This year’s World Mental Health Day will be celebrated on Tuesday 10 October with the theme that ‘mental health is a universal human right’. This seems fitting: after all, every one of us has mental health and it can be good or bad at different stages of life – a fact that seems as widely accepted now as it ever has been. Why then do so many people with mental illness experience stigma, discrimination, and prejudice?

The theme of this year’s Scottish Mental Health Arts Festival is revolution. While we arguably need revolution in many areas of society, just imagine the massive material change that could occur if we all rose up and made it a bit easier to be mentally ill in Scotland in 2023. Now, I appreciate that you might not feel equipped to start a revolution, particularly if you’re one of the one in four people who live with a mental illness. However, meaningful change is often best started on a small scale and what I’d urge during this festival period is that we consider the small changes that we can adopt. And so you might ask, where is change most needed? Well, I’d like us to think about stigma.

Mental illness presents people with a huge variety of barriers to accessing and experiencing life. I hope it is self-evident that this is challenging enough without the added pressures and consequences brought about by discrimination and stigma. It is not for me to illustrate here the extent to which these are issues in Scotland, but I would like to point towards recent research published by the Mental Health Foundation and See Me Scotland.

Their Scottish Mental Illness Stigma Study outlines the alarming structural barriers faced by those of us who live with mental illness, in areas such as work, healthcare, and education. As individuals, it can sometimes feel frustratingly futile to try and fight the stigma that is engrained in the fabric of our society. This absolutely does not mean that it’s not worth trying: on the contrary, I believe it’s essential that we resist and dismantle discrimination wherever and whenever we can. However, let’s focus here on the smaller, more achievable ways that we can reduce stigma in the every day.

I think it’s important to make it clear from the outset that we are all capable of stigma and internalised prejudice. I was first diagnosed with mental illness over twenty years ago and yet I still have to wrestle with my own internalised prejudice on an ongoing basis. To give one example as illustration, I shared my diagnosis with a new colleague a while back and found myself initially delighted when they said “wow – you’d never know there was anything wrong with you.” There’s a lot to unpack there, but it’s my own prejudiced attitude that disquiets me the most. Why was I so ready and willing to distance myself from my illness when it’s a core part of who I am? It’s hard to attribute it to anything other than a misplaced sense of shame.

There are definitely ways in which we can reduce the shame that many of us with mental illnesses feel. We can challenge discrimination and prejudice when we’re confronted by them, and we can challenge them in ourselves. For example, even though the parlance of mental health has become better embedded in society, how often do we still hear people described as “a bit OCD” or “totally bipolar”? Such trivialisation of debilitating mental illnesses is ignorant at best, harmful and cruel at worst.

Some of the most insidious examples are when people appropriate the language of mental health and illness to describe perfectly natural feelings of sadness, anxiety, or overwhelm. To give an example that I heard this week – “I nearly had a panic attack there!” Let’s not forget, we all experience uncomfortable feelings and emotions, and this is not the same as experiencing mental illness. Consider how much you might help those around you by resisting casually stigmatising language like this.

And, while we’re at it, this is as good a time as any to do our best to stop buying into or perpetuating stereotypes about mental health. Easier said than done, I know. I mean, picture someone experiencing depression: do you see someone with their head in their hands? It’s hard not to when this is the almost obligatory image that accompanies stories, reports, and accounts of mental ill health. Let’s work to change this: stereotypes and assumptions