What happens when we’re confronted with a problem? What do we do when we have an issue we’re trying to fix at work or trying to solve a problem in our schoolwork? What do we do when we can’t fix something at home–a jammed window, a dislodged door, a flat tire on the car? What can we do when we’re having difficulty figuring something out on our own?
Clearly, the expected solution would be to look for help from the outside. We reach out to our supervisors and co-workers to help address issues or to help complete projects at work. We research online for do-it-yourself remedies, or hire a specialist to fix problems with our home or vehicle. We call upon our professors, tutors and academic peers to conquer the hurdles of education.
In facing our most personal troubles, we typically call on those closest to us or people we trust for guidance and assistance. We lean on our spouse, family and close friends for support when facing a personal crisis or emergency; we look to our pastors and ministers for spiritual guidance, and mental health counselors to help overcome mental or emotional blockades.
Or we don’t. We may continue to go solo, taking breaks away from the task before returning to find the solutions ourselves, or we may give up and move on to different things. Still others may choose to endure or continue enduring whatever issue they’re facing, refusing to acknowledge the possibility of needing help facing the issues they face. For some, asking for help is difficult.
For some us, admitting that we need help feels like a sign of weakness and uselessness, which can be detrimental to the individual, especially in the case of mental health issues.
According to the National Alliance on on Mental Illness (NAMI), millions of people face mental illness and mental health challenges in the United States each year, and the stigma that surrounds mental health–the fear and the lack of understanding, which can lead to isolation, shame, harassment, and even bullying and discrimination from others that can turn violent–can still be felt.
“When my husband asked me to keep his secret, I didn’t hesitate,” said Carolyn Ali in her New York Times piece, Alone With My Husband’s Secret.
Carolyn and her husband worked to battle his depression on their own, taking care to avoid telling their families and loved ones. But the secrecy and the severity of his depression wreaked havoc on the two. As Carolyn attempted to navigate their way through the channels of the mental health system, her husband dropped out of the master’s program he was enrolled in and spent the majority of his days sleeping. When they did tell their family, he downplayed the severity of his depression and, after mustering every ounce of energy to appear upbeat through birthday gatherings and Christmas dinners, would crash for days once they returned home, utterly depleted.
For Carolyn, maintaining the secret of her husband’s depression was costly for her as well.
“Because it was his illness,” she wrote, “and he didn’t want to talk about it, I felt as if I had no right to talk about it either. So outside of my family and a few close friends, I didn’t talk about it with anyone. I didn’t talk about my frustrations in trying to find him proper medical care. I didn’t talk about how helpless and hopeless I felt as I tried to lift his mood. And I definitely didn’t talk about that leaden, sickening feeling I had every day after work as I pulled open the front door of my apartment: I’d check every room one by one, not knowing what I would find.”
Two years after he spoke about his depression, Carlyn’s husband began to recover from his depression and, today, he is open about his history of mental illness and challenges the stigma himself, recognizing the impact the silence had on him and Carolyn, both individually and as a family.
Today, the grip that the stigma of mental health seems to hold has been loosening in the U.S. A 2017 report from the Barna Group showed that approximately 42 percent of adults in the U.S. have met with a counselor at some point of their lives, and at least another 36 percent saying they’re at least open to seeing a counselor.
That being said, the fear of seeing a counselor is still prevalent to this day.
Dr. Benjamin Keyes is the Director of Training and Internships for the Eastern States for Divine Mercy University’s School of Counseling, Director for the Center for Trauma and Resiliency Studies, and has spent his career helping people in the U.S. and around the world recover from traumatic or stressful situations while providing organizations with counseling and training, including Charlottesville Virginia following the of the White Supremacist Rally.
“The stigma of having to go see a counselor or a psychologist is the perception of being seen as crazy or psychotic,” he said. “People think this true with their family, at work or the other people they may see on the day-to-day. The reality is that there are a lot of reasons as to why people meet with counselors.”
Dr. Keyes has also worked with many individuals whose jobs put them in stressful environments and situations regularly, including firefighters and members of the military and police forces.
“There’s a perception of ‘going to the shrink,’” he said, “and there’s a fear that this stigma may have a negative effect on their careers or hurt their chances at promotions so they may be more inclined to avoid counseling to avoid that appearance.”
Outside the U.S., the stigma of mental health still holds an even tighter grip, causing thousands of people around the world who need treatment for mental health issues to avoid seeking treatment altogether.
Mental illness has a long history of being stigmatized around the globe, from being considered a sign of demonic possession in its early history, to being seen as a shortcoming or a sign of weakness today.
For instance, in Korea, the concept of mental health simply does not exist.
“In Korea, there is no such thing as mental health,” said Jin-Hee, a Korean-American mental health professional in an interview with the University of Washington’s Forefront Suicide Prevention center.
South Korea has one of the highest suicide rates in the world, and it’s been attributed to pressures relating to conformity for those in their 20s and 30s, loneliness, cultural dislocation, and lack of social connection for the elderly. But there’s still an aversion to accepting mental health treatment. According to Jin-Hee, depression is perceived as a sign of personal weakness instead of a clinical issue in Korea.
Instead, it’s seen as a burden on a family’s reputation. “One is seen as ‘weak’ if they have a mental health issue,” she said. “People with mental health issues are seen as ‘crazy’ and the issue is something that must be overcome.”
In Africa, the absence of treatment is the norm rather than the exception. In the face of many other challenges like conflict, disease, maternal and child mortality and intractable poverty, the importance of mental health is often neglected or overlooked typically due to a lack of knowledge about the extent of mental health problems, stigmas against those living with mental illness and beliefs that mental illness cannot be treated. The proportion of people with mental illness in Africa who don’t receive treatment ranges from 75 percent in South Africa to over 90 percent in Ethiopia and Nigeria.
“The stigmas are very pervasive in places like Eastern Europe and Africa,” said Dr. Keyes, “but the church in these nations and elsewhere is really making the inroads to address this, with pastors and clergy receiving education and counseling training to help their congregation and countrymen. Education goes a long way in rectifying these stigmas.”
Research shows that tens of millions of people throughout the world will at some point in their life experience a mental health illness or disorder. It’s estimated that only half of those people will receive treatment, and the stigma and silence of mental health is a critical barrier that holds them back, leaving the individual without the critical help they need, and their loved ones–their spouses, siblings, parents and children–from receiving the essential support they need.
“There are many different reasons people receive counseling,” Dr. Keyes said. “Some may be trying to help or save their marriage. Some may need an outlet for their anxiety while others go to address and treat depression. As counselors, we try to normalize the experience as much as possible.”
“If I could go back to that fall morning in our kitchen,” Ali said, “I would tell my husband this: ‘I know what you’re going through feels unbearable. It breaks my heart. I so desperately want to make things better. But we can’t keep this between us. We need as much support as possible to get the help you need. You are not alone.’ ”