The “Family Members, Friends, Neighbors” approach to Mental Illness: Analysis of 2013′s National Conference on Mental Health

“We all know somebody — a family member, a friend, a neighbor — who has struggled or will struggle with mental health issues at some point in their lives.” – President Obama, June 3rd, National Conference On Mental Health.

It will not shock you to learn that I really, really care about mental illness. After all, approximately half of all the blog posts I’ve written since fall 2012 have been about mental illness. It’s an issue of some interest to me!

And in most of those posts I’ve talked about how stigma and stereotypes about mental illness need to end, how the issue deserves more (intelligent and nuanced) national attention, how we need to create more access to mental health services, and, perhaps most importantly, how we need to change the way society respond to mental health issues.

A few days ago – on Monday, June 3rd – President Obama convened a National Conference On Mental Health at the White House. The Conference was ostensibly called in response to the Newtown shootings, although Newtown was never referenced by name. It brought together advocates, elected officials, medical professionals and others (including Hollywood actors) together to discuss the state of mental illness in the United States today. Both the President and the Vice President gave speeches, as did Kathleen Sebelius, the Secretary for Health and Human Services. The conference included a panel on reducing stigma associated with mental illness. Two prominent Hollywood actors – Bradley Cooper, who played a man with bipolar disorder in Silver Linings Playbook and Glenn Close, who has family members with mental illnesses – also spoke.

The conference did almost everything I could want. There was a panel about reducing stigma. President Obama specifically said that mental illness doesn’t lead to violence (!!!). Everyone – including the President – pointed out that one in five Americans will suffer from a mental illness, and less than 40% of them will ever receive treatment.

You would think I’d be pleased.

And I was!

… okay, I was only kind of pleased. In fact, as I read coverage of the conference, I found myself getting increasingly frustrated. Because, for all that the conference was supposed to be about mental illnesses, it turned out to focus far more on *sane* family members and friends of the mentally ill, rather than on people with mental illnesses themselves.

This tendency was  exemplified in the President’s speech, when he stated:  “We all know somebody — a family member, a friend, a neighbor — who has struggled or will struggle with mental health issues at some point in their lives.”

Note the construction of the sentence: “We all know somebody – a family member, a friend, a neighbor – who has struggled with mental illness.” The person with mental illness here is always someone else. They are always removed from ourselves. They are the people we help, the people we are sad for, the people we want to save. The people who are sick, the people who are hurting, the people with the problems – they are categorically not us. They are other.

They are, moreover, specifically not the implied audience of the sentence. The implied audience is the people who “know somebody’ with a mental illness. Obama probably wanted to evoke sympathy for people with mental illnesses. But in doing so, he reinforced the trope of the mentally ill as the “other” – as people who aren’t worth speaking to, and about, directly. Despite the fact that one in five Americans suffer, or will suffer, from a mental illness, and thus make up a fairly sizeable portion of the audience.

***

Thing is, I do actually know a family member, a friend AND a neighbor who has struggled with mental health issues. You know who else has struggled with mental health issues?

Me.

It’s frustrating, as someone with mental illnesses, to feel like conversations about mental illness include everyone except people with the illnesses themselves. It’s incredibly frustration to hear public speakers talk directly to everyone except me – even when they’re talking about something that directly affects my life. And yeah, it’s pretty damn annoying to feel like my “friends, family and neighbors” are more important to this conversation on mental illness than I am.

The otherizing component of the President’s sentence is not a difficult problem to fix. Example: “We all know somebody — a family member, a friend, a neighbor — who has struggled or will struggle with mental health issues at some point in their lives. Indeed, many of us suffer, or will suffer, from mental illnesses.” See the change? It’s a small one – from “them” to “us “- but a crucial one. Suddenly, people with mental illnesses aren’t just other people to be taken care of by their friends and family – they are us. They are a part of the discussion.

And you cannot have a constructive conversation about mental illness without centering the voices, needs and experiences of people with mental illnesses themselves. Not people who KNOW people with mental illnesses. People with mental illnesses. The people, in other words, who are most affected by the problem.

***

There were a few moments in the President’s speech where he spoke directly to, or about, people with mental illnesses. But they were overwhelmed by addresses to, and anecdotes about, “friends and family members.”

