide of mental illness requires a shift in thinking about “mental health,” which is often erroneously interpreted in terms of mental illness. Positive mental health affects all Canadians each and every day.”
So this is why I say it’s not mental health I have issues with, it’s mental illness that is giving me troubles.
Let’s call the kettle black
So why does stating a simple truth, that I am mentally ill or that I have a mental illness, provoke fear and judgement?
My pancreas doesn’t produce enough insulin to regulate the sugar and salt in my body. This means that I have diabetes, that I am diabetic. I don’t say that I have pancreatic health issues. I also have high blood pressure, I’m hypertensive. I don’t say that I have circulatory system cellular elasticity issues. I’m overweight as well, I’m fat. I don’t say that I have personal mass-based volumetric displacement issues.
I have chronic depression and generalized anxiety. I also deal with social anxiety disorder. Symptoms of these are panic attacks and for me, an increase in hypnopompic and hypnogogic hallucinations (these occur when you are falling asleep or waking up, not while you are fully awake).
Depression and anxiety are two types of mental illness that fall in the category of mood disorders. Therefore, I have a mental illness; in fact, I have more than one mental illness. Why should I be afraid to say that? I’m not afraid to say I’m diabetic, and I’m not afraid to say I have high blood pressure. Those are medical conditions, but so is mental illness, contrary to those with an axe to grind about the psychiatric profession[iv].
Why are they medical conditions? I don’t go see a doctor when my car needs an oil change, nor do I call my doctor when the pump in my water well stops working. I go see a doctor when I’m ill. I see my doctor for my diabetes, my hypertension, and my mental illness. I see my family doctor regularly, and she has me on medication to assist me in dealing with this illness. I also see a psychologist regularly to help me learn the skills to get back to a place where I can put these illnesses behind me. I’m seeing doctors for this, so, yeah, it’s a medical condition. Deal with it, axe-grinders.
If you have mental illness, then the very first thing that I want you to know is that there is real help available and it is effective, if you are responsible with your treatment. The next thing I want to tell you is, do not be ashamed of it!
When I first recognized that I needed help, it was a difficult acknowledgement. I had gone through these exact same conditions many years ago, but I didn’t ask for help then. It was hell. This time I knew that I didn’t want to do it on my own, so I called my family doctor. It’s one of the best phone calls I have ever made. With her attention and concern, medication, and the help of mental health professionals, I am on the road to recovery.
As I work in the emergency services field, I have a lot of experience dealing with people with mental illness. However, as it is emergency services, no one ever calls us when they are having a good day. My experience with formalized mental illness up to that point had always been negative. When you hear about mental illness in the media, it’s usually in a negative light because, again, the media rarely writes about someone having a good day.
Bell Canada’s “Let’s Talk” campaign (letstalk.bell.ca) has done a wonderful job about raising awareness over mental illness and promoting an end to the stigma associated with it. There is, unfortunately, still a long way to go. This means that it is up to you and me, the people with mental illness, to get loud and be brave.
When I first acknowledged that I had mental illness, it was very difficult for me to talk about. Taking heart from the Bell Canada campaign, I decided to start sharing. I eventually shared it with my employer as well. Through this process of opening up, I have had some wonderfully positive experiences. I’ve found that people care about me to a depth I never realized before. I’ve found some wonderfully supportive people that were part of my everyday life.
Not all of my experiences have been positive. I’ve found a lot of worried glances and looks, I’ve found people treating my based on stereotypical perceptions, and I’ve encountered up-hill struggles from people that I thought were friends. Did this depress me further? At first it did.
But then I got mad.
If I say I’m ill with a cold, with diabetes, or with high blood pressure, none of these things will cause you to bat an eye. But when I say I’m mentally ill it evokes a different response in some people.
I have mental illnesses, I am not: defective, dangerous, incapable, weak, faking it, or irresponsible.
Have you ever been depressed over something that occurred in your day, perhaps the loss of a job? Have you ever been anxious over an upcoming test or exam, maybe a fight with the spouse, or perhaps you had to go to court and sit at the table on the left? Then you have a glimpse of what my life is like. The difference between the mental illness you experienced and what I experience is that yours was episodic, whereas mine is chronic. So why does it make people more uncomfortable that I’ve acknowledged that I have an illness, that is, a medical condition?
The media[v],[vi],[vii] is largely to blame, so is social culture. Literature is something that rarely portrays mental illness in a positive light[viii]. Unfortunately, because of a lack of real information and accurate knowledge, you and I are treated according to misperceptions and inaccurate stereotypes. The only way these things will be changed, however, is also by you and me.
