Mental Health Labels: The Problem or Solution?

One man fell and broke his arm. Another man lost his family income, and it broke his heart. One goes to the doctor and gets a cast put on while his arm heals. The other buries the pain and hopes to make enough to cover the week’s meals. What’s the only difference to the outcome of these two stories. Shame. But why? Why is there so much shame surrounding mental health, and how do we challenge it?

I was chatting to a friend the other day about how this last year and a half has been a crazy time for many people. People being separated from family, friends and loved ones. People unable to attend weddings, funerals, birthday parties, visit their parents at nursing home. It seems like it has understandably shaken a lot of us. This shaking impacts ourselves, our children, our relationships, jobs and marriages and plays out in many forms: increased stress, anxiety, fear, depression, isolation and conflict. 

As I mentioned in a previous post, I work with families, specifically I am a, wait for it, a Family Intervention Practitioner. It’s a big mouthful of words that means when a family is in a crisis (Domestic Violence, drugs/alcohol, trauma/mental health, parenting or relational conflict), I throw my hat into the ring and support them to identify pathways towards healing, safety and connection. I’m definitely interested in sharing some practical tips and knowledge in coming weeks, but the reason I bring this up today is that in my work, I have seen a significant rise in people both encountering these above mentioned crises throughout the pandemic and also an increase in people reaching out to friends, family and services for support. 

I have loved seeing the latter, seeing families face-time when separated and communities rallying around each other. However, I think especially with mental health, there is still so much stigma around getting formal support such as counselling, which causes a lot of people to ‘bottle up’ their feelings and bury them deep down inside (which we all know is not the greatest solution). In saying that, I can’t really talk, there is another saying that ‘doctors are the worst patients,’ and I think the same thing applies to most jobs, mine included. 

I realised recently that while I strongly advocated for people accessing supports, such as counselling for mental health and just general wellbeing, I was often resistant when facing an issue. So I challenged myself and decided to book into a counsellor two weeks ago. It went much better than expected! It wasn’t weird, (I don’t know why I thought it would be since I do it all the time with others) and it was nice to have the opportunity to unpack life with a supportive, non-judgemental person, in a safe space. I honestly wasn’t even sure what I was ‘going in for’, just the general hectic nature of life I guess, but I wanted to be open to where it might take me. I’m proud to report that I am going to go back again, and if I got nothing else out of it, it would still be a great opportunity to reflect and grow as a person.

But it got me thinking about this whole ‘issue’ of mental health or mental wellbeing and why I was personally so against getting support in this area at the start. What I realised and it may ring true for you too, but the issue for me was that I was seeing mental health as a negative ‘issue’ or problem needing to be dealt with or removed, rather than a natural part of life that needs to be exercised to be maintained. 

I think we often treat our mental health the way I’ve treated my car lately- driving it into the ground, skipping my services and maintenance, doing the bare minimum to keep it on the road until it breaks down. Then I take it to the mechanic to get support as it can no longer function with the fumes I’ve been running it on and is now significantly impacting my ability to complete day to day tasks. Sound familiar? 

But mental health IS a normal part of life, it has ups and it has downs just like our physical, emotional or spiritual health does. Consequently, just like health in these other areas, if neglected, our mental health will decline. We talk lots in this day and age about wellbeing and holistic approaches and yet I feel like we still often default to only addressing the physical aspect of our health. Then we sit back and wonder why we are still facing all these health ‘issues’ in our life. It’s not a good model. To put it even more bluntly, it doesn’t work.

But remember the two men and the shame I mentioned at the start, well that pesky shame keeps on getting in the way of us being able to openly discuss with safe supports, our mental health issues. It gets in the way of us getting a mental health care plan so that support is affordable. It even gets in the way of seeing a counsellor all together. We don’t want to be ‘that person’ or have a label of someone with ‘mental health issues’. I think shame has been associated with mental health for far too long because we as a culture and society have allowed it through a process called ‘the individualisation of man as a unit’. 

We have taken people who are situated within a time, culture and context; people who are unique and complex. We have isolated them from this context and complexity and reduced them to an individual, isolated unit.  We have finally assessed these individuals, trying to derive meaning and interpret individual symptoms from the very limited ‘presenting issues’ rather than exploring the deeper contextual, environmental or systemic issues from which they likely derive. 

Maybe there is a mum who is dealing with extra stress with her children switching to distance education (context) in the past year (time). She has tried meeting up with other distance education families for support in this area (culture), however due to ongoing domestic violence (DV) occurring in the home from her partner (context), she has been self-harming to cope (presenting symptom). 

Rather than seeing this mum as a resilient woman trying to find a way forward under exceptional circumstances, our mental health model and culture strips her of her experience, strengths and context. The mother comes into a clinic and is assessed and treated as her presenting isolated symptoms, ‘an overwhelmed woman who is self-harming’. She walks away with some therapy sessions focused on helping her develop better self-care strategies, medication and some new labels of anxiety and depression which she can carry right back into her stressful circumstances and continuing DV relationship. 

I feel for so many people that go through this injustice, and I see it all the time in my work with families. So many unique and complex, but ‘normal’ people walking through life, dealing with crappy situations, reach out for support and are then labelled with a very ‘un-normal’ identity label. Identity labels such as depression or mood disorder that these ‘normal’ people then carry with them, often viewing these labels as now a permanent or unchangeable part of who they are. An added weight to add to their already hard situations. 

It is this gripe with the current model in the west that I struggle with regarding mental health. I mean who wants to go to a counsellor, GP or support service if its only to have their stories, strengths and struggles silenced and reduced to labels of: being depressed, having a disorder, being suicidal, ADHD, etc. We need to re-evaluate how we view mental health. It is not a dirty or shameful word, but an important area for all of us to care for. I believe we also need to be careful how we use labels in mental health and not to apply them so flippantly. If we do, I believe we run the risk of de-valuing the complexity of hardships people face. I would argue this practice of symptom-based labelling in mental health is verging on a form of cultural gas-lighting, where people are treated as ‘crazy’ or a ‘categorical problem’ simply for reaching out when facing mental strain or dysfunction at a particular time in their lives.

I will be the first to acknowledge that there is certainly a place for mental health diagnosis, especially where it can be used as a platform for helping increase education and understanding. I have seen many client’s express relief at finally having a name to express what they are experiencing. However, in my experience, when we start reducing people’s unique, individual and complex circumstances to a labelled box, we lose that person to the box. If we treat people as a sum of their presenting symptoms, we will encourage them to do the same. I have personally found when people take mental health labels on as a part of who they are, it often has a sadly demotivating effect on that person’s willingness or belief that they can move beyond or achieve the change they want to see. It is a big part of the reason I will always advocate for a more holistic and relational approach to mental health, but that is a topic I will have to take up in another week. 

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