Anti-Ableist Amherst: The Limits of Mental Health Awareness

On Oct. 10, the world celebrated World Mental Health Day. According to the World Health Organization, the aims of this annual holiday are to “raise awareness of mental health issues around the world and to mobilize efforts in support of mental health.” However, I find that mainstream mental health advocacy often stops at the first goal — raising awareness, and nothing else.

Awareness is an important first step, but it is, ultimately, a first step. One needs to be aware of the issue in order to remedy it, but it’s still fundamentally passive — it’s easy to be “aware” of mental illness and do nothing to improve the conditions of mentally ill people.

And mainstream awareness is incomplete — it often stops at anxiety and depression, with little acknowledgment of conditions that disable people in ways that are unpalatable in a society rife with ableism. Anxiety and depression are serious, painful conditions, but they are not the only mental illnesses that exist. People with borderline personality disorder and psychosis (to name a couple examples) are often cast by the wayside, not fitting into the convenient clichés that mainstream mental health advocacy frequently perpetuates.

Additionally, it is notable that we speak about mental health advocacy but never mental health activism, or mental illness activism, as one blog post on the subject, titled “Mad Liberation: The Missing Piece of the Puzzle,” deftly notes.
“Perhaps [advocacy, instead of activism] connotes simply raising awareness within the status quo,” the writer proposes, “continuing to adhere to systems already in place rather than radically opposing them and fighting for change.”

I argue that we need to go beyond the dominant narrative of awareness. The problems that afflict mentally ill people are often systematic problems that mental health awareness alone cannot fix — when it even recognizes them at all.

Mentally ill people face high rates of police brutality. One recent example is the high-profile murder of Sonya Massey, a Black woman with paranoid schizophrenia, killed by Officer Sean Grayson, who said, “this fucking bitch is crazy” before he shot her. Similarly, in 2020, police killed Angelo Quinto, a Filipino man who had been in the midst of a mental health crisis when officers knelt on his neck.

Even so-called “care” for mentally ill people can prove fatal: David “Rocky” Bennett, a Black Briton with schizophrenia, was killed by four nurses who restrained him while he was in a psychiatric clinic. An inquiry into the murder reported that Bennett had been treated as a “lesser being” by staff. These horrific cases illuminate the intersections of racism and ableism.

Mentally ill people are, additionally, more frequently homeless. 27 to 36% of people discharged from state psychiatric facilities became homeless within six months. An estimated 20% of homeless people have schizophrenia, despite people with schizophrenia comprising only 1% of the population.

Often-lauded mental health treatment is inaccessible to many due to its steep costs. Emily May writes about their inability to afford mental healthcare, noting that “[n]either shame nor taboo” (mental health advocacy’s frequent targets) prevent them from getting therapy, but rather the fact that they simply cannot pay for it. According to a 2022 survey by the National Council for Mental Wellbeing, 37% of American adults who needed mental healthcare in the past year could not afford it.

And ultimately, mental health awareness cannot reckon with the ways in which many people’s mental illnesses do not stem solely from personal neuroses or chemical imbalances, but are rather reactions to an unjust and unequal society that actively produces mental distress. Economic austerity politics, for example, are correlated with an increase in suicide rates. Journalist Micha Frazer-Carroll writes in her indispensable book “Mad World: The Politics of Mental Health” that “[s]uffering follows the political contours of our lives."

Mainstream mental health advocacy regularly neglects these issues, choosing instead to focus on individualistic solutions to improve mental well-being. But simply asking for help or seeking therapy will not mitigate the disenfranchisement of innumerable mentally ill people whose suffering is ‘inconvenient.’ The awareness framework is ill-equipped for the complex and uncomfortable realities of mental illness. This frequently creates a disconnect between the lived experiences of people with profound mental illness and the saccharine rhetoric of mental health awareness.

“In recent years the discussion around mental health has hit the mainstream. I call it the Conversation. The Conversation is dominated by positivity and the memeification of a battle won. It isn’t a bad thing that we are all talking more about mental health; it would be silly to argue otherwise,” Hannah Jane Parkinson wrote in a Guardian article. “But this does not mean it is not infuriating to come home from a secure hospital, suicidal, to a bunch of celebrity awareness-raising selfies and thousands of people saying that all you need to do is ask for help — when you’ve been asking for help and not getting it.“

The 10 principles of disability justice state that we must prioritize “leadership of those most impacted.” Those who are most harmed by the existing paradigm of psychiatric ableism — those dismissed as “crazy” or “mad” — must be our guides as we navigate a world that viciously enforces a hegemonic "normal,” even internally, within mental health advocacy.

We need to be activists for mental health, not just idle observers. We need more than just mental health awareness.