Promotion, Prevention, and Recovery: Let’s Talk About How We Talk About Mental Illness

By Janet Phillips
E-mail: jmp3@ualberta.ca
Twitter: @Jan_Phill

It's that time of year again. On January 27, Bell Canada held its annual ‘Let’s Talk’ campaign with the social media hashtage #BellLetsTalk. The goal of ‘Let’s Talk’ is to combat stigma while raising money for mental health initiatives across Canada. Aided by a cast of Canadian heroes such as Clara Hughes Michael Landsberg, Mary Walsh and Michel Mpambara, this year Bell raised a whopping $6 million. 

 

  

As many of you know, ‘talking about’ mental health is a relatively new practice. As recently as twenty years ago, the subject of mental health was taboo. Granted, some of us have had family members or neighbours who were ‘unwell’, and who may have needed to ‘go away’ for a little while. But, no one talked about why.

         Today, it seems that everyone is talking about mental health. Public figures ranging from Eminem to David Swann have gone to the media with their stories. The University of Alberta is pursuing a plethora of mental health and ‘wellness’ initiatives, ranging from Giving Day to ‘Unwind Your Mind’. We can’t even move across campus without running into ‘wellness happens here’ stickers, or stumbling over mental health awareness signs that tell us to take breaks and smile at each other. 

These conversations about mental health aren’t just happening at the local level: 2007 saw the birth of the Mental Health Commission of Canada, and in 2010 British Columbia released its own mental health strategy, followed by Ontario, Manitoba, and New Brunswick (just to name a few) in 2011. As well, governments and non-profit organizations are calling on ‘everyday’ folks just like you and me to give our two cents worth of feedback. Alberta’s mental health policy is currently under review and its committee has reached out to the public to ask for their input. If nothing else, this is the decade that mental health has come out of the closet.

Amidst this mental health flurry, I’ve noticed that the way in which people, universities, and governments talk about mental health is guided by two problematic principles. The first of these concerns promotion/prevention. The goal of mental health promotion is to encourage good mental health practices that will help us take life’s blows and prevent our needing to rely on already overstretched specialized services. To put it simply, mental health promotion is all about resilience: the ability to bounce back, no matter what the world throws at us. How do we become resilient? Rest assured, there are a plethora of opportunities. 

Promotion/prevention resources often indicate that good physical health is an important component in good mental health. So, take in one of the University’s ‘wellness walks’, eat fresh fruits and vegetables, go to the gym, and don’t even think about smoking, even if it is the only five minutes of pleasure you get in your day. The University of Alberta’s Clinical and Counselling Services offers us a workshop on ‘Creating a Resilient Mindset’, and Alberta Health Services has released a Bounce Back Book Series to help create resilience in kids beginning from infancy. 

I know what you’re thinking – isn’t all this a good thing? The problem is that while promotion/prevention are effective ways of offsetting the suffering for some, these tools are neither effective nor accessible for all. For people living with chronic mental illness, resilience isn’t going to cut it. We need well-funded social supports and services. In terms of accessibility, promotion/prevention overlooks deeply embedded structural barriers, such as poverty, racism, ableism, and transphobia. For some, these barriers make memberships to Yoga studios and shopping at organic grocery stores impossible. The truth is that many of us may share diagnoses with Bell’s spokespeople, but many of our lived realities are quite different. Not everyone can just bounce back, which is exactly why basing mental health policy on this principle is potentially dangerous.  

         This begs the question: what do we do when promotion/prevention doesn’t cut it? Never fear, recovery is here. Please, don’t get excited. There’s no ‘cure’, although a history of violent ‘treatments’ and eugenics in Canada reveals that folks sure have tried to find one. Here, recovery refers to living a pleasant, meaningful life where we can still contribute to society, despite our ongoing symptoms. In other words, we may suffer from mental ‘illness’, but we can still go to work, get married, buy a house, and lead a normal life (regardless of whether or not we find ‘normal’ desirable). What’s so problematic about that? It sounds like the barriers that kept us from fully participating in society in the past have been removed. The problem is the assumption that if the barriers have been removed, nothing is keeping us from fully participating in society except individual, personal failing. And this assumption has very real consequences in neoliberal times, when we’ve experienced devastating cuts to social services, and when everyone is more concerned about gaining a competitive advantage over the next person than they are with helping them out.

And it is here that we see the fundamental paradox underlying the way we talk about mental health today: everyone is impacted by mental illness, but responsibility for mental health is put on the individual’s shoulders. If this really is the decade that mental health has come out of the closet, then we must realize that we’re in this together. What’s lacking in discussions, from dinner tables to policy tables, is the importance of collective responsibility in ensuring that we all have access to the resources necessary to ease our suffering, and in ensuring that those who don’t ‘bounce back’ are protected and cared for, and on their own terms.

The line between normal/abnormal has been redrawn: mental ‘illness’ doesn’t make you abnormal, which is exactly why some of us can afford to talk about it. But, the failure to make it on your own does. The new inclusion of mental illness in Canadian society is conditional on the grounds that as ‘individuals’ we do everything in our power to recover and assimilate. If we do not, we are responsibilized for our own failing and there is no safety net to catch us when we fall. This is not to say that we should not discuss mental ‘illness.’ By all means, ‘let’s talk’, but let’s also recognize that not everyone is being heard.

Janet Phillips is a PhD candidate and instructor in the Department of Political Science at the University of Alberta. Her research examines the governance of mental abnormality in Canada from the 1830s to the present, with a particular focus on recent discursive shifts surrounding mental healthcare reform.