World Mental Health Day 2023

I wrote this post last year (2022) and I’d left it stopped dead in the middle of a sentence. I found the draft last week and felt that it still accurately described my thoughts and feelings about today so I’ve finished it off and added the last paragraph. I’ve not updated the middle so all of that is written exactly as it was a year ago so all of the ages, timescales and talk of the present or “recently” are a year out as it made most sense when read that way. Only this current paragraph and the last paragraph were written today.

Today is World Mental Health Day. It’s a day I increasingly dislike. I’ve been mentally ill for exactly half my life and in that time I’ve seen awareness of mental health skyrocket but attitudes towards mental illness aren’t changing half as much. We seem to have sanitised it, spread it to the masses, because we all have mental health, just like we all have physical health and so we all get to have an opinion about it. Year after year we get to read empty, vacuous articles about the benefits of exercise and a healthy diet and while these are true and accurate, they’re rife with assumptions, unacknowledged privilege and stigma. You see, I didn’t become mentally ill because I ate too much pizza or didn’t go for enough walks in the park. I became mentally ill for all sorts of complicated reasons that don’t fit nicely and neatly into a feel-good article. My mental health is on the floor and no amount of awareness of that is going to help me or any of the other mentally ill people I know. I’m so far beyond mindfulness and a set bedtime.

Just this week I experienced what I assume was a flashback. I’ve never had a full-blown one of these and let me tell you, despite being aware of them for years and working with people having them, I was unprepared for how visceral and all-encompassingly awful it would feel. I knew they were awful, I’ve seen people experience them and it’s terrifying trying to reach them, trying to bring them back to the present, trying desperately to help them feel safe but it wasn’t something I’d experienced fully before and here it was, 16 years into being mentally ill and it still throws up the most hideous surprises. Awareness can’t possibly prepare you for what these things are like to experience: to hear voices that no one else can, see things no one else can, re-experience things you lived through over half your lifetime ago, feeling an absolute sense of dread and fear so strong that you wish that you’d die, feeling urges to hurt yourself in horrible ways just for a momentary break from the pain you’re mentally going through. None of these things are mentioned in the mental health awareness day posts because they’re not tidy, or clean, or pretty. Most of us who are mentally ill feel hugely stigmatised by this awareness day, like the other minority groups who also have to sit through awareness days, weeks and months where companies, businesses, politicians and individuals all declare that we need to be aware, that it’s ok not to be ok and to reach out for help and it all just fades into the ether and dissipates as the awareness period comes and goes and we go back to ignoring the issues and back to placing personal responsibility on those suffering. I see people every year getting more and more frustrated by this day. I thought it was just me. I thought I was being ungrateful, intolerant, but clearly I’m not, it really isn’t good enough and falls so far short of where we need to be. We don’t even have a Mental Illness Awareness Day, there are days and weeks for specific conditions but those split us up, put us into boxes and factions rather than uniting all of us who experience mental illness and being able to share our experiences of that to create awareness and shared understanding.

There’s a huge movement online where people are reclaiming the word Mad and it’s something I subconsciously and somewhat inadvertently did when I named this blog. I’ve always described myself as mad because it’s how I feel. I don’t feel “normal” or “well” or like I did before I became mentally ill. There’s a big push to move away from medicalistion and descriptions of illness and disorders and this isn’t something I personally feel able to subscribe to because I feel ill and definitely feel disordered but that doesn’t mean that I think there’s something fundamentally wrong me as a person. Who I am is not disordered, who I am isn’t due to illness but my experience of the world is marred by illness, like a really crap pair of sunglasses, it tints my view of the world and changes everything I experience, it’s all viewed through the lens of anxiety and often depression too. Madness is often used as a slur, so much as I describe myself as it and some of those closest to me do on occasion too, it’s not something that I’d expect others to describe me as because they’re unlikely to understand the nuances I live with and the ways in which my madness affects me. Equally, I’d never describe someone else as mad unless they self-identified that way and I knew them exceptionally well. I don’t view mentally ill people in that way. It’s hard to explain and I’m not sure that all of the ideas are fully formed in my head yet. It’s a work in progress.

The difficulty with this day is it never just sticks to mental health and always slightly strays into mental illness territory but those of us who’ve firmly set up camp there often feel like outsiders and pushed out by the rhetoric of this heavily sanitised version of mental health and illness. People don’t like thinking about the fact that although there are protective factors and things that you can absolutely do to improve your own mental health, that won’t necessarily protect you from mental illness. Some people are dealt much riskier hands than others but ultimately there’s always an element of risk and it’s not a person’s fault if they become ill, they’ve not done something wrong, they’re not to blame. Huge numbers of mentally ill people exist within our society and they’re being let down at every turn. Funding is cut, treatments withdrawn, postcode lotteries dictate what services you can access and you have to be ill just the right amount to access treatment and if you have multiple conditions or diagnoses then you might as well not bother because none of these systems join up anymore and so you have to split up your symptoms, your experience, and neatly fit it into a box in order to access 6-12 sessions of something designed for one, mild condition. None of this is how humans work. None of this is humane. Mental health is not mental illness just like physical health is not physical illness and we do a disservice to everyone when we meld the two together. So often the term mental illness is nowhere to be seen. I recently discovered the phrase “mental health illness” which made me double-take because I thought I’d read it wrongly. By removing illness from our language you add in shame as if it’s wrong to be ill or that we’re deficient in some way, it doesn’t make the symptoms, the lived experience, any easier to handle but it makes it more comfortable for society to describe us in these ways and to minimise our struggles. Mental illness isn’t polite, or neat, or simple, it’s often not manageable, it’s overwhelming, it’s exhausting and using ever-softer ways to describe it, mental ill health, mental health illness, just puts separation between you and the sufferer but it doesn’t lessen our suffering. I often feel like I’m banging my head against a wall when I post here because I feel like I just say the same things over and over again. I second-guess myself and often talk myself out of posting all together or even writing because I don’t want to keep saying negative things, I don’t want to keep sharing a bleak message or coming across as ungrateful but I, and so many others like me, are so tired of screaming into the abyss, telling society what we want and what we need and still being bombarded with these vacuous awareness campaigns that do nothing but stroke people’s egos and allow companies to virtue signal.

