This is the second in a four-part series exploring the Let’s Talk campaign. Part One is here. If you would like to read the article in its entirety right now, it is available on my Patreon.

Let’s Talk about hospitalization, and the “Scary Brain Stuff” – an interview with Emily

Emily is a creative, playful, artistic woman with strong connections to her family and friend group and a penchant for wearing T-Rex costumes.

I’m glad that conversations are trying to happen and that more attention is being placed on people with mental illness – that it`s not the scary, “crazy” thing that we continue to see in movies and TV. The fact that initiatives like this are happening in order to try and destigmatize these issues and get people talking is good.

However, after today people will forget. This isn’t enough. It needs to be a constant public dialogue.

I’m glad people are showing solidarity but I still don’t feel like I can just come out and say that I have a severe anxiety disorder and Bi-polar II.

I told my boss last week about my Bi-polar II. She had no clue what it was and immediately started acting weird.

Mental illnesses such as Bi-polar, Depression, Schizophrenia, are all under a blanket of “scary brain stuff” that people don’t seem to understand and don’t get because the people that have these can look and act “normal”. It’s scary because we can’t identify it or label it right away.

Initiatives like #letstalk are nice and all but it’s not actually starting a conversation. It’s just giving most people something to do so they can feel good about themselves and have their Good Deed of the Week crossed off.

I still know that I can’t call into work because I’m having an awful day and can’t get out of bed because today I’m out of spoons and crying. It’s not visible, it’s not understood, and therefore not an acceptable illness or weakness. Mental illness is still joked about, feared, and not taken seriously.

I spent almost a year (on and off) in the hospital because my brain was literally trying to kill me. I am doing so much better now and I’m on medications that make it so I can live and love and FEEL and work. I HAD to go to the hospital in order for that to happen.

But I can’t tell most people that I spent time in a psychiatric ward because to them that’s where “crazy”, “unstable”, “weirdos” and “freaks” go.

It’s not a place that is viewed as where you go to get help.

If I were to say that I had to be in the hospital because of kidney issues or another major physical illness, but that it was all good and I’m well and there’s nothing to worry about, no one would bat an eye. There would be minor concern, obviously, but it wouldn’t have the impact that saying I had to be hospitalized for mental illness would.

One of those wouldn’t keep me from getting a job.

Let’s Talk about long-term and alternative supports

That issue of being able to get, and keep, a job is one that came up in most of the conversations I had about this issue.

The standard work week, and the expectation that people will be productive in these normative ways – work the regular job, pay the rent, see your therapist after work and read some self-help books on the weekend – really limits the avenues to health that are available. For most of the working population, taking an extended period of time away from work to access support is not a reasonable option. And for individuals who find themselves without a choice because their neurodivergences don’t allow them to work, the costs are huge. Emily needed that time in the hospital, but the impact on her ability to find work after an extended absence was significant and the financial impact of that time is still an issue for her.

Current workplace culture and expectations also cut off access to alternative supports and paths to healing.

Teresa says, “So, I’m not a huge fan of the Bell campaign although I’m certainly for more talking, reaching out and asking for help. I am a big fan of peer supported open dialogue, sanctuaries like Soteria and Diabasis House, health and lifestyle coaching, depth and transpersonal psychology, humanistic, existential, ecotherapy, art therapy, narrative therapy, trauma therapy…there is lots of good stuff out there but psychiatry holds too much power and is far too often the first place people are directed by campaigns like this.”

Accessing a sanctuary like Soteria or Diabasis House is expensive and time-consuming, and although sanctuary-supported living has significant positive outcomes for participants, it doesn’t have the necessary funding and our work culture doesn’t support it.

Part of the reason sanctuary spaces aren’t commonplace or accepted is because they challenge the deeply individualistic model that we take towards almost everything. Community care is critical, but our emphasis so often is on self-care and self-reliance.

Although I am a “self-care coach,” I believe strongly in the importance of community care. Often, community care is self care, and it is only possible to maintain sustainable community care when you have good self care practices.

We need safe spaces to fall apart in community, and we need to find ways to integrate community care with self care.

Let’s Talk about the intersection of race and mental health

Communities that have been marginalized for generations, and denied access to mental wellness supports, are the leaders when it comes to finding and creating alternative strategies for self and community care.

Black women, who are so often held to an impossible standard of strength, and whose struggle is often dismissed as nothing more than anger, are doing a lot of work when it comes to moving the conversation around self-care and community-care forward. This post at Blavity, by Amani Ariel, is important. She speaks explicitly about the ways in which self-care culture – with its heavy individualism and the isolating effect of an underlying message that says “you need care, so take care of that yourself” – can exacerbate rather than heal trauma.

Let’s Talk included Gloria Swain and the Let’s Actually Talk initiative, acknowledging the ways in which access to mental health supports and even space for the conversation is restricted for marginalized communities. It’s an important step.

It’s hard to talk about mental illness, especially if you’re a Black woman whose ancestors have suffered in silence for centuries because we were told we had to be strong and not complain. It’s difficult for the Black community to end the stigma when the people speaking about this illness look nothing like us. Mental illness does not see race, sex or economical status; yet, those who are marginalized are the ones whose voices and needs are not prioritized in such campaigns and dialogue. Making me feel like my depression isn’t important doesn’t help me heal. I am not invisible.

My name is Gloria and my depression is political. (Text from this Let’s Talk campaign image.)

Indigenous communities also face significant barriers to access, and see their traditional practices and sacred teachings appropriated into contemporary self-care/self-help practices that erase and exclude the indigenous cultures being used as inspiration. This happens throughout our culture, but particularly in many new age approaches. (A similar appropriation, erasure, and exclusion happens in a lot of yoga studios. Decolonizing Yoga is a great resource for folks who want to bring an intersectional awareness to their practice.)

SooJin Pate has also written about self-care within marginalized communities. This post includes specific ideas for self-care practices, including narrative framing strategies that are similar to my own work.

Communities that are vulnerable in multiple ways face significant barriers to accessing the mental wellness resources that are available, and since those resources are underfunded, understaffed, and the demand far exceeds the current capacity, it is often the most vulnerable who are the least able to access care, or to find care that acknowledges the specific intersections of their experience. Race, class, gender, orientation, ability – none of these identity categories exist in a vacuum. It can be difficult to understand how someone else’s experience is different from our own, but the willingness to stay present for uncomfortable conversations is a critical part of deep community care, and it is a valuable tool for self-care and growth.

In Part Three, we’ll talk about social determinants of health, and moving beyond individualism in an interview with a resident physician.