President Obama’s construction of mental illness in his speech was, unfortunately, emblematic of a wider problem at the conference: it seemed much more aimed at those fictional “family members, friends and neighbors” than it was towards actual people with mental illnesses.

None of the actors, elected officials or advocates invited to speak identified as mentally ill. Only one woman on a six-person panel on reducing stigma actually had a mental illness – and thus some first-hand experience. Why are people with mental illnesses so badly represented at, of all places, a National Conference on Mental Health? For fuck’s sake, somewhere around 20% of the country has, or has had, a mental illness. It can’t be that hard to find speakers and experts from that population.

Contributing to the problem, speakers continually praised the efforts – or the struggle – of the “family members and friends” of people with mental illness, while simultaneously failing to mention the struggle and efforts of people with mental illnesses themselves. Vice President Biden, for example, talked about a friend whose son had a mental illness. President Obama talked about former Republican senator, Gordon Smith, and how his son’s suicide led him to start a campaign designed to change attitudes about mental illness. There were very few mentions of the struggles of people with mental illness, or the work or advocacy they were doing (be that work “getting out of bed in the morning” or “starting an organization”).

I don’t think that friends and family members of people with mental illnesses don’t struggle, or that their struggle isn’t important. I don’t think that friends and family members of people with mental illnesses don’t do great things to help, or that those things aren’t important to talk about. What I object to is centering their experience and their work at the expense of the experience and work of people with mental illnesses.

In one of the more frustrating moments, Biden mentioned that his friend felt like he was holding a string to his son, and if he tugged too hard, the string would break and he would lose his son forever. Biden ended by saying: “That is how a hell of a lot of people feel.”

I’m sure they do… but a hell of a lot of people feel like they’re the ones on the end of that string about the break. A hell of a lot of people feel like they’re about to lose themselves forever. Why aren’t we talking about them? Why aren’t we centering their experiences? Especially at a Conference supposedly addressing their issues? Why would you choose to center the stories of people who have a secondhand experience with mental illness, rather than the stories of people who have a firsthand experience with mental illness?

Because the Conference wasn’t really about, or for, people with mental illnesses.

***

Once I realized that the conference wasn’t about people with mental illnesses, many things were suddenly clear. . Like the presence of Bradley Cooper and Glenn Close. When I saw they were on the guest list, I was all: “WHAT THE FUCK ARE BRADLEY COOPER AND GLENN CLOSE DOING THERE?” But now I understand! It’s because they know people with mental illnesses!

And that’s the important thing to highlight!

No disrespect to Bradley Cooper and Glenn Close. I like Bradley Cooper and Glenn Close! They seem cool. But like everyone else at the conference, their experiences of mental illness are second-hand. Glenn Close has two family members with mental illness.And Bradley Cooper played a mentally ill character in a film. How’s that for a tenuous connection?

(since I’ve played not one, but two characters locked in insane asylums, I am eagerly anticipating an invitation to deliver the keynote speech at the National Conference for Reforming Our Psych Wards. I am QUALIFIED.)
(I am not qualified. Do not invite me.)

As Bradley Cooper himself put it: “I’m sort of here by accident. It’s not that I didn’t know about mental illness. I think it’s just that I just didn’t see it as a part of my life.”

Couldn’t the White House have chosen to invite someone for whom mental illness IS an inextricable part of their lives? Did no one even consider inviting a Famous Person ™ with an actual mental illness? They are out there! They exist! What about Rachel Maddow, who has discussed her problems with depression?  Or Demi Lovato, who often talks publicly about her eating disorder, addictions and bipolar disorder?

Why would you invite Bradley Cooper, who PLAYED a man with bipolar disorder, when you could invite Demi Lovato, who actually HAS the illness? Or Catherine Zeta Jones? Or Carrie Fisher? Or Emilie Autumn? Or Francis Ford Coppola? I’m not kidding when I say there are lots and lots of celebrities with mental illnesses that the White House could have chosen to invite. How about Emma Thompson, Stephen Fry, Brooke Shields, Hugh Laurie, Halle Berry or Janet Jackson?

I understand that the point of inviting Bradley Cooper and Glenn Close is to enlist star power to the Conference’s cause. But how much more effective would that star power have been if the stars had actually struggled with mental illness? And could speak from a place of personal experience?

