Hieronymus Bosch’s The Ship of Fools, ca. 1494-1516
For those of you who didn’t know the month of May has been National Mental Health Month. And even if you did know about Mental Health Month, you may not know that we have been celebrating this since 1949. According to a press release from Kathleen Sibelius, Secretary for Health and Human Services:
Mental Health Month was established in 1949 to increase awareness of the importance of mental health and wellness in Americans’ lives, and to celebrate recovery from mental illness. We know that mental health is essential for a person’s overall health; prevention works; treatment is effective; and people can recover from mental disorders and live full and productive lives.
Cited in the press release as positive signs in mental health are the changes offered by the Affordable Health Care act—which may be altered or overturned by the Supreme Court next month—as well as various grants and programs that have been instituted to provide “comprehensive” and “evidence-based” treatments (Sibelius, 2012). For Mental Health Month, Bring Change2Mind, an organization formed by Glenn Close that is working to combat the stigma of mental illness, has produced a television ad available on YouTube. The ad shows “sufferers” in the crowd in a busy train station wearing T-shirts featuring the mental illness with which they have been labeled along with a family member or loved one wearing a similar T-shirt indicating their relationship to the “sufferer.”
While I do truly believe it is vital to educate people about the value of psychological health, I found this advertisement very troubling. Labeling people with their “illness,” and even using the dichotomy of mental illness versus mental health, perpetuates the all-pervasive belief that those dealing with difficult issues, from anxiety to psychosis, need to be labeled and separated from the so-called “normals.”
And in this country, thanks to the insurance companies, labels are required for payment. A psychiatrist or psychologist trying to bill an insurance company for reimbursement must include the diagnostic code in the request.
In “Madness and Civilization,” Michel Foucault (1965/1988) discusses the history of asylums as emerging gradually from the way lepers were treated in the Middle Ages. He describes how lepers were segregated in Europe from the rest of the population. Foucault says that while the disease of leprosy waned in the 14th and 15th centuries, the buildings that housed them to keep them away from the healthy remained. He writes:
Often, in these same places, the formulas of exclusion would be repeated, strangely similar two or three centuries later. Poor vagabonds, criminals, and “deranged minds” would take the part played by the leper, and we shall see what salvation was expected from this exclusion, for them, and for those who excluded them as well. (p. 7)
In a recent interview for “The Sun” magazine, Christopher Lane, a historian and professor of English, spoke about how there was a time in the early 19th century where “being different” was embraced and espoused by the Romantic culture. But by the end of the same century, the move was back toward conformity, with those who “thought differently” ostracized in various ways.
If what the world calls “mental illness” actually manifested as physical disability, no one in this country would stand for the labeling we give to people with psychiatric diagnoses. Despite the protection afforded by the Americans with Disabilities Act, people who have a disability have fought long and hard for inclusion, rather than exclusion. But there are people in that television spot literally advertising their diagnosis and exclusion across their chests. While the stated aim of the ads are, as noted above, to combat the stigma—a.k.a. ostracizing—surrounding mental illness, the diagnostic labels dilute the impact and support the medical model of psychology and psychiatry.
An existential perspective of building awareness around psychological health would eschew the diagnostic labels. Rather than talk about the sick versus the well, we might talk about varieties of psychological experiences, and how those experiences might impact a person’s ability to navigate their world. Being-in-the-World is not a dualistic concept—it does not imply an opposite concept of Being-out-of-the-World. We are always in relationship to Others in the World, even when we try to dismiss them from our World. What a waste of energy trying to dismiss them is.
If I were remaking that television ad, I would show that same busy train station. But no one would be wearing labeled T-shirts. Rather, I would use a voice-over to simply state that a percentage of these people need psychological support in one form or another. However, you might not be able to spot which ones amongst the thousands of commuters. Nevertheless, they need support on their journey just as we do. Supporting “them” then becomes a way to support us. That would make it a happy Mental Health Month.
References
Foucault, M. (1965/1988). Madness and civilization: A history of insanity in the age of reason. New York: Vintage Books.
— Sarah Kass
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