I’m not happy that I have mental illnesses, but I also know that I am a capable and responsible person with skills and abilities that can contribute to both my personal life and my professional life. I am not defective, I am not dangerous, I am not weak, I am not “faking” it. I am no longer hesitant to talk about my illness, my medical condition. I no longer back down when faced with opposition or challenge because I happen to have a medical condition. I am fully aware of my rights under the Human Rights Code and labour law. I demand that I be treated fairly, equitably, and without prejudice in all areas of my life, be it work, social areas, family and friends, or when accessing services.
This is how I own my mental illness.
People with mental illness have real protections from discrimination and harassment
Every jurisdiction in Canada has Human Rights Code legislation. In the United States, those with mental illness get protection from the Americans with Disabilities Act[ix] and from the Protection and Advocacy for Individual with Mental Illness Act (PAIMI Act)[x].
In Ontario, where I live, we are protected from workplace harassment by the Ontario Human Rights Code[xi] and Bill 168[xii]. In the United States, you are protected from workplace harassment by the US. Equal Employment Opportunity Commission[xiii]. As well, many U.S. departments have their own policy on harassment, such as the United States Department of Labor[xiv].
There are several forms of discrimination and harassment that a person with mental illness can encounter. The first, of course, is direct harassment involving unwanted comments that are known, or ought to be known to be offensive; and direct discrimination, where you are not given an opportunity specifically because of your mental illness; in the parlance of the Human Rights Code, your disability.
The second type of harassment you may encounter is called “mental health profiling”[xv]:
“Mental health profiling is any action taken for reasons of safety, security or public protection that relies on stereotypes about a person’s mental health or addiction instead of on reasonable grounds, to single out a person for greater scrutiny or different treatment. A “stereotype” is a generalization about a person based on assumptions about qualities and characteristics of the group they belong to.
The concept of “profiling” comes from the experiences of people in racialized and Aboriginal communities who have been subjected to racial profiling. Many court and tribunal cases have confirmed that racial profiling happens. Although mental health profiling may look different than racial profiling, it is still damaging.
One common stereotype about people with mental health disabilities is that they are violent, even when there may be little objective evidence of this.”
Another form of discrimination is called “subtle discrimination” or “covert discrimination”[xvi].
“In some cases, discrimination is subtle or covert. Intent or motive to discriminate is not a necessary element for a finding of discrimination – it is sufficient if the conduct has a discriminatory effect.
Subtle forms of discrimination can often only be detected after looking at all of the circumstances. Individual acts themselves may be ambiguous or explained away, but when viewed as part of the larger picture, may lead us to think that discrimination based on a ground in the Code was a factor in how the person was treated.”
Even a person repeatedly asking how you are doing, asking about your condition or your treatment, or taking steps to intercede with those around you to “make things easier on you” can quickly become bothersome and vexatious.
One of the most frustrating forms of discrimination/harassment you will encounter is paternalism. The OHRC has this to say on paternalism and mental illness[xvii]:
“People with mental health issues may also be perceived to lack the capacity to make decisions in their own best interests, even where this may not be the case. They are often seen as “childlike” and in need of help. These perceptions may result in paternalistic attitudes and practices that can create barriers.”
While well intentioned, paternalism is destructive, insulting, and can worsen a person’s mental illness and their self-image. The person who has a responsibility to you should not be telling you what is best for you; they should be asking you, “How can I best help you be successful?” That person in a position of authority does NOT know better than you, what you need. If they take actions that affect you, that you do not want, from paternalistic intentions, then they are violating your rights.
So how do you handle these things?
While the law is there to protect you, the best way to handle these is to begin by directly confronting the person harassing you. In most cases, a person will not realize their attention is unwanted or aggravating for you. Knowledge brings respect and understanding, and knowledge of the truth about mental illness is one of the things we need to be loud about. That said, when it comes to your employer, I would suggest that you consult with any association or union that you may belong to first, and have them assist you. When you need to discuss this with a position in authority over you, from any of the social areas covered by Human Rights legislation, I would also recommend you always have a witness present with you.
Failing the direct approach to dealing with harassment and discrimination, as stated, the law is there to protect you. Do not be afraid to use it.
Be loud and be proud of who you are
I won’t go so far as to say I’m proud of having mental illness, but I’m proud that I have the strength and courage to face a world of misinformation and stereotypes. I’m proud of the fact that I knew I needed help, and that I had the courage to ask for it. I’m proud of the fact that I have so many friends and coworkers who, when they found out about what I am dealing with mentally, stepped up and offered their support, their caring, and their love.
