It’s May! That means it’s Mental Health Awareness Month, which in turns means there’s going to be “well meaning” people coming out of the rafters in fake support of mental health issues and disparities – preferably without letting those with mental disorders talk or only picking ones that are super general (depression) or “sounds a little worse but still marketable/not too scary” (bipolar). Then there is the “omg, self care!” crowd. I’m sure it started as something real but it’s a bunch of meaningless capitalistic bullsh*t at this point, aimed at people who have little wrong with them.
Let’s start with Self Care:
Dealing with mental illness is difficult. Many people across the globe struggle and experience it everyday, me included. However, instead of actual, viable solutions such as better access to authentic mental health care, more genuine diversity in psychology/therapy fields, things of that nature – we get “self care”. Which is a paltry, hyper-capitalist idea that basically boils down to “Treat Yourself!”
An article written by Shayla Love “The Dark Truths Behind Our Obesession with Self-Care” talks about this in depth:
From the ashes of these increasing mental health burdens has risen a trendy, Instagrammable solution: self-care. We young people, suffering in unprecedented numbers, have been forced to take on the responsibility of caring for ourselves, and have fallen under the spell of this hashtaggable term to do so.
Self-care is a nebulous name for a group of behaviors that should have a simple definition: taking care of yourself. But it’s no longer just meditation and journaling; everything can now be #selfcare. Eating healthfully or indulgently; spending time alone or seeing friends; working out or taking a rest day; getting a manicure or forgoing beauty routines.
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These activities and products are not sinister in and of themselves. I would hope that a life includes leisure, time with loved ones, and exercise. But self-care has been appropriated by companies and turned into #selfcare; a kind of tease about the healthcare that we are lacking and are desperate for. As Baba realized, you can’t actually treat an anxiety disorder with a bubble bath or a meditation app, and the supposition that you can is a dangerous one.
The article is a very good read (even despite being a Vice work, which is pretty rare for me to say) and strikes on how the captialized version of self-care, not necessarily the concept itself, is not a decent replacement for mental healthcare.
I have ran into people preaching self-care over and over again, especially when I bring the fact I have mental disorders, particularly trauma disorders.
“Do exercise!” I have practiced martial arts for over 10 years. And I roller skate. And I go biking. And I’m usually told this by folks who are less healthy than me.
“Do yoga!” Been there, done that. Doesn’t do anything for suicidal thoughts. Or stop attempts.
“Get a hobby!” I already knit, crochet, build robots, code, do martial arts, cook, write long length stories, make books and journals, create CADs, 3D print, roller skate, draw, sketch, bike, fix cars, fix bikes, speak several languages and more … and yet I still have several disorders. Huh, it’s almost like the two aren’t related. Like I can be really good at something, and still my brain will malfunct. Y’know, like how you can be really, really good at deep breathing but that’s not going to stop you from having lung cancer – or cure it.
“Have a gratitude journal.” Sounds like bullsh*t and I’m both a writer and a bookbinder. Gratitude journals are worthless because while being grateful for things is nice – it doesn’t fix problems. It’s just pointless distraction better aimed at those who have little wrong with them.
While doing these things are not bad in and of themselves, they are a shabby and crap replacement for actual mental health care. Happy thoughts and “positive vibes” can’t heal cancer nor mend a broken leg, why would it do the same for a messed up mind? It is important for people to have access to real resources for proper care. While having green tea every morning is nice, it doesn’t cure depression (if that were the case, Korea and Japan wouldn’t be fiercely competing neck and neck for who has the most suicides and China would save massive yuans on anti-suicide nets they put on buildings). Real conditions should be met with real solutions.
Then there is the money part – a lot of these “self-care” things cost money. Luxurious amounts. Here is the thing: if a poor person can’t participate, it is not a legitimate practice. I always use that as a litmus test because if something is supposed to authentically help but ices out those who need it most, then it is probably a fad for the rich and self-indulgent. I mean, who truly believes that wearing a temporary tattoo that says “you got this” actually fixes PTSD? Either you’re nursing a drug habit or plain stupid to believe this.
The Self-Care movement seems borne from the fact that, honestly, it is far too hard for the average person to get psychological help if they need it. On its face, Self-Care sounds very individualistic, pull-yourself-up-from-your-bootstraps … which conveniently ignores the fact you have to wait long months for a professional you can’t afford. As if being besieged by a disorder is a choice and can be greeted with simple solutions, like buying expensive tea or buying fuzzy pillows.
