Just over three weeks ago my best friend since childhood died. She killed herself. It came as a bolt out of the blue to everyone except her immediate family, who had seen her struggling with a mental health condition in the final weeks before she died.
So why hadn’t anyone else known this horror was brewing? She swore them all to secrecy, not wanting to be judged by the wider world when something was going so haywire in her head.
The fact that an autopsy showed she had a tumour on her brain, most likely the cause of her distress, to some extent tempers something that, ultimately, can make no sense.
But what it can’t do is answer all the ‘what-if’ questions that will haunt those of us who loved her for the rest of our lives.
We can only assume that it was the stigma of admitting to a mental health problem that held her back from seeking the extra support she (and her family) could have had from those of us who cared.
She had a high profile job, which she no doubt felt would be undermined if it was known she was ill.
How has it come to this? How is it that we feel ashamed and guilty by a chemical imbalance in our brain that is not of our own making?
I have other friends with long-term mental health issues that simmer away, occasionally boiling over before they again subside. They, too, feel an enormous shame, and only admit what is going on to their nearest and dearest.
What does it say about us as a society that we place such judgements on someone who, instead, deserves our sympathy and support? The stigma of mental illness is as destructive as the illness itself.
While I applaud the advertisements on TV trying to destigmatise depression, we need to go much further than this.
We need to show through our talk and actions that we value and support someone struggling with their mental health as openly and actively as anybody else who is diagnosed with a chronic and potentially debilitating illness.
And we need to acknowledge what a delicate balancing act stable mental health is. Any of us can slip off the tightrope any time, for any manner of reasons, often temporarily, sometimes not.
Instead, we treat those with mental illness as if they have chosen this path; as if the brain’s tiptop health is the only facet of a person worthy of respect.
We put them outside of the ‘normal’ spectrum of human behaviour, when the truth is many (if not most) of us will struggle with anxiety, depression, psychosis etc at some point in our lives. It can be injury induced.
It can be stress induced. Alcohol or drug induced. Or it can be inherited. Or as a result of hidden illness, as in the case of my dear friend.
None of these reasons are a crime. None, something to be ashamed of. Yet the stigma, oh the nasty stigma, drives such people underground, ashamed, alone, and bloody scared. And sometimes drives people to end their lives. To end the torment or the pain.
The support systems around those with mental illness are sketchy at best. Hospitals are underfunded. Beds are limited. Trained professionals are scarce and over-stretched.
It seems to me the only way each of us can attempt to improve this situation is to speak out, to lobby those who control the purse-strings (and the popular messages that are spread) for more funding, more support, more understanding of those in need.
And we need to fight the stigma attached to mental illness with the same ferocity that we would racism, or sexism, or any other ‘ism’ that excludes a section of society from the benefits, respect and privileges of the rest.
Statistics taken from Te Rau Hinengaro – New Zealand Mental Health Survey show that some experience of a mental disorder is common (20% of the population or 1 in 5 New Zealanders within the past year) and those having more than one event are also common (37% in any year).
The most usual combination of disorders is anxiety and mood disorders. Having more than one mental disorder is linked with suicidal behaviour (such as suicide attempts) and increased mental health service use (if they can get it.)
There is significant unmet care need for people with mental disorders. As someone who has watched others struggle to get adequate and effective help for their loved one’s mental health issues, I can tell you it’s a shit fight that takes persistence, resilience and confidence — and, even then, this often still fails to garner the help that is required.
Until we stop seeing mental illness as a failing, more families and friends will be devastated. It’s time to speak up now.
To read more about stigma in the world of mental health see: