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Mental health advocacy doesn’t equal visibility for everyone

Marginalized groups are consistently left out of conversations surrounding mental health and treatment

By: Carter Hemion, Staff Writer

Mental health awareness is vital to mitigating stigma around mental illnesses and improving access to health care, but awareness gestures often leave people out of the conversation. General mental health advocacy leaves out the most marginalized voices and their lived experiences.

Mental health awareness is often centred around sharing the experiences of people suffering from mild to moderate anxiety disorders and/or depression. Such presentations leave out and regularly demonize people with other disorders. While it is important to spread awareness about anxiety and depression, they should not be the sole focus of mental health initiatives.

When prioritizing anxiety and depression, many advocates uplift people with these disorders at the expense of people with more stigmatized mental illnesses. One common example of this is the argument that people with anxiety or depression are not violent or dangerous, while attributing those traits to people who experience psychosis or other heavily stigmatized symptoms. This kind of ideology promotes ableist ideals and further harms people who deserve the same understanding and acceptance. It is wrong for any movement to throw marginalized people under the bus for the sake of other groups gaining acceptance.

When one in three Canadians have a mental illness in their life, it is necessary to bring awareness to all facets of mental health.  It is erasure to selectively address the most common mental illnesses just because they are more socially acceptable to talk about. Expanding our knowledge on anxiety and mood disorders is important. Spreading wider awareness about eating disorders, personality disorders, impulse-control and addiction disorders, psychotic disorders, obsessive-compulsive disorders, dissociative disorders, trauma-related disorders, and neurological disorders among other categories is also vital. 

With the heavy focus of awareness movements being on moderate anxiety and depression, mental health advocates often push lines of thinking that do not address the root of mental health concerns. For example, advocates frequently promote Cognitive-Behavioural Therapy (CBT) as a first-line and catch-all treatment plan, while other kinds of therapy and treatments go widely unrecognized. CBT is not trauma-informed and can even be harmful for treating some mental health concerns. This approach to treating mental health concerns, while helpful for many, also promotes that irrational thoughts cause maladaptive behaviour and mental illnesses. When therapists focus on changing distorted thoughts or on retraining a person’s behaviour without addressing the underlying causes, they leave out an important foundation for personal growth.

While in many cases the harmful thoughts that perpetuate unfavourable behaviours and mental rituals can be irrational, they can also come from real and continuing experiences. Basing mental health awareness on a CBT-style approach exclusively leaves out people whose stress and struggles come from physical health concerns or trauma perpetrated by others’ actions, among other causes. This further harms people with trauma as a result of racism, sexism, homophobia, transphobia, ableism, classism, and whorephobia — as well as other forms of bigotry. Their voices deserve to be heard too, and that does not happen when mental health awareness focuses on changing maladaptive thinking without addressing the root causes of mental health concerns.

Gestures of awareness are not enough to protect mental health in Canada. We need to actively seek out information from the voices with a wide array of lived experiences so that we can educate ourselves, work towards creating a more comprehensive health care system, and actively address the prejudice and barriers in society that lead to mental health concerns. For mental health advocacy to move from awareness to action, we need to listen to the most stigmatized and marginalized voices and take their lead.

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