Content warning: brief, non-graphic mentions of suicide


Few managed to avoid the social media frenzy that ensued on World Mental Health Day (10th October). 

"As a day of awareness, World Mental Health Day would be less exclusionary if it gained more self-awareness. It should recognise those who feel sidelined by it; it should recognise its limitations; it should recognise that hashtags and aphorisms and wearing particular colours are never going to eradicate stigma."

Many people viewed it as an opportunity to share their experiences of mental health difficulties or to show their solidarity with those who experience them. Perhaps the surge in visibility is what encouraged someone to seek support and maybe it facilitated conversations that would have otherwise remained unsaid.

Exclusion from the “just talk” narrative

But there are lots of us who felt excluded from the World Mental Health Day narrative: be it for reasons such as cultural or religious attitudes, being multiply marginalised, or having no support system to turn to when instructed to talk to someone. The “just talk” narrative seems deceptively accessible. What could be the harm in telling people that life is often difficult for you? 

Others saw it as nothing more than a commercialised, virtue-signalling feat that failed to recognise barriers to accessing support. Accessible, well-funded, and inclusive NHS services, please, not hashtags and yellow outfits. A number of people questioned whether “awareness” is enough – is the bar on the ground? Who can resist a chance to bust stigma by dressing in yellow? How can we even contemplate awareness when austerity means services are not fit for purpose?  

A hierarchy of acceptability

Ever since I became aware of World Mental Health Day’s existence I knew it wasn’t for people like me.

Attitudes towards mental illness are changing for the better but I display symptoms that can be scary, bizarre, or unpalatable. And that's something that World Mental Health Day campaigns won't tell you. The day is about mental health but it should also about mental illness. 

This is not to say that people expressing their experiences of, say, anxiety or depression receive unconditional support and understanding - often they don’t. But most people have some concept of these experiences. Even though not everyone has lived with anxiety or depression on a clinical level, they can think back to a time in which they had some of the experiences that characterise these disorders. When I tell people that I am diagnosed with Dissociative Identity Disorder, their only frame of reference is a film in which someone with the diagnosis kidnaps and murders teenage girls. 

Regardless of what your symptoms are or what disorder you are living with there is always a risk that you will be met with an unsupportive and even offensive response when confiding in someone. No disorder or symptoms are immune from insensitive responses. However, prevalent World Mental Health Day narratives suggest a hierarchy of acceptability in what we should be talking about. Not that I’m saying it should perpetuate a free-for-all approach in which boundaries are transgressed and we all overshare, but it rarely engages with the sordid, chaotic, unpalatable, bizarre side of mental illness. 

World Mental Health Day isn’t for people like me

If on World Mental Health Day – or any other day of the year - I casually slipped it into conversation that sometimes I become a completely different person with no memory of it, the response would likely be one of fear or salacious curiosity. 

It's the same when people with symptoms like mine try to access support; the staff telling us we're probably depressed and anxious because their knowledge of mental illness doesn't stretch beyond that. Or the ones whose faces reflect their fear yet refer me for treatment that wouldn’t address the symptoms which make them uncomfortable. Well meaning people have responded in this way, even ones who tend to be compassionate and experience mental health problems of their own. Lots of people who have responded like this initially are now my greatest advocates.

I know that “it’s okay not to be okay”, yet World Mental Health Day’s existence is centred around a particular type of “not being okay”. 

I feel comfortable telling people that sometimes I feel so overwhelmed by sadness that I can’t leave my bed; that certain situations fill me with dread; that I think about suicide every single day. I am comfortable telling people these things not because they are any easier to talk about than some of my other experiences but because I know that they fit in with the picture of mental illness that we are slowly becoming more accustomed to discussing, thanks to initiatives like World Mental Health Day. 

The fear of the unfamiliar

I understand that the symptoms of my Dissociative Identity Disorder and Complex Post-Traumatic Stress Disorder can be difficult to witness or even conceptualise as being real. If you're unaware that repeated early life trauma can prevent the personality from forming one cohesive self, then watching this happen to someone you know is undeniably uncanny. Scary, even.

This fear comes not necessarily from the symptoms themselves but a lack of education about them. Dissociative Identity Disorder is not characterised by inherently "scary" symptoms, it's their unfamiliarity that makes them sometimes appear scary to others.  

When I am met with fear after disclosing my disorder I understand it - genuinely, I do. I used to feel the same way. 

When I first became aware of my emerging alters (dissociated personalities) I attempted suicide repeatedly because, for me, death was less terrifying than living with these unexplained symptoms that I knew were terrifying for those around me. When confronted with teary-eyed friends saying “it was like you were a different person - I was so scared” all I could do was apologise and say that I understood their fear because I felt it too. I was scared. Of myself. Of my symptoms. Of my other parts. Of my ability to scare others. 

What now?

I used to think that the alienation I felt on World Mental Health Day meant I would never receive the understanding I desperately wanted and needed. If I felt unable to speak about my mental illness on a worldwide awareness day, then would I ever?

Now I understand the day as a useful tool. This doesn't mean that I find it easy; I would rather have retreated into hibernation with all mental health related phrases muted on Twitter. World Mental Health Day may be helpful for some through achieving what it sets out to achieve - to open up conversation which leads to someone giving or receiving mental health support. 

For others, like myself, it is useful in a different way. World Mental Health Day illuminates attitudes, stigmas, and narratives that prevail even in the face of almost worldwide visibility. It can be disheartening at the time. But it ultimately informs us about the avenues which our activism could explore if we had the energy. For some people living with mental illness, days like these can be a draining and painful reminder of how misunderstood we feel even within the mental health community.

As a day of awareness, World Mental Health Day would be less exclusionary if it gained more self-awareness. It should recognise those who feel sidelined by it; it should recognise its limitations; it should recognise that hashtags and aphorisms and wearing particular colours are never going to eradicate stigma. 

Maybe next year will be different.