Huma Munshi: on the importance of understanding mental health

In this article, Huma Munshi discusses important issues surrounding mental health.

You have written extensively about mental health issues, including your own experiences, how has writing about your experiences helped you?

Writing is my life-line, it is my catharsis and it reminds me that even in my darkest days I can create. I started writing in earnest after an acute bout of mental ill-health a few years ago. I took a short writing course in the evenings and it gave me a window into what was possible. My first forays into writing were centred on love and loss as these were the emotions I was experiencing at the time. But I was soon immersed in the world of plot, structure and character development.

When I have written about my personal experiences, such as being a survivor of a forced marriage, it has allowed me to own my history and to slowly combat the feelings of shame that I associate with that part of my life. My shame was based on the feeling that somehow I was to blame, that I deserved this horror, that I was a bad person and when I wrote, these feelings were slowly addressed, hence the catharsis.

Through sharing my story, I was able to develop some very valuable solidarity through social media and online networks. I heard other stories and learnt the value in speaking out. Writing has been the single most important thing to aid my recovery

You have written about how people can struggle to come to terms with a diagnosis regarding their mental health;are there still issues with accepting a diagnosis of some mental health conditionsover others?

Any mental health diagnosis comes with stigma. Imagine if there was shame attached to being diagnosed with cancer as there is with being diagnosed with bipolar disorder or schizophrenia; it is the latter two that are heavily stigmatised. Stigma makes it even harder to access appropriate support because there is a shame attached. It does not help that the tabloid press use crass and sensationalised headlines to stoke up hatred and ignorance of people with mental health problems. See the Sun’s headlines: “Knife-wielding schizophrenic woman in court after killing gran in streetand “Killer ‘Psycho’ attacks jail chaplain”. If your source of all news is tabloid press, you will not be aware that disabled people are statistically far more likely to be victims of hate crime, rather than the perpetrators.

Without a culture of understanding and inclusion, it silences the person and “others” them as if they are somehow abnormal.

As an equalities professional, how much of a stigma remains around mental health conditions? Do you find that employers or potential employees feel that it is something to avoid mentioning?

There is a huge misunderstanding about disability equality in the workplace because there is often ignorance about the range of impairments that are listed within the Equality Act 2010. The Act defines ‘disability’ as:

“A physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.”

If there is a workplace culture that promotes diversity and inclusion, it should enable people to get the right support. In tandem with this there should be policies covering reasonable adjustments; dignity and inclusion; managing diverse staff; combatting bullying and victimisation. Such measures will safeguard against the potential of disabled people, with physical or mental impairments, being discriminated. An employer may also wish to have an internal communications policy that seeks to raise awareness about mental health and well-being.

How important is it that people disclose their mental health issues on employment forms?

It is illegal for an employer to ask if you have a disability at recruitment stage. A person may choose to disclose the nature of the disability if they require some specific adjustments to attend the interview. Adjustments to the working environment or conditions can be agreed once an offer of employment has been made. I cannot think of any reason for someone to disclose their mental health issues at recruitment stage.

Do you find that there are differences in the stigma attached to mental health issues between cultures and communities? Or between men and women?

There are barriers within communities that make it harder to speak out. I read an excellent blog on Time to Change by someone who has depression and anxiety. In that blog Salma writes:

“I had two big issues to deal with, one of culture and tradition and the other of my mental health. At that time I didn’t know it was referred to as a ‘mental health’. Why? Because there is no term for what ‘mental health’ is in Urdu or Punjabi. In its literal translation it means something like ‘problem with the brain’, which implies ‘being mental/crazy’. In my experience there was a lot of stigma, ignorance, discrimination and oppression against those that were identified as ‘mental/crazy’.”

There is also stigma attached to accessing talking therapies. In many cultures it is not the “done thing”. In British culture we pride ourselves on having a “stiff upper lip” and showing stoicism in the face of the turmoil. I wonder why? It is damaging to us in the long-term to suppress pain and distress, eventually those emotions must be released. That’s why accessing appropriate talking therapies is of paramount importance because it enables a person to talk about those feelings in a safe space.

Statistically, men are less likely to be diagnosed with a mental health condition yet the Samaritans reports: “male suicide rates are on average 3-5 times higher than female rates and men aged 30-44 are the group with the highest rate.In the Republic Of Ireland men are also the group with the highest suicide rate, it is approximately 5 times that of females, and highest for men aged 45-49.”

This incongruence between the low rates of disclosed mental illness and the disproportionately higher rates of suicide could be a result of men not accessing support. There is a culture that equates asking for help as a sign of weakness or it may be an alien concept because no one else in the family has accessed such support. Undiagnosed and untreated, just like any other ailment, mental health problems will not simply disappear and has the capacity to be equally damaging.

How much of an onus remains on people who suffer with mental health conditions to “help themselves”? For example, high profile individuals like Louise Mensch have written very controversial and sweeping statements about mental health problems.

Louise has written:

“Self-esteem: exercise is the best anti-depressant and ANYONE can do it. Try this – 3 minute desk-side mini walk.”

Louise is a professional troll so it is difficult for me to engage with her in a reasonable dialogue on this. There is a more important point in people not treating mental health conditions with the seriousness as any other medical condition. The lay person does not seek to diagnose and prescribe treatment for arthritis or sickle cell so I wonder why they do so for mental health conditions. Again, it is ignorance.

A healthy lifestyle is helpful in-keeping with a range of medical treatment dependent on the nature of the mental illness. Often when a person experiences depression, they feel very lethargic and are not able to get out of the bed. The “pull yourself together” approach will do more harm. It is understanding and supporting the person while they access the appropriate medical support which will enable the person to re-build their life.

Shaming a person that is not well will only feed their sense of self-loathing. See how pointless that is?

There has been an increasing awareness of mental health issues over the past few years, and this has becoming an important issue in intersectional women’s movements, such as Fementalists; is there still a problem with mainstream feminist organisations understanding mental health issues?

Understanding how cross inequalities impact on a person’s life is something we can all strive harder to understand and practice. The intersection between disability and gender is important because it compounds the disadvantage a person experiences. Social media has provided a platform to highlight these issues, which may be lacking in the discourse by feminists in the mainstream media.

“World Mental Health” is now an annual event which aims to draw attention to mental health issues. Do you think that such initiatives will help tackle the stigma?

Having these symbolic days has the potential to stimulate constructive discussion and should be encouraged. The themes for World Mental Health Day include: schizophrenia; Older Adults; Depression; Mindfulness; Look after yourself. All of these are useful in galvanising public discourse. Attitudinal change is important but is only one step. We also need to ensure that mental health services are fit for purpose and this fight has a long way to go before it is won.

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