Now the party’s over: what is World Mental Health Day for, anyway?

For the mental health community, it’s The Morning After.

Those involved in the community have spent the past month pushing the mental health message. It’s been taken to political party conferences. It’s appeared on talk show sofas. 7^th October marked Bipolar Awareness Day, but was quickly eclipsed by yesterday’s World Mental Health Day, 24 hours dedicated to global recognition of the mental health needs of 7 billion people. For me, today feels like getting out of bed and surveying a field after a festival, taking in the cracked plastic glasses and the spent glow sticks, while wondering: what was it all for?

According to http://www.awarenessdays.co.uk, there are about 20 awareness days/weeks in the UK in October alone, covering everything from health topics such as Breast Cancer Awareness Month and National Arthritis Week to the hipster-challenging No Beard Day (18^th October, if you fancy a trip to the barber). Meanwhile National Egg Week and National Potato Week will just have to fight it out as the nation’s favourite staple, since they occupy the same section of the calendar. Given that I was oblivious to the existence of all these special days/weeks, clearly there’s a lot more to generating awareness than just designating a day. But even suppose we are conscious of an awareness day, suppose indeed that it’s hard to escape that consciousness, do we necessarily know what to do with it? Are we, indeed, supposed to do anything? Is an awareness day a call to action, a call to contemplation, a call for celebration – or something else?

World Mental Health Day has been running since 1992 and is described by the Mental Health Foundation as “the annual global celebration of mental health education, awareness and advocacy”. This is slightly different, and rather more positive, spin than the World Health Organisation’s, which describes the overall objective as “raising awareness of mental health issues around the world and mobilizing efforts in support of mental health”. WMHD always has a designated theme. In 2012, the theme was the “global crisis” of depression, last year it was the mental health of older adults, and this year the focus in on schizophrenia. WMHD has widely taken up by organisations for as long as I’ve been involved with mental health, yet this year especially I have seen many individuals who live with a mental health problem asking how meaningful WMHD is to their own lives and whether it really generates awareness among others.

I can certainly see the reasoning behind having a focal point for bringing together and celebrating good work that is done rather more quietly all year. I can also understand the impetus behind trying to connect with people who might genuinely benefit from increased knowledge about mental health issues. I was, therefore, happy to speak at a WMHD event run at Bournemouth University on Wednesday. Late adolescence and early adulthood are prime years for developing mental health conditions, including psychotic disorders (Jonny Benjamin took part in a Q&A just before my talk and shared something of what it had been like to grow up with undiagnosed schizophrenia). It seemed to me to be good and useful to try and improves students’ knowledge of mental health conditions and the services that can help them (local representatives of Mind, Rethink Mental Illness and other support organisations had stands at the university to this end).

However, I’m less comfortable with simply marking awareness such days for their own sakes. As many people observed on Twitter, they couldn’t be more aware of mental health issues, thank you very much. Those of us struggling through on a daily basis don’t need our awareness raising, nor should it be incumbent upon them to do something special or attempt to raise others’ awareness unless they particularly want to. Aside from specifically invited to take part in a WMHD event I didn’t really feel that there was anything I could or should have done differently for the cause. I was somewhat disconcerted to be sent several very well-intentioned “Happy World Mental Health Day!” tweets, as despite the MHF’s stated aims of the day I have never had a sense of there being anything celebratory about the WMHD. If anything, I have frequently heard people complain that it is depressing, focusing as it does on huge, global “disease burdens”.

In the past I have felt able to blog when the day’s special focus has touched me personally, so I wrote a post when the topic was depression. Last year I had a story to share about the mental health of a close friend in her 80s and the reflections that inspired in me about becoming an older adult with bipolar. This year however I felt that it was not for me to speak or write on the subject of schizophrenia as I don’t have enough of an immediate connection to make that subject mine to explore. Yet I saw remarkably little on the subject anyway, and what there was felt drowned out in general “awareness-raising” along the lines of “Just talk about it!”, “You’re not alone!, “Read these four amazing recovery stories” and “One in four people suffer mental illness!” This is WMHD as a free for all, where any mental health topic or story or campaign is offered up as deserving of traditional and social media attention. I was uncomfortable with the fact that aside from some strong messages from Rethink Mental Illness and some personal stories, including this excellent blog from Katie Gray, the voice of people living with schizophrenia was squeezed out by the very event that was supposed to “shine a spotlight” on their condition.

There is a personal irony amongst all this. Having delivered my talk without a hitch, and having told the audience that life was good (and meaning it), over the past couple of days I have not been very well at all and have found myself closer to crisis than in many months. And despite everything I do year round to counter the stigma and discrimination around mental health issues, I feel nothing but shame about this. I feel like a fraud, like I somehow presented myself as something that I’m not. I have found it very hard to admit that I really do need extra help and yesterday I finally forced myself to contact my psychiatrist. I have never been so aware as I was yesterday of the shame that mental distress can bring, on a day when it felt expected that I would raise the profile of mental health even higher.

This is probably heresy, but maybe we need to scale WMHD back. I think we need to strip out any component of expectation that struggling people “should do something” to raise awareness. And I believe we need to focus on the theme, so that the voices of people with marginalized conditions like dementia and schizophrenia are not further squeezed out by a cacophony of mental health messages. Because maybe the festival has become too big.