From The Counseling Couch: Floating a New Perspective on Mental Health

A rather famous mime artist has a fantastic performance in which he struggles to move a balloon around on stage. The act begins with him carrying the balloon out from behind the curtain, appearing to struggle with its weight. To his audience, the balloon is assumed to be light and chuckles ensue. As he moves the balloon around, he appears to really struggle to push and pull the balloon in different directions. His movements are intended to showcase the balloon’s stubbornness and persistence, despite its nearly weightless appearance. This act is humorous because we assume the balloon is light and full of air. What if, for our performer, the balloon was filled something else, something heavier perhaps? What if our assumption is wrong?

Staying Afloat

What is mental health? By its simplest definition, mental health is defined as psychological well-being. Mental illness is some persistent or notable disruption in this psychological well-being. A mental health diagnosis is a term that involves a bit more specificity to define properly. It is a set of symptoms, behaviors, thoughts, emotions, or other signs that fit a pattern of dysfunction. The diagnostic process is complex and takes into account all areas of social, cognitive, and physiological function. Mental health treatment is then the way individuals receive care for issues related to their psychological well-being.

Let’s return to our performer and his balloon. Imagine his balloon represents his mental health. For most, the balloon is filled with air and easily moves around with them. Sometimes, the wind may pick up and the balloon may be tougher to keep a handle on, but for the most part it floats along the path you guide it on with some minor adjustments here and there. What if there was no wind and your balloon simply would not budge? That same balloon could be bogged down, heavy with something others can’t plainly see. They may see you struggle but cannot always identify what’s inside.

Weighed Down by Stigma

Mental illness is a term that carries a stigma. Despite its simple definition and advances in our understanding of mental illnesses, it is often associated with words and phrases like weakness, being a phase, fake, or shame. This stigma related to mental health, mental illness, and mental health diagnosis too often leads to discrimination, a lack of compassion, self-stigma, and the incredible burden of shame or guilt for those who suffer from mental illness. According to the National Alliance on Mental Illness (NAMI), nearly 9 out of 10 individuals impacted by mental illness have faced discrimination.

Now, our performer’s balloon is not just heavy and difficult to manage but marked also by stigma. Imagine, the balloon has words like “weakness” or “shame” scattered around it and was shaded a darker color than the others. As our performer tries to move his balloon, struggling to make it float as the others do, he must stare at the words stamped on it. Those letters do not just appear on his balloon, however. They are stamped and painted on by those he meets, by the television shows and news broadcasts he watches, by the laws that govern the help he can obtain and the lack of protection he has, and political pundits who propagate those laws.

Care Needed

With just over 1 in 5 individuals struggling with mental illness at some point in their lives, you can imagine the impact a negative stigma can have. But, unfortunately, it's not just stigma and discrimination that are problematic. NAMI indicates that millions of people each year go without treatment and access to proper, affordable care is a large barrier to ensuring proper mental health treatment. Although some are surely not seeking treatment due to stigma and discrimination, a large portion of those impacted by mental health do not seek treatment due to a lack of access to proper care or this care being cost-prohibitive.

Imagine looking from a high building or a camera drone down on to a bustling Times Square. Each person’s balloon would be settled just above them where you could see. The populous of people would now appear as lighter and darker circles with nearly a quarter of them being heavy, stamped, and darker than the others. The pattern would appear in such large numbers that it would surpass the look of being scattered or even dotted, but rather as swaths and streaks of color and defamatory script.

Assistance Takes Several Forms

The problems related to mental health can seem vast. With the U.S. population at around 330 million, that means that upwards of 66 million people are impacted and need care. Still, there are positive steps that can be taken. The first is often to just consider mental health awareness. How do we let others know what mental health means, what a mental health diagnosis means, and what mental health treatment entails? Mental health advocacy can help us spread this awareness and the truths about mental health. Advocacy takes many shapes and forms. Some choose to work in direct service, providing care for those who need it most. Others choose to advocate for policy or legal reform at their local, state, or even the federal level. Still others may choose to build campaigns of awareness, conduct research, or push back against stigma through directive efforts. Clinical mental health counselors, including those trained in our graduate program at Southern New Hampshire University, are not just trained to provide services but to serve as advocates for those they have elected to serve. Other professions such as social work, psychology, and the medical community continue their efforts as well. The question you may ask is, “What can I do?”

As you gaze down at the crowd of people, every so often, you see a balloon change or move in a strange way. Although it may seem small, one balloon shifting from darker to lighter is clearly noticeable in the crowd. Maybe for some, the letters of stigma on their balloon fades or a hand reaches up to scribble out the defamatory language scrawled there. Maybe for others, proper treatment makes their balloon lighter and you see not just hands of support, but also the balloon appears more airy and buoyant in the breeze. Staring down, you begin to wonder what the crowd might look like if we could solve some of these issues, if more hands were helping to hold up and brighten these balloons, a topic we will explore in the next post in this series.

An Addendum on 'Distancing'

Something many may not realize about mental health treatment is it has a paradoxical nature. Although these issues are diagnosed and relegated to an individual, mental health is only improved by and through the interactions between the client or person seeking care and the helping professional, often a counselor, social worker, psychologist, or psychiatrist to name a few; and the interactions between the client and the world around them, e.g.family, friends, and their community. Healing does not happen in isolation. It happens in connection. Although we face an unprecedented physical health crisis that forces us to “physically” distance, we should be socially closer than ever. The isolation that is occurring creates the propensity for harm to mental health. To ensure that we as a people can be well and mitigate this, we must connect with one another more so now than ever, distanced physically six feet apart, but emotionally connected by our common goal to see each other through. Let’s begin by changing the narrative of “social distancing” to “physical distancing” or perhaps even a step further. Maybe we need to adopt the phrase “Come Together Without Being Together."

Eric J. Perry, PhD, NCC, ACS is a clinical faculty member in Southern New Hampshire University's master's in clinical mental health counseling program.