The campaign theme for World Mental Health Day this year is Mental health care for all: let’s make it a reality.
This, the WHO states, “presents an opportunity for government leaders, civil society organizations (CSOs) and many others to talk about the steps they are already taking and that they intend to take in support of this goal.” The directive taken this August by the Ministry of Education to ramp up social services available on school campuses is promising, along with the establishment of a Mental Health and Wellness Committee.
The surge in awareness and attention being paid to this issue indicates a positive trend, but in order to truly work towards the goal of making mental health care a reality for all, we must be wary not to let “mental health” and “wellness” lose their specificity, or begin to be used interchangeably.
General distinctions can be made in that “wellbeing” or “wellness” refers to the maintenance of healthy physical and mental habits: a healthy diet, exercise, fulfilling hobbies and stable relationships with loved ones. This undoubtedly undergirds sound mental health.
However, mental health must be understood and dealt with in a more holistic way. It cannot be treated as a straightforward formula in which one can plug in positive habits and expect to be feeling and functioning perfectly. We must also recognise that we can no longer subscribe to a normative understanding of psychological health. That is, we need to start accommodating the existence of neurodivergence in our discussions, and in our social systems more generally.
Neurodivergence is “the term used when someone’s brain processes, learns and/or behaves differently than what is considered ‘typical’”. This can include common diagnoses such as autism and ADHD, amongst many others. It is important to note that these are non-pathological, i.e. not caused by a disease.
Physical variation amongst humans is evident in so many obvious ways, so it should not be controversial to recognise that variation in our neurological structure is perfectly normal. On the other hand, mental illness refers to the behavioural or mental pattern that causes significant distress or impairment of personal functioning.
Our approach to mental illness should hence be to prevent, alleviate or cure such disorders. Neurodivergent people are often caught up with mental illness as a result of going undiagnosed, and/or struggling within the social constraints and expectations that neither recognise nor make room for the variations in brain function and behaviour.
A mental illness can be caused by a combination of what is referred to as “risk factors”. This includes genetic predisposition, living conditions, traumatic or stressful experiences, brain chemistry and lifestyle habits.
In a society forged on the foundations of the plantation economic model – where maximum productivity and minimal disorder or disruption were the highest priority – we are still entrenched in the collective mindset of policing each other’s behaviours to “fall into line”, of withholding compassion towards those who are unable to cope with the demands of our current capitalist model. Issues of racism, sexism and homophobia are well recognised legacies of our colonisation, but in the matter of mental health we must recognise that of ableism.
Ableism refers to the social prejudice against people with disabilities and/or people perceived to be disabled. Ableism strongly manifests itself in Barbados in the deep stigma towards neurodivergence and mental disorders, or in the denial that these realities exist at all. In circling back to the crucial role of specificity in addressing mental health, two major commitments must be made: that of consolidating our intentions and informing ourselves.
What is meant by consolidating our intentions? As a CSO with the role of providing Comprehensive Sexuality Education (CSE) curriculum and advocating for reproductive health rights (SRHR) for young Bajans, Dance4Life can attest to the need for a multifaceted, dynamic approach to dealing with youth mental health.
We cannot let the increasing interchangeability of “mental health” and “emotional wellbeing” mislead us into over-relying on the promotion of individual wellness habits being the sole response to these issues. Over the course of the eleven years we’ve been delivering our programming we have recognised that no one youth issue is completely isolated in its causes.
Working through a SRHR focus reveals many of the collective issues that perpetuate the challenges to youth mental health. For instance, strongly homophobic attitudes – often compunded by internalized homophobia – not only result in the higher rates of unprotected or unsafe sexual relations amongst LGBTQ+ youth , it also contributes to the overwhelming rates of self-destructive behaviour and depression in this community.
Our drinking culture should be scrutinised when dealing with sexual and intimate partner violence, as the role of alcoholism and substance abuse is found to be intrinsically tied to the cyclical nature of abusive relationships.
It can also be argued that the broadly accepted practice of corporal punishment on children plays into the normalisation of the use of violence as a means of problem solving, and to the imposition of disempowering silence and fear as a means of dealing with young people. Current studies indicate that this form of discipline is linked with mood disorders, involvement in school violence and later on in interrelationship violence.
If we want to be serious about taking responsibility for protecting our youth, we need to reckon with these attitudes, which we often apathetically accept as vague demarcations of our cultural identity. While changing social norms that contribute to risk factors for mental health is an undertaking that happens gradually, there are ways in which protective measures could be established to mitigate these risks.