The narrative would shift from  “this horrible thing happens to some people and we should help them” to “this horrible thing happens to me.” And that’s a crucial shift, because it forces people – the media, politicians etc. – to stop treating the mentally ill as “other” and start treating them as “us.” It is much harder to objectify, otherize and stereotype people with mental illnesses when they are the featured speakers at your conference.

(As an aside: I would argue that the comic-blog-thing Hyperbole and a Half published a month ago was more influential culturally than the entire conference, precisely BECAUSE it focused on Allie’s personal experience with mental illness. I’ve shown that post to SO MANY PEOPLE and been like “this is exactly how I experience depression” and seen a mental lightbulb go off.)

Moreover, if we assume that the Conference was supposed to help people with mental illnesses (a fairly naive assumption at this point, but bear with me), inviting stars who actually have mental illnesses would have been far more effective than inviting Cooper and Close. Seeing successful, respected people who suffer from similar diseases is inspiring – it shows that mental illnesses are an illness, not a destiny. When I read about, say, Rachel Maddow’s struggle with depression, I feel hopeful. She’s a woman I admire a great deal, and hearing her talk about her illness makes me feel, in the most visceral way possible, that my depression isn’t a sign of weakness or of incapability.

Inviting Cooper and Close sends the message that mentally ill people can be the friends and family of great people. Inviting Maddow, Lovato, Autumn, sends the message that mentally ill people can be great people themselves. Which sounds like a more effective message?

***

Okay, so, it’s frustrating that the President and the Conference won’t speak directly to people with mental illnesses. It’s annoying that they’re incapable of inviting speakers who actually have mental illnesses, rather than people who have friends and family with mental illnesses? But is it anything more than annoying?

Yep! There are some pretty grim consequences to the trope of highlighting  “friends and family” of the mentally ill at the expense of  actual people with mental illness. I mean, aside from otherization and erasure (HAHAHAHAHAHAHAHAHAHA, like those aren’t grim consequences in and of themselves, oh, I do make myself laugh).

Ahem.

First, it adds to an already-potent cultural myth that people with mental illnesses are so addled and deranged that they can’t possible voice their own experiences, or participate in discussions about their own illnesses.By choosing to highlight the “friends and family” (and actor-portrayers) of the mentally ill rather than the mentally ill themselves, the conference reinforced the idea that people with mental illnesses are incapable of advocating for themselves. They are incapable of speaking for themselves. They are incapable of solving their own problems, or of being responsible for wider social change. They are problems to be solved (by sane people), not problem-solvers.

There’s a long history of giving families and governments the power to control the lives of people with mental illnesses, because we assume that people with mental illnesses are irrational and incapable of making intelligent decisions. Reinforcing that trope is dangerous as fuck.

Second, the “friends and family” approach makes it seem like people with mental illnesses are only important in the context of their relationships. In the President’s speech, we are defined not as individuals, but within the structure of relationships with “sane” people – the “family member, friend, neighbor” who knows us. This makes us secondary players in our own illnesses: our conditions are important not because they’re destroying our lives, or making every day a struggle, but because they’re making our loved ones miserable.

If you’re going to try to improve the state of mental illness in the USA, please, don’t do it because you want to spare my parents, my family, my friends, my neighbors. Do it because you care about how it affects people with mental illnesses. 

I have a family. I have friends. I have neighbors. I have loved ones. But that’s not why I deserve to be treated as a human being. That’s not why you should reduce the stigma around mental illnesses, or increase mental health access, or change societal attitudes.

That’s not why people with mental illnesses deserve help.

Not to mention the fact that some people with mental illnesses DON’T have family or friends. I’m serious. Some of them are kids in foster systems. Some of them are kids with abusive parents – they have family, but their family is the source of their mental illness, not their support system. Some people with mental illnesses don’t have friends. Some have lost their family. Some are far away from the people they love. They are still valuable people. And they are worth our time and attention, regardless.

***

There was a lot of good stuff in the conference. People pointed out that mental illnesses aren’t inherently linked to violence! There was an entire panel about reducing stigma! There was talk of improving access!

Unfortunately, the conference’s potential was marred by its lack of focus on people with mental illnesses. In a conference where people  pointed out that one in five Americans will suffer a mental illness in their lifetimes, there were shockingly few people with mental illnesses, either as speakers, as the implied audience, or as the focus of speeches and discussions. Instead, most of the focus was on “sane” friends and family members of people with mental illnesses – their experiences, their advocacy, and what they could do to help.

