who gets to talk about mental health?

on may 18, i asked here on this blog, on twitter and on facebook what you think i should talk about at the upcoming mental health camp. this ended up being the winner:

who gets to speak up about mental health?

in the process of coming up with a useful definition for mental health, we also realized that there are different ideas who “gets” to have a mental illness and who doesn’t. depression, anxiety, obsessive-compulsive disorder – all these are “accepted” mental illnesses. but what about the mental health of people with addictions, brain injuries, aspergers or ADHD, just to name a few? are they taken seriously when they speak about mental health? and what about the perceived hierarchies among mental illnesses – from anxiety being “better” than schizophrenia to binge eating disorder being more “noble” than a crack addiction?

so i thought today i’d do a bit of thinking out loud about the topic.

it occurred to me that this whole topic is not just about who, but also about when, why, how and what. today, i want to talk about “who.”

who is perceived to have the authority to speak up about mental health? a story comes to mind told be a clinical psychologist who has supervised and taught other psychologists on an international level. “i used to give talks at hospitals,” he said. “often, afterwards, someone would walk up to me and the first thing they’d ask me was whether i was a psychiatrist. when i told them no, i’m a psychologist, they immediately dismissed me and all that i had said.”

it’s almost funny that even at that level, you can’t win; there is a pecking order wherever you go.

so here’s part 1 of the “who” question:

who gets to talk about mental health? mental health professionals, and if yes, what kind? professionals (or “simply” workers) in the helping profession? people with “serious” mental illness; people with any sort of mental illness; people with addiction, etc.? people whose loved ones are experiencing mental illness? everyone?

part 2 is: who do we get to talk about?

ever been to a psych ward and overheard a nurse yelling across the hallway to another nurse, “you better watch your step with joe, he doesn’t want to take his meds again!” that brings up the interesting question of subject and object. who gets to be the subject – the doer, the talker, the actor – and who gets to be the object – the done-to, talked-about, acted-on? can these roles be interchangeable?

in the next few days i’ll talk about the other parts – when, why, how and what. in the meantime, i’d love to hear your opinion, especially:

do you think that in order to talk about mental health (or mental illness), a person needs to be qualified? if so, what are the qualifications?


  1. I love that you wrote what you were thinking. Yes, there is a pecking order within the profession; however, I do not believe that that makes a difference on who talks. It depends on the audience…scientific versus practical, clinical experience.

    For me personally, I want to hear both, but it is more important for me to hear about how someone experiences their illness and some ways that they manage the symptoms which opens the door to many people being able to talk about mental illness.

    I may not have the education about mental illness; however, I’ve worked with people with mental illness for almost twenty years which includes DID, schizophrenia, personality disorders, develpmental disabilities and geriatric…does that make me qualified? Will I be taken seriously?

    .-= ClinicallyClueless´s last blog ..Memorial Day Why?…Sacrifice =-.

  2. Hi Isabella, as you know I think professionalism is part of the problem not part of the solution.

    I think the criterion is authenticity. Professionals can speak with authenticity – if they are prepared to take off their white coat and leave professionalism. Those who have experiences with ‘mental illness’ can also relate authentically (or not).

    The big problem I have is that the authorities get the privelege of interpreting. The clients’ interpretations of the therapists aren’t seen as authoritative while the therapists’ interpretation of the clients are. So it isn’t only about who gets to speak – clients are sometimes invited to speak at conferences (though not terribly often so far as I know) – it is also about what happens next.

    Another approach is to ask: Why is this still an issue? These kinds of critiques have been around since the 1960’s quite publicly – and before that as well. Why haven’t things changed? My answer is the forms of power exercised by institutions. Before this can change in a major way I think we need new kinds of ‘institutions’. That’s a bit off topic I guess.

  3. So much of it changes so much from time to time, I think it behooves us to keep the channels open from any and every aspect of involvement; from the most learned professional right on down to the guy on the street.
    It is, after all, our mind – the species, humanity – about which we’re trying to figure out what is “healthy” or not. Right?
    .-= A. Decker´s last blog ..We Went; We Saw; We Perspired =-.

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