There already exist many proactive community niches within Barbados, but it is possible that this pandemic can serve as the catalyst to formulate proactive community networks that can serve more effectively as a safety net for young people. The energised activity happening at the level of governance – evident in the local formulation of the commission for Mental Health and Wellness, as well as the recently launched regional observatory on SRHR by the United Nations Population Fund – can help facilitate the horizontal consolidation of local, grass-roots efforts and organising that are necessary for direct engagement with our youth. This would look like better connectivity amongst school counselors, CSOs, religious organizations, sports and outdoor groups, charity groups and creative initiatives.
With horizontal consolidation we can start to make our distinct practices and engagements more accessible to the youth by working at the intersection of our common intentions and goals. This diversity could pave the way for the success of possible initiatives such as the Big Brother Mentorship programme mentioned by Minister Bradshaw.
Based on Dance4Life’s long-term involvement with the Government Industrial Schools, one major gap we can attest to that should be prioritised is the establishment of a youth safe house system, which is currently lacking in any substantial way in Barbados. This is something that could work in conjunction with a mentorship programme.
In sum, there is much to discuss and collaborate towards fulfilling a broad horizon of potential. On the issue of informing ourselves, how prepared are we to shift our attitudes to young neurodivergent people in light of understanding the challenges of going through our education system with atypical processing and learning functions? If the Mental Health and Wellness committee consists of experts brought together to address the challenges students are facing, how many of these experts are themselves neurodivergent who could advise on how to recognise neurodivergent behaviours, which often appear distinctly depending on age and gender?
Can we commit to approaching these students compassionately and making adjustments to curriculum and evaluation? What steps can be taken to make teachers and parents aware of these behaviours that are so often perceived scornfully as incompetency or misbehaving? Frustration from teachers and parents often results in ostracisation, punishment and deepening antagonisms in a young person’s relationship to work and social life.
According to our recent surveys of students between 12 to 16 years old, 35.19% have reported a worsening of their mental health (increased anxiety, feelings of anger, sadness); 43.92% reported feeling sad or hopeless every day for two or more weeks in a row; 69.38% find it more difficult to stay focused during online classes and 72.8% prefer in person classes at school.
In light of their particular challenges brought about by this consistent disruption to their social and academic life the need for greater awareness and information accessibility regarding mental disorders in youth is urgent. For instance, Obsessive Compulsive Disorder (OCD) is generally thought of lightly as the need to be organised or cleanly. However, it is often experienced as severely disruptive and unwanted thoughts, intense fears and /or needing to do things in a very particular way.
Disassociation is a little known and complicated problem relating to how one’s brain handles information, and is experienced as a disconnect from one’s surroundings, perception of time, and sense of identity. This is often perceived as being “spaced out” or forgetful.
Eating disorders are notoriously prevalent amongst young women (though not exclusively), entailing a conflictive, difficult and detrimental relationship to their body, food and diets Mental illness can be the elephant in the room that turns into the bull in the chinashop when relationships, education, self-confidence and career aspirations are badly damaged if not destroyed by untreated or unregulated symptoms.
According to WHO, “Although there are known, effective treatments for mental disorders, more than 75 per cent of people in low- and middle-income countries receive no treatment.
1 Barriers to effective care include a lack of resources, lack of trained health-care providers and social stigma associated with mental disorders. In countries of all income levels, people who experience depression are often not correctly diagnosed, and others who do not have the disorder are too often misdiagnosed and prescribed antidepressants.”
It is easy as adults to see “grown up” issues and stressors as more serious, and that a young person being cared for does not have the right to be acting out. But care goes beyond a roof over one’s head and food on the table, it also consists in listening to and validating psychological distress being experienced.
Listening does not always come in the form of a conversation, as young people and children can often lack the words and concepts to effectively communicate the complexity of these experiences (this applies even for adults!).
Listening can also consist of being attentive to and interpreting certain signs of behaviour changes or patterns.
To make mental health care a reality for all, we must start by being realistic about re-examining our social outlook and adopting a thoroughly holistic approach to mental health, reforming our homophobic laws and rigid educational structures, and embrace a kinder, more compassionate approach towards our young people.
This article was submitted by Dance4Life Barbados.
World Mental Health Day will be celebrated on October 10.
