If someone were to ask me if they should self-disclose their mental health status, I’d undoubtedly say not if they want to preserve their dignity. I’d probably consider the society in which they live and the community of their interactions, but if it’s anything like T&T, I’d be forthright about the dreadful consequences.
Here, you (quietly) become the subject of intolerance, are ostracised, and every future action is judged by the standard of people’s prejudice, people who are superlatively assertive in their misinformation. Basically, you’d be relegated to private hell.
Family may treat you with tokenism. I’m guessing you’d have less friends as they allocate their time to “less heavy” people. And you could imagine the rest, which you may not realise includes primary care and mental health caregivers among the prime offenders in discrimination against the mentally ill.
I’m a peculiar person. Despite recognising the stigma associated with mental illness and that in ignorance people discount every good thing they know about you, downgrading your every action to the realm of madness, I decided to self-disclose very early.
Cautiously to peers and co-workers, to boyfriends, too, and finally, when the opportunity came to address a forum that could make my disclosure global, indelibly set in cyber and other spaces, I was ready. I believed I could/should/would become a leading advocate for the mentally ill. And so, knowing the Caribbean has a special brand of small-mindedness so there’ll be consequences.
Confidently, my attitude was/is “to hell with your (collective) ignorance, you are going to hear me and you’ll have to make decisions about me and those like me, however you care to do so.”
Remarkably, I feel better about myself. Honestly, I don’t care if you know what my secrets are. I care only that I do not have to carry a secret and live a lie.
“Hiding information and worrying that someone will discover your secret consumes a lot of personal energy. It also detracts from the quality of your life,” says the Human Rights Campaign (www.hrc.org).
I do not pay attention to adverse chatter and hush-hush associated with my name or cause. What I know, from my desire to live freely in the knowledge that my illness(es) is/are not issue(s) of defect or weakness, is that there are countless people who need hope. Many have committed suicide in hopelessness, more are contemplating even as I write. So my lone-ranger advocacy must be robust. I concede it’s a hard, desolate road.
Secretly, I hurt deeply. Often, I bawl my face off privately when the anguish of stigma and discrimination hits me. But I continually take my battered dignity through self and other therapies, dust my backsides and “still I rise.”
Ultimately, I’ve counted the cost. I recognise I’m already paying the price. Discrimination threatens my livelihood, cancels my expertise, and works covertly to forget whatever’s left of my name, but by divine intervention it will be well.
Thankfully, I’ve gained support each year. Recently, my buddy Patricia Bethel said, “There’s an incredible amount of people who need the hope you provide,” which was followed by a classmate/peer at UWI Faculty of Medical Sciences, discovering this column last week and taking time to commend me on how well I’ve done given 35 years of lived experience. These moments buoy me.
“Research has shown that public attitudes about mental illness improve when people have contact, or interactions, with people with mental illnesses. Meeting individuals who have received mental health services and who are productive members of the community challenges stigmatising attitudes (Corrigan and Lundin, 2001). For these contact strategies to work, individuals must self-disclose or identify that they have received mental health services (https://store.samhsa.gov/).
That same paper at samsha.gov carries my favourite quote by Kay Redfield Jamison, PhD, clinician and client of the mental health system: “One is what one is, and the dishonesty of hiding behind a degree, or a title, or any manner and collection of words, is still that: dishonest.”
Redfield Jamison also says, “There is no easy way to tell other people that you have manic-depressive (bipolar) illness—if there is, I haven’t found it. So despite the fact that most people that I have told have been very understanding—some remarkably so—I remain haunted by those occasions when the response was unkind, condescending, or lacking in even a semblance of empathy.”
I support self-disclosure for its private and collective good. I wish more people here would disclose so that the real incidence/prevalence of mental illness would emerge. Yet, I caution, if self-disclosure becomes necessary, do seek counsel about what and how much to disclose. I wish it were not so, but it is what it is. Believe me though, better days are coming.
• Caroline C Ravello is a strategic communications and media practitioner with over 30 years of proficiency. She holds an MA in Mass Communications and is pursuing the MSc in Public Health from the UWI. She has been living/thriving with mental health issues for over 35 years. Write to: mindful.tt@gmail.com.
• Reference: https://store.samhsa.gov/shin/content/SMA08-4337/SMA08-4337.pdf