And this is just Self-Care. There is also the fact the bulk of mental health assistance really is just, “pills are the new strait jacket, everything useful is expensive, White people only – preferably women. Everyone else can go to jail. Or die.”
This isn’t to say that proper medication does not help conditions but A) not every mental disorder can be solved with a pill (or a litany of them) B ) Pills do not replace talk therapy, at all. US mental health care honestly feels that if someone winds up in a psych ward, they just need to be drugged up, no need for cohesive one-on-one therapy. And if they are not White, even their cultural experiences and perspectives are going to be labeled as a disorder, usually one of the psychotic ones. By the way, that is a historical problem because, long story short, White people always thought Black folks were legitimately crazy for believing racism exists. Give those same White folks a clipboard and hospital badges, and you get a lot of misdiagnosed people who never get helped – or get swept into a system that just rather dose them into silence or compliance. I actually had to argue with doctors over my diagnosis because they wanted to diagnose me with – guess what? Schizophrenia! Or bipolar. Because it was easier to ignore the fact I had a trauma-filled childhood that gave me memory problems that heavily hinted I had major dissociation. Y’know, a dissocative trauma disorder? Since I believed, “cops harm Black folks on the level of serial killers, the drug trade literally poisons and rot communities, and racism exists”, I was considered “militant and bananas”* – oh, and they weren’t too interested in shoving me in front of a therapist but they were pretty quick about “what pills should she be on?” That’s a problem. A big one. And pretty oft ignored.
And if you get tossed in-patient? Problems just compound. Remember, you will just about never see a therapist if you’re general admissions (which is most people: the suicidal, the psychotic, the addicted, everyone in between. They all wind up here) so if you want to talk out your problems, you have to settle for your fellow patients during down time – which is not what they are there for, by the way – or group therapy, where if you are not really cool with telling swaths of strangers your problems, you really don’t have options. And there is really little to do so if you want to stay outside your head, that’s probably not going to happen.
Should you spend too much time in your head and fall into an episode, the options are restraints, being tersely spoken to, solitary, or getting the Spike (sometimes three needles, sometimes one, always a knock-out serum). Restraints are no fun, you feel like you’re in The Exorcist. Solitary is exactly that, just you and your thoughts in a teeny room. Some places have teeny 6×6 rooms with four walls, a mattress and a camera staring riiiiiiight at you embedded in the corner of the room. You get a sheet and pillow but nothing more than that. Other places, it’s just a cleared out room – most hospitals have done away with padded walls, those are a thing of the past (and bad movies). The burnt out nurses have no idea how to talk to you so they opt for “as if speaking to a bad child”. The ones who do use training were trained by people who read from guides crafted by idealists and edited by paranoid lawyers – useless. And most do not seem to know how to reference the DSM, the handbook of mental health and disorders, when they meet a patient whose disorder they do not understand. Despite the fact I am diagnosed with dissociative identity disorder (old name: multiple personality disorder, hasn’t been used since 1994), nurses would go directly down the “schizophrenia” route in treatment and mannerisms towards me. If not outright ignore me because, eh, what is there to do? I’ve seen others get the Spike, it’s fast acting and you either wake up in restraints, in solitary or in your room. In some places, you’re surrounded by a small crowd of people when you come to, in others, you just wake up on your own but someone is definitely checking on you.
Psych wards pretty much are like holding cells for the mentally bereft. You’re not allowed outside, you get three squares a day, the nurses act like wardens, and your time is dictated with little variation. Not to mention, it’s a holding cell you get a massive bill for. And I am talking “You could buy a fancy Tesla with all the trimmings” massive. I thought I amassed student debt fast, I managed to outpace what I accumulated in four years from college in less than three weeks at a mental hospital for my trauma disorder.
Speaking of which – yes, there are mental health programs. For example, there are a few for trauma disorders – emphasis on few because there are about twenty hospitals maybe on the planet that can treat DID. I’ve gone to one of them twice. However, mental health programs are hard to get into and prohibitively expensive. Just one night there is about $1,500 USD. For my disorder, I need about at least six weeks for treatments to actually work. Some have stayed over a year. Yes, you get one-on-one therapy and structured plans but still cultural barriers exist (yay, being labeled “aggressive” even when you’re not and not being allowed to discuss institutional prejudice or racism). And if you opt out on meds, things get a little worse because it concerns the doctors. And the insurance companies think a mental disorder is like a cold – you do a couple things and the person is all better again.