Don’t let your own illness shame you. Don’t allow yourself to be marginalized because you have a sickness, a medical condition. Don’t accept paternalism from those in power over you, in any setting, be it social, employment, or government.
And for heaven’s sake, do not be stigmatized for being who you are. Your mental illness is only one small portion of the person that you are. You are so much more than that one small part of your life. And believe me when I say that no matter who and what you are, there is no one else like you because YOU ARE PERFECTLY YOU!
Don’t be ashamed.
[i] Oaks, D. (n.d.). Let’s Stop Saying “Mental Illness”! Retrieved on June 05, 2016, from http://www.mindfreedom.org/kb/mental-health-abuse/psychiatric-labels/not-mentally-ill
[ii] World Health Organization [WHO]. “Strengthening mental health promotion (Fact Sheet No. 220.), Retrieved on June 05, 2016 from www.who.int/mediacentre/factsheets/fs220/en
[iii] GermAnn, K., Dr., & Ardiles, P., MHSc. (2009, April). Toward Flourishing for All… Mental Health Promotion and Mental Illness Prevention Policy Background Paper [PDF]. Pan-Canadian Steering Committee for Mental Health Promotion and Mental Illness Prevention . Retrieved on Jun 05, 2016 from https://healthycampuses.ca/wp-content/uploads/2015/01/TowardFlourishingBackgroundPaperFinalApr09.pdf
[iv] Real Disease vs. Mental Disorder. (n.d.). Retrieved June 05, 2016, from http://www.cchr.org/quick-facts/real-disease-vs-mental-disorder.html
[v] Baun, K. (n.d.). Stigma Matters: The Media’s Impact on Public Perceptions of Mental Illness [PDF]. Toronto: Canadian Mental Health Association.
[vi] Baun, K. (2009). The role of the media in forming attitudes towards mental illness. Moods Magazine, (Winter), 27-29. Retrieved on June 05, 2016: http://ontario.cmha.ca/files/2012/07/moods_media_200812.pdf
[vii] Tartakovsky, M. (2015). Media’s Damaging Depictions of Mental Illness. Psych Central. Retrieved on June 05, 2016, from http://psychcentral.com/lib/medias-damaging-depictions-of-mental-illness/
[viii] Edney, D. R., MSW. (2004, January). Mass Media and Mental Illness: A Literature Review [PDF]. Canadian Mental Health Association. Retrieved on June 05, 2016 from http://ontario.cmha.ca/files/2012/07/mass_media.pdf
[ix] Americans with Disabilities Act of 1990,AS AMENDED with ADA Amendments Act of 2008. (n.d.). Retrieved June 05, 2016, from https://www.ada.gov/pubs/adastatute08.htm
[x] Hill, E. (2015, July 7). Protection and Advocacy for Individuals with Mental Illness. Retrieved June 05, 2016, from https://www.justice.gov/opa/blog/protection-and-advocacy-individuals-mental-illness
[xi] Policy on preventing discrimination based on mental health disabilities and addictions. (2014, June 18). Retrieved June 05, 2016, from http://www.ohrc.on.ca/en/policy-preventing-discrimination-based-mental-health-disabilities-and-addictions
[xii] Bill 168, Occupational Health and Safety Amendment Act . (n.d.). Retrieved on June 05, 2016, from http://www.ontla.on.ca/web/bills/bills_detail.do?locale=en&BillID=2181
[xiii] Harassment. (n.d.). U.S. Equal Employment Opportunity Commission. Retrieved June 05, 2016, from https://www.eeoc.gov/laws/types/harassment.cfm
[xiv] What do I need to know about… WORKPLACE HARASSMENT. (n.d.). Retrieved June 05, 2016, from https://www.dol.gov/oasam/programs/crc/2011-workplace-harassment.htm
[xv] Mental health profiling (fact sheet). (n.d.). Retrieved June 05, 2016, from http://www.ohrc.on.ca/en/mental-health-profiling-fact-sheet
[xvi] What is “discrimination”? (n.d.). Retrieved on June 05, 2016, from http://www.ohrc.on.ca/en/iii-principles-and-concepts/2-what-discrimination
[xvii] Ableism, negative attitudes, stereotypes and stigma. (n.d.). Retrieved on June 05, 2016, from http://www.ohrc.on.ca/en/policy-preventing-discrimination-based-mental-health-disabilities-and-addictions/5-ableism-negative-attitudes-stereotypes-and-stigma