mental health awareness day is the definition of insanity

I'm all for the 'therapy revolution,' but come on.

I’m about to complete the final stage in my diploma course in cognitive behavioural hypnotherapy which means that one day soon, I’ll get to call myself a therapist. Look Mom, no hands! Seriously though, it’s an evidenced-based program and I’m good at it and while I know it’s not a PhD in neuroscience from Cambridge, I’ve never had a ‘professional qualification’ before, so I’m chuffed. The point is I believe in it and and I know it helps people because it’s helped me, and I hugely enjoy the work.

This is all to say I’m down with today, the much-media-ballyhooed Mental Health Awareness Day. Yes, today is the day we are all meant to officially be aware of our own brain peculiarities and the suffering they cause us and others in our midst. In my fledgling, baby-therapeutic practice I’ve now successfully treated people for a range of difficult mental health issues, everything from intrusive thoughts to insomnia, compulsive eating, chronic pain, anxiety, depression, ADHD, sexual and relationship struggles, and perimenopause-related symptoms… I could go on. The point is, I know first hand what a powerful thing mental health awareness is and how fundamentally it’s changed the culture we inhabit in just a short time.

People are now so much more aware of the nuances and interplay between their own thoughts, emotions and behaviours. Call it neurodiversity, psychodiversity, eccentricity, difference, existential pain, the human condition, it’s more or less the same. We are collectively suffering but this is nothing new. Humans have long been the most neurotic of mammals thanks to our brilliant, stupid, over-sized brains, but the fact that so many of us are no longer prepared to do so in silence is surely a good thing. We want to understand ourselves better. We want to heal. And increasingly, when and where appropriate, we are willing to seek out the best professional help we can afford in achieving this aim. Only a complete cynic could pooh-pooh such a wholesome impulse. So yes, I’m down with mental health awareness day. Of course I am.

But….

…. in addition to being a proponent and practitioner of therapy, I am also someone who’s family life has recently been ravaged (and irrevocably altered in a tragic way) by the effects of a different kind of mental illness than the sort that tend to be highlighted on days like today. I am talking about acute and serious mental illness.

The kind that very few therapists like me are qualified to treat. This kind of mental illness (which to be clear is not my illness but the illness of a close relative) is acute, chronic, debilitating and not as rare as you might think. It is not a mental affliction that can be effectively treated on its own with anything that doesn’t involve triple-locked institutional doors and months-long courses of strong pharmaceuticals, often forcibly administered. And even then, when the illness is treated the results are questionable at best. Many consultants working the field of acute adult mental illness in fact question whether it can actually be effectively treated at all.

One of the most complicated aspects that acute, long term mental illness often characterised by a complete and abject denial of the condition on the part of the sufferer themselves. In this sense it’s a bit like an addiction for which there is no rehab or possible return to normal life. If no ‘first step’ occurs, and the ‘problem’ exists only in the suffer’s psyche, how can the patient in denial ever possibly recover? Mental illness, like all things, is a matter of perspective. It absolutely exists, but yet it’s all the sufferer’s head.

This maddening Catch-22 is why most psychiatric consultants quickly give up on acute long term patients. In the system, there is no talk of them rehabilitating them to full mental health, only freeing up beds. At best it’s about managing the condition and at worst preventing them from hurting themselves and others. If the sufferer refuses treatment consistently, over time, there is little hope beyond long-term institutionalisation. If you’ve ever visited state-run acute psychiatric facility you will know that such places are not really rehabilitation centres. They are high-security jailhouses with pills.

So what does ‘mental health awareness day’ actually mean for those who need it most? Not much, I’m sorry to say. I am all for the therapy revolution as a therapist, but the fact that acute mental illness remains shockingly stigmatised after decades of celebrity ‘ambassadors’ banging on about the issue, in spite of the endless succession of consciousness raising campaigns and the various days and ribbon campaigns that come and go… it’s maddening to say the least.

The fact is acute, longterm mental illness still exists all around us even if we refuse to acknowledge it. The swell of interest in neurodiversity and other mental health-spectrum disorders should not shield us from the truth: This level of illness is invisible but it still shatters families and lives. My family lives in the long shadow of a loss for which there is little empathy or acknowledgement. My sons in particular lost a loved one suddenly and tragically. We lost them to acute mental illness, and because of that no one around us said a word. Not a single mental health professional, teacher, social worker or executive (at said-loved-one’s progressive-establishment-media workplace of thirty-plus years) even bothered to ask how we were. Not one.

My eldest son recently asked me plaintively through tears, Why don’t we even get a funeral? Why?

It’s a question I’ve now pondered at length and here’s what I think: We don’t need an awareness day. We need another language to talk about this stuff.