For me, Awareness of Mental Health needs to begin with awareness of Mental Illness. We need to identify illness early and treat symptoms quickly. We need more trauma-informed approaches and we need to stop dismissing the traumatised and invalidating their experiences. We need quick access to a multitude of different treatments because we know a one-size-all approach doesn’t work and yet that’s what we’re increasingly pedalling now. We need timely referrals and assessments for Neurodivergences and these need to be screened for as standard. Research shows that at least 20% of all people accessing mental health services are neurodivergent in some way and many aren’t diagnosed as children due to atypical presentations so these need routinely screening for and waiting lists need to be shortened so they’re not years long but months or even weeks. People need to know who they are and this would go a really long way to sorting some of that problem out. It would also help people to access suitable treatments because neurodivergent people often have poor results from CBT and can have varied reactions to psychiatric medications which need to be listened to and adapted rather than dismissed or ignored by doctors who assume they can’t possibly be suffering as much as they’re reporting. We need joined up support with mental health services talking to other services in the local area so that people with housing problems or living in poverty can be helped quickly and robustly. We need funding and research and we need lived experience at the heart of all of this so that we stop doing what we’ve always done in a system that’s unbelievably broken. We need to look at the role that society is playing and realise that mental illness doesn’t exist in a vacuum. If people are worrying about housing, neighbourhoods, bills, employment, physical health or addiction, how are they going to get better?

And for the companies who’ve been virtue signalling all day, I wonder how many of them offer truly accessible employment because I’ve found almost no one does. One of my biggest hopes when covid started changing the world was that it would create permanent improvements for disabled people. I hoped that working from home would stick and that truly remote positions would continue to exist but they’re all fading away and new positions are almost always hybrid at best. As someone who’s severely agoraphobic, this isn’t an option for me and yet so many companies made it work for almost 2 years with almost all of their staff and now I can’t find work because everything is returning to “normal”. This isn’t inclusive, it’s not accessible, and it shows a really distinct lack of awareness of mental health (and illness). I’m capable of specific, limited work, I have been for the majority of the time I’ve been agoraphobic but thanks to how our society functions, I’ve not been employed for 8.5 years and counting. The majority of people with severe mental illness aren’t in employment and for many that’s because they’re not well enough and we need a better, more accessible social security system for that. But for some of us, it is systemic and societal barriers that prevent us from reaching our potential. Applying for disability benefits 2 years ago nearly killed me, it’s a genuinely horrific process that I wouldn’t wish on my worst enemy and it took me months to recover from that experience. We must do better than this, we can do better than this, but the system needs smashing down and building completely differently from the ground up so that we’re no longer putting people through such an undignified, intrusive and inhumane begging process.

I’ll leave you with this – the theme for World Mental Health Day (2022) last year was “make mental health and well-being for all a global priority” and this year (2023) it’s “mental health is a universal human right”. To me, those mean very similar things. A year on, we’ve not progressed, nothing has changed and we don’t even have a plan or a way of measuring that these goals are being worked on, being improved, or achieved. They’re wishy-washy soundbites that sound good, they make you nod along in agreement until you ask yourself, what does it mean? What does that look like? How do we achieve it? The 2023 theme is simply a factual statement, but just saying something true doesn’t make it happen and these statements end up being meaningless. It’s not a call to arms, it’s not a highlighting of injustice, it’s not a concrete plan of how things can be changed or improved, it’s just another nothing slogan that makes companies and businesses feel better when they plaster it all over their social media channels for the day and isolates people like me who know for a fact that we’re years, if not decades away from mental health being a human right. I haven’t been mentally healthy since I was 15, I’ve not received NHS treatment for my mental illnesses since I was 22, I’m now nearly 33 and no amount of exercise, journalling, reaching out, or hot baths has won me back my human right of mental health, but at least you’re now aware of it – I’ve done my bit for the day!

My previous posts written on this day and other awareness days can be found here:

Dignity and Respect – Being Treated Like a Human Being (World Mental Health Day 2015)

World Mental Health Day 2017

Why it’s Not OK Not to be OK – World Mental Health Day 2020

Mental Health Awareness Week – Awareness is No Longer Enough 2021