And it’s not like President Obama and the other organizers don’t understand the value of personal experience. In my favorite moment of the President’s speech, he talked about Patrick Kennedy: “when he was running for reelection back in 2006, he could have avoided talking about his struggles with bi‑polar disorder and addiction. Let’s face it, he’s a Kennedy. His seat was pretty safe. Everybody loved him. And yet, Patrick used his experiences as a way to connect and to lift up these issues, not hide from them. One day a woman came up to Patrick at a senior center and told him she was afraid to tell her friends she was taking medication for a mental illness because she was worried they might treat her differently. She told Patrick, “You’re the only one who knows aside from my son.”

From this anecdote, it’s clear to me that Obama understands (some) people with mental illnesses have agency, and that having people in prominent positions talk about their personal experiences with mental illness can make a tremendous change.

I just wish that anecdote had set the tone for the conference, rather than the “we all know someone with a mental illness” sentence. If it had, this conference could have been tremendously influential. Imagine a giant panel of superstars like Rachel Maddow, Janet Jackson, Demi Lovato etc. talking about their experiences, their successes, their struggles, and what they think is necessary to change the state of mental illness in the USA. And then a panel of non-superstars – just regular people with mental illnesses – doing the same. Now THAT would have been a conference.

It’s not that hard to change the focus. You just have to stop seeing people with mental illnesses as the “other,” and start seeing them as part of the “us.”


13 Comments on “The “Family Members, Friends, Neighbors” approach to Mental Illness: Analysis of 2013′s National Conference on Mental Health”

  1. Gametime says:

    It seems like a pattern with the Obama administration to “advocate” for marginalized groups by appealing to non-marginalized people with marginalized friends and family. Women’s issues are important because men have wives and mothers and sisters! Mental health is important because neurotypical people know neuroatypical people!

    And like, that’s definitely an approach that I think has a time and a place, because part of the work in combating oppressive systems is recruiting people with privilege to your fight. But when that’s the only focus, when you’re only talking to the privileged people about the marginalized people… yeah, that’s gross.

  2. victoria says:

    Thank you for writing this and for slogging through the conference. I didn’t watch any of it, precisely because I feared that it would indeed be just an insulting series of “experts” and “loved ones” talking about us and what a burden we are, instead of letting us speak for ourselves. (I see that my fears were not the irrational fears of a paranoid “crazy” person, I was right to have low expectations of this so-called dialogue on mental health.)

  3. Nick Chu says:

    I’m one of the “us” with (a cocktail of) mental illnesses, trekking on and doing activism. I often minimize the explicitness with which I speak about my illness(es), instead emphasizing that in the context of the larger movements I’m in, mental illness is just a small part. Yet the reality is that my own illness has been a huge driving force for me to want to eradicate social injustices that predicate upon people’s identities.

    I’m so grateful that you wrote this, and I’m so proud of you. Even though I talk quite openly about my mental illnesses, I feel trepidation, fear, and even queasiness sometimes when I speak about them in a large group. I still combat stigma within myself, and I still contend with the paranoia that there will be negative repercussions for “telling everyone that I’m crazy, self-hating, self-harming, violent, and emotionally unstable against the world.” Sometimes even juxtaposing my struggles and weaknesses alongside my accomplishments doesn’t seem to assuage the feeling that I’m hopelessly broken, deranged, and just “wrong.”

    But I do it anyway because hearing it out loud helps me fight my own stigma, and letting others hear it gives them the chance to do the same. I do it, and it’s the scariest thing in the world, feeling like the most unstable, vulnerable, “disgusting” person in the room for a few terrifying minutes.

    Your writing makes this world a little less scary.

    Thank you.

    Because of you, I will continue to speak up and stop holding back.

    Thank you, thank you, thank you.

  4. Alexandra says:

    Great article, really well done. Another mad person checking in to say that I wish people would talk to me, and not at, about, or around me, more often.

