Why Mental Health is a Societal Issue, not just a Personal One.

Summary

The article argues that mental health is not solely a personal issue but a societal one, deeply intertwined with factors such as gender, race, and poverty.

Abstract

The author reflects on their personal experience in a marriage and family therapy program where the curriculum initially seemed to dismiss the importance of discussing racism, sexism, and other societal issues. The article emphasizes the necessity of understanding how societal factors like systemic racism, gender discrimination, and economic hardship significantly impact mental health. It highlights the inadequacy of therapy that fails to consider these systemic issues, suggesting that a lack of cultural competence in mental health professionals can lead to ineffective treatment, particularly for marginalized communities. The author advocates for the inclusion of these critical topics in therapy training and the ongoing education of mental health professionals to better address the complex needs of their clients.

Opinions

The author believes that it is crucial for therapists to understand the mental health implications of societal issues such as racism, sexism, and poverty.
There is a concern that people of color and other marginalized groups may avoid therapy because they cannot find culturally competent therapists who understand their experiences.
The article suggests that the mental health industry has a diversity problem, which affects the quality of care provided to clients from different backgrounds.
The author is critical of educational programs that do not include discussions of societal issues, arguing that such omissions are detrimental to the training of effective therapists.
The author posits that addressing mental health requires more than just coping skills; it involves understanding the societal contexts that contribute to clients' mental health challenges.
The author stresses the importance of continuous learning and self-education for mental health professionals to better comprehend the societal factors affecting their clients.

We need to talk about how things like gender, race, and poverty are related to mental health.

Storytime. It’s 2017, and I am starting my first week of a marriage and family therapy program at a new graduate school. It had already started rough. I had gone from living alone during my undergraduate to living in the basement of my brother and sister-in-law’s house.

While I am forever grateful for their accommodation and the steps they took to allow me to do this, it was a massive change and if I’m being honest, felt like I was taking a step back.

I was 20 hours away from my boyfriend, now husband, and I was driving one hour to school in the morning. Again, not necessarily the end of the world for most people, but I had been used to walking to school so one hour of traffic to go like 18 miles was absolutely exhausting to me. But, I was willing to stick it out and was the most excited for the “race and gender” class at the beginning of the week.

These had been my favorite topics of study in undergraduate and I was excited to learn the more nuanced and in-depth things in graduate school. However, my hopes and excitement were instantly dashed with the professor's opening line.

“We will not be talking about the isms in this class. Meaning racism, sexism, things of that nature.”

This may not be a direct quote, as it was almost five years ago, but something around those lines. I was shocked to hear this. This is a therapy program. To me, we needed to discuss the “isms” to do our jobs.

The program was smack dab in the middle of an area that had a population of mostly Black people. How are you expected to be a good therapist if you don’t understand the mental health, relationship, or other implications of racism?

How are you expected to be a good therapist if you don’t understand sexism? Especially in marriage and family therapy, where the inner workings of a marriage can often go back to multiple aspects of patriarchy.

I was thinking about this today and just wondered how many people don’t go to therapy when they desperately need it because they can’t find someone that understands how their lives/ how society treats them, impacts their mental health. How many people of color have gone to a therapist that doesn’t understand how detrimental experiencing racism is to not only mental but physical health as well.

Did you know studies have come out saying that Black people don’t get enough sleep/ rest largely due to racism being present in society? Because people are forced to work harder and longer for the bare minimum. Did you acknowledge how absolutely traumatizing the summer of 2020 might have been for Black people? What about the trauma of Latino people watching the last four years of Donald Trump spouting/promoting racist and violent rhetoric towards them?

These are all things that impact mental health. You can’t just “fix” minor issues, or prescribe an antidepressant and move on. People need to understand how much society is impacting mental health.

What about with women? Do you understand how it impacts a woman to be sexually harassed at work? What about the feeling many women with families have about “failing” at both things if they both work and take care of their children. What about men? How did being raised in a patriarchal society impact them? Are they closed off from their emotions, have been told never to cry, feel pressure to be “manly” at all times? Once again, these nuanced things are important, not just “isms” that can be ignored.

Beyond all of these, we need to talk more about how poverty impacts mental health. I’ve talked many times about my experience after I finally did finish graduate school (sociology, we talked about “isms” a LOT). I couldn’t find a job, and we were very effectively broke, surviving only on door dash and a few freelancing jobs I could find.

This was by far the worst my mental health had ever been. I was depressed, stressed, lonely, scared, anxious…. just all of the feelings. Like most people in this situation, I couldn’t afford a therapist. Beyond that though, I’m scared if I did find a therapist it wouldn’t have helped. Sure, you can give some better tools to deal with the stress and anxiety but at the end of the day if there’s no food in their fridge, no lights in their house, and no money to pay the rent, what does that do to help?

Additionally, along the lines of the “racism and sexism” aspects, I think it would have made me angry to see a therapist. Why? Because here was someone that may have never experienced what I was experiencing or never learned about what it was like to have this experience, telling me how to address it. It’s no secret that the mental health industry has struggled with diversity in all aspects and this influences the ability of people to have productive and helpful experiences.

So, here’s my thinking. First, if you are teaching young therapists, please don’t say anything like my professor said. If it made me (a white, grew up middle-class, woman) upset, I can’t imagine how that felt for the multiple women of color that were in my class. We need to be teaching about all lived experiences. All aspects of society can impact mental health and ignoring them is not going to make them go away.

If you are currently working in the mental health profession, I would recommend continuing learning. Continue reading, listening, and going out of your comfort zone to understand how society impacts mental health.

Helping someone goes beyond giving them coping skills, it’s about understanding what they need to cope with. We need to understand, not just in the mental health field, but as a society, how different aspects of lived experiences impact people. Only then, will we truly start making any progress.