Meds, methods and selective treatment

Mental health advocacy is experiencing a surge. People are talking about it, and public acceptance of mental illness an all-time high.However, the conversation feels limited. It’s often centred around high-functioning individuals who don’t notice their depression until it’s too late. Though important, these discussions leave little room for discussing the system of mental health treatment.

It seems as if somewhere in the discourse of “r u ok?” we have ignored the need to consider what happens after that question is answered.

As somebody who has historically been more troubled by the chronic and debilitating nature of my mental health issues, rather than by being immediately high-risk, both mental health advocacy and mental health treatment often feel inadequate. When expressing my feelings of distress or chronic low-functioning, I have often felt dismissed by mental health professionals who tell me that there is little to nothing wrong.  It took multiple years for professionals to take me seriously enough to prescribe medication, despite a number of tests returning with evidence of my illnesses. Often, this came down to how I physically presented myself, having been told numerous times that I didn’t look as unwell as I said I was. The socialisation of women of colour, which influences how they conduct themselves within gendered expectations of presenting a certain way, is scarcely considered.

For women of colour, it’s hard to give up the act for an hour in a clinic, when at all other times we are expected to be agreeable and talkative to be deemed acceptable. It becomes even harder when the power dynamic between the clinician and client is unbalanced. Sometimes subconsciously, I have internalised unequal power dynamics between me and men who have provided me with mental health care, finding it hard to reach a state of unfiltered authenticity without significantly investing in establishing trust.

When yearly provisions for free mental healthcare are limited to ten sessions under a mental healthcare plan or six Counselling and Psychological Services (CAPS) sessions through the SRC, this delay in proper communication can result in inadequate provision of relevant mental healthcare.

The legitimacy of women’s pain is and taken to be less serious than that of men, leading to a situation where many women end up receiving inadequate treatment. Gendered expectations of men being less emotional or psychologically vulnerable create a situation where expression of distress is often met rapidly with the prescription of medication, whether or not such medication is necessary.

These circumstances point to a broader structural problem in the preferencing of certain forms of mental health issues over others. For example, numerous resources exist for suicidal and otherwise high-risk mentally-ill individuals. However chronic mental illness, despite not being life-threatening, can worsen quality of life often seems to fall to the wayside. Additionally, public mental healthcare programs provide limited mechanisms, which focus largely on surface level solutions, like cognitive behavioural therapy. This leave little room for those lacking the financial means for ongoing talk therapy, and associates contingent symptoms of unaddressed mental health such as low energy with personal failure.

In the absence of affordable public mental healthcare, the prescription of medication becomes a financially lucrative substitute. Over time, whilst they may not become life-threatening, the compounding burdens of chronic mental health overwhelmingly reduce the quality of a person’s life and put them at a greater risk than they would otherwise be.

Currently, the mental healthcare system lacks the capacity to comprehensively address these shortcomings, leaving many individuals without a level of support that can materially improve their situations in a meaningful way, creating an increased level of risk for those not deemed to be critically at risk.

When a focus is put on broad ideations of mental health awareness, instead of on mental health support systems, it results in situations where SRC candidates’ mental health policies advocate for more therapy dog days over providing more monetary support for counselling services.

Mental health advocacy must actively work to improve the quality and availability of mental health supports from clinical services to disability rights, to fighting against a capitalist system that prioritises productivity and efficiency over people’s health and stability. By becoming politically engaged and actively working against oppressive conditions––like poverty––that aggravate mental health issues and reduce the efficacy of available, accessible mental healthcare, we can work towards a system of adequate support.