The Challenges and Next Steps for Mental Health Advocacy

mhadvocacyHave you listened to the Conquer Worry podcast on mental health advocacy yet? If not, I strongly urge you to check out the conversation Jay Coulter had with advocates Andy Behrman and Gabe Howard. Their discussion covered a number of the different challenges facing mental health advocacy and they talked about some potential solutions, or at least some different starting points.

I’ve decided that rather than present a point-by-point write up and analysis of the entire conversation (since you should/can listen for yourself) that I would instead focus on what I heard as the major themes that Andy and Gabe brought up, and they fall into two categories- the challenges of mental health advocacy and the steps we can be taking to make things better.

The Challenges

I think the big takeaway from the conversation is the community of mental health advocates faces three principal challenges. I could spend all day going back and forth with myself about the causes for each or whether one is a result of the other, but at the end of the day I’m presenting them in no particular order. If you want to discuss it a little more in the comments that’s certainly welcome:

The fractured nature of the advocacy community-  This one has been a sort of personal frustration for me, so I might as well start here and get it out of the way. There are a lot of different mental health organizations out there, from support groups to lobbying groups, from groups for those with a mental health issue to those supporting the families of people with mental health issues. Each group tries to cater to a niche constituency- sometimes based on diagnoses, sometimes based on demographics. Either way the result is many different messages and many different strategies on how best to deliver those messages. There is competition for attention from policy makers, the media, and other influential groups and proliferation of different messages actually hurts the ability of mental health advocates to get a consistent message to these audiences.

The “Crisis” Problem- The crisis problem actually refers to two challenges we face as mental health advocates but they’re related to each other. The first is the problem that by and large in the eyes of the public, policy makers, and the media mental illness is defined by the crisis moments. Gabe mentioned that nobody pays attention to mental illness until someone is in crisis, when a person is experiencing the worst of their illness. This could be anything from self-harm to hallucinations, and it is scary for anyone, but by focusing the attention on these moments they come to define the illness rather than the day to day reality. Many people with mental illness are stable and can lead “normal” lives with treatment and self-care. But understanding that for many people with a mental illness the challenges we experience day to day are not crises but challenges with accessing affordable care, managing our medication, and finding ways to incorporate self care into our routine. Unfortunately this isn’t the image most people have of mental illness. 

The second part of the crisis problem is that because crisis has come to define mental illness it also means society tends to deal with mental illness from a crisis perspective. For example, if a school has a student who commits suicide they will very quickly bring in counselors to meet with other students to discuss mental health and self care. By only looking at mental illness through the lens of crisis we set ourselves up to deal with it in a reactive way instead of working to deal with it in a preventative way.

The resources problem- The crisis problem also influences the resources we put into mental health care. Andy mentioned the example of colleges that spend millions of dollars on their athletic programs but will underfund campus mental health centers. And because of the crisis problem resources for sustained programs on mental health and self care typically aren’t in place in schools or the private sector. Both Andy and Gabe speak to corporate groups about mental health when they can, and they talk about the economic productivity that is lost each year due to workers struggling with a mental health issue. If companies would devote resources to proactively promoting positive mental health programs for employees they could save money and have a healthier and more productive workforce, but unfortunately advocates like Andy and Gabe have to compete for attention with these audiences with any number of other business and motivational speakers. Getting schools and workplaces to commit the resources to mental health needs to be a priority for advocacy groups.

outsidethecircleThe Next Steps

I think the biggest takeaway one can have from the podcast is that we must start by engaging people outside of the mental health advocacy community. One of the frustrations Andy mentioned, and it is one I share, is that we spend so much of our time preaching to the choir. It’s easy to write for an audience of other mental health bloggers and advocates. But in the long run if all we’re doing is patting each other on the back what progress are we making? Gabe said it best- we have to start talking to people outside the circle. This requires mental health advocates to start engaging with your local media, your local chamber of commerce, etc. to tell your story. Write a letter to the editor, ask to speak to local business owners. It means that we need our mental health organizations to equip us with knowledge and information about what kinds of self care programs are available and how to implement them in a school or a workplace and what the benefits of sustained mental health education are. This could be one topic or goal that mental health organizations could unite around. It won’t happen overnight but I think it’s worth trying.

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