  5. Lacey says:

    Ok… I get (and agree with) everything you’re saying, but I have some possible insights into why this conference was NOT the best one to include successful people who have mental illness, or even average people with mental illnesses. Why it was designed to talk specifically about the friends and family, the impacts that letting our society ostracize people who are mentally ill. And that is because it was a conference about community. About that as a community we need to put more efforts towards funding and understanding the real problem that we have right now in even admitting that we are so deficient in addressing this issue. So Obama and the other presenters had to put the emphasis on SOCIETY. This wasn’t about understanding. It was about MONEY. And weirdly enough, that’s always done on behalf of the people who need the funds, not involving them.

    And also, I am sorry, but the President of the United States could never use “us” when referring to the mentally ill population. He can use “them” or even “you”, but he would not include himself in that umbrella even if he spends his weekends chatting up trees in the park.

    I hope, and indeed know, that in the future when the voting is over and the money is secured, the conversations will include actual mentally ill people. There will be entire ad campaigns where Stephen Fry talks about his suicide attempt and how things can get better with help, and if you call this number you can be added to the Federal Program™. For now it has to be about “them” and about how “they” need help and we should do something as a society because “they” could adversely affect our lives by being someone we are responsible for, even if in reality “they” are also “us.”

    • moviemaedchen says:

      The thing is, you’re never going to create a stable, workable, and GENUINELY HELPFUL community of support for people with mental illness if you don’t include people with mental illness in the building of it. You have to listen to them, ask them what they actually need, hear about what their real and most pressing problems are from them, in order to fix any of that. Not including members of a marginalized population in the community will not only mean building relatively useless ‘solutions,’ it can and often does create actual HARM for them.

      Money doesn’t get committed to a project like this and spent without first establishing what it will be used for. Getting a giant heap of money together is worse than useless if it isn’t aimed at fixing the ACTUAL problems people with mental illness face – if it’s aimed at what privileged people without firsthand experience think are the important problems. You can’t just say ‘oh it’s ok it’s just to get money, THEN we’ll listen to you and use the money the way YOU need it to be spent.’ Why would they listen to us about how to spend the money if they won’t even listen to us in the process of getting it in the first place? The whole point is that (at best) they don’t trust us to voice our own needs correctly. And it ignores the fact that not being listened to or treated as if our voices matter is ITSELF a giant problem with very real negative effects.

      @C.D.: Thank you for this article, thank you thank you. Great job dissecting exactly what is so off about this conference.

  6. […] The “Family Members, Friends, Neighbors” approach to Mental Illness: analysis of 2013′s National Conference on Mental Health […]

  7. Gametime says:

    Ok… I get (and agree with) everything you’re saying, but I have some possible insights into why this conference was NOT the best one to include successful people who have mental illness, or even average people with mental illnesses. Why it was designed to talk specifically about the friends and family, the impacts that letting our society ostracize people who are mentally ill. And that is because it was a conference about community. About that as a community we need to put more efforts towards funding and understanding the real problem that we have right now in even admitting that we are so deficient in addressing this issue. So Obama and the other presenters had to put the emphasis on SOCIETY.

    If you’re approaching the issue of de-stigmatizing mental health issues and increasing access to mental healthcare from the perspective of “people with mental illnesses are separate from the broader society,” rather than “people with mental illnesses are a large and vital part of the broader society,” you’ve already fucked up.

  8. Yeah, I kind of thought that centering the voices of the people you’re trying to help was Activism 101. I would have expected a veteran community organizer to get that.

  9. […] 1. If you only read one of these things: Over on Culturally Disoriented, there’s a piece about the “family members, friends, neighbors” approach to mental illness advocacy, as exemplified by President Obama at the National Conference on Mental Health. It is so difficult to pick out just one quote from this, but here you go: […]

  10. Part of what makes Community uniquely awesome is its attempts (at least when Dan Harmon was running to show) to keep an even balance of male and female writers!

    Also, it does a great job with black characters – http://thinkprogress.org/alyssa/2012/02/29/434138/communitys-yvette-nicole-brown-on-sassy-black-women-and-rage/?mobile=nc

    One episode even has Yvette Nicole Brown’s character in the exact situation she describes in the article, with an in-universe director (The Dean, making a commercial for the community college) telling her to act like a sassy black woman. It’s an excellent commentary on the problem.

  11. Site title says:

    […] The “Family Members, Friends, Neighbors” approach to Mental Illness: Analysis of 2013′s Nation… (via gruntledandhinged) […]


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