I think what I find particularly alarming about mental health stigma is the way some people become so habituated to it. The way one case manager expressed it to me early in my career, for some people wellness is a completely foreign country and that is frightening to them. This was particularly about a client we were both working with, who really was not interested in recovery, but simply wanted to be maintained and feel supported where she was at.
I have interacted with a lot of individuals with this kind of mentality. Discouraging, yes. And frustrating. Sometimes exhausting. But really discouraging, since they have become so used to the aromatic raw sewage of stigma they have been wallowing in that the very idea of changing that for pure clean water is not only threatening, but abhorrent to them. So, they appear content to live in their medicated fog, while shuffling back and forth between their mental health boarding home or subsidized apartment, to the mental health team or the activity centre for meds, activities, outings, and some sense of friendship and support from people who are being paid to look after them.
And I get it. If the alternative is going to be nothing, then even this is going to be better than nothing. Much better. In exchange for being compliant mental health consumers they get stable housing, meds to keep them quiet, three square meals a day, and free movies and coffee shop outings. Walks in the park and swimming as well. Some actually do form friendships, lasting friendships among themselves, others just stay on their own (I suspect a clear gender divide here, with the women being more inclined to be social), but the whole deal is, that if you don't stay sick, if you actually do recover and get well and stay well, by contemporary society's standards, that is, then you will be left out in the cold uncertainty of ordinary life, you will lose everything, and simply end up alone, isolated and worse off than ever.
People who end up relying on mental health services are usually just the same people who do not do well under competitive market capitalism. It is too rapacious, competitive, and merciless. And isolating. Those who do best in cooperative and collaborative environments, who rely on and offer the support that comes from a warm and supportive community, are going to be the first and worst casualties of market capitalism. Especially without supportive families. Add to this mix survivors of child abuse and dysfunctional families and of course we are going to need extended and enhanced mental health services, if only to help keep people alive and well enough to not really fall through the cracks.
When I was getting ready to apply for disability, some eighteen years ago, I was actually looking forward to no longer having to take full responsibility for my ,life. Not because I was lazy but because I was so emotionally exhausted. When I was refused advocacy after being turned down for a disability pension, I was of course disappointed. but there was also something very empowering about being left on my own,. Still frightening, yes. And even though I have done relatively well, I am still appalled that there are not more and better supports available for people on low incomes and especially for the working poor. Perhaps had I lied, had I acted better, they would have been persuaded to advocate for me and approve my claim for disability, but I have way too much personal integrity to want to go down that particular hole.
Risking wellness has actually propelled me towards greater wellness. Refusing to use a mental health diagnosis as an excuse for not moving forward has moved me all the further in life. I am not going to speak for others because it would be totally unfair to judge them. But this much I know. We have to reframe and redefine wellness, or we will simply be leaving behind more and more people whose lives and gifts are precious and essential to us all, and without whom we are all going to be left all the poorer.
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