For example, my insurance, United Healthcare, did not want to pay. They actually had me booted out a day after being taken off suicide watch, saying I was all better. Refused to talk to the doctor, just said “she’s good.” Oh, and they do this a lot. United Healthcare’s reason? As expressed in the linked article:
United had a structural conflict of interest in applying its own restrictive coverage rules because it felt pressure to keep benefit expenses down so it could offer competitive rates to employers.
… A major issue in the case was the adequacy of United’s coverage of behavioral and substance use disorders as chronic rather than acute conditions. The plaintiffs said United’s guidelines inappropriately limited coverage once patients’ symptoms subsided, rather than covering the range of services needed to maintain patient’s stable health conditions over a longer term.
And they were doing this for yeeeeeeears. That is a lot of people under-served because of one insurance company’s belief of “crazy people are crazy expensive”.
In Baltimore, my hometown and where I live, hospitals practice “patient dumping”. Still out of your mind and nowhere to go? Not their problem, out you go. I remember asking nurses when they would prepare discharge to people without stable homes, “Where do they go now? Like, they still seem not well.” The nurses would shrug and reply, “We give them a three day supply of meds and turn them loose. We can’t keep y’all here that long, state laws.” Because in Maryland, you’re out in a matter of days, it doesn’t matter if you’re really well or not. There is no infinity of beds and, again, “crazy people are crazy expensive” so that’s just how it is. They do try to point you to shelters and homes, they even try to give you bus vouchers and cab fares sometimes but if you’re not mentally fit when it’s time to go, you’re not going to understand any of that. Doesn’t matter though, out you go.
And as for the hospital that did the January patient dumping, University of Maryland Medical Center (better known locally as “UMMC” and used to be Maryland General Hospital), I am not surprised they did this because this hospital in particular is pretty nefarious about how they treat the mentally ill. When my doctor was seeking out hospitals for me, first thing she said was “Not UMMC” because of how poorly they treat patients. Other patients who have been to UMMC have described over-bearing security guards, non-caring staff and higher ups who pretty much don’t care as long as there isn’t a nagging lawyer staring over their shoulder. I bring this up because these are the same exact places that present themselves as forward-thinking and probably has countless “Mental Health Awareness Month” events that look wonderful but, let’s face it: they don’t actually care. Might as well say on a banner, “It’s nice to be nice to crazy people, but don’t ever become one.”
I personally don’t always believe in social awareness months. Black history month? Sure, be great if it was naturally embedded into everything already, though. Asian American Heritage month? Sure, be great if it was naturally embedded into everything already, though. Domestic Violence awareness month? Sounds like a checkbox excuse, a way to pretend to care about gender violence issues without actually doing anything. Same for Mental Health Awareness month. It’s a checkbox issue to pretend to care without actually doing anything. Outside of the occasional depression screening events, I honestly do not really see anything actively useful for people who have disorders. Maybe those who get a case of the blues or fret about a test but nothing more than that. Again, handing out bath bombs do not cure disorders. It would be poignant if it was a year-round thing and not something to do for a month because it looks good in the eyes of the unaffected.
For all the awareness month does, it really doesn’t do much. People still think mentally ill people are dangerous and vicious. You could get fired for having a disorder, and don’t bother with EEOC – they’re too overburdened to care or do anything about it. You could get placed into a hospital where you don’t get any sufficient care, just pills and apathy. You could find someone to treat you but it will put you in the poorhouse by hour 3. You might not be able to find anyone who can treat you at all. An awareness month on the issues of mental health is absolutely pointless if it’s does not cause any action and no one is better informed or impacted by these efforts. It simply feels like a way for neurotypical people (people who do not have disorders) feel like they’re good people, great allies – without lifting a single finger.
Actually, that’s probably the point.
* I still think it is ridiculous I was declared “militant” since I have friends who could make Spike Lee sound like Ben Carson. That and their solution for “militant” is not therapy but pills. Talk therapy isn’t lunacy but appears to the doctors I’ve ran into, it is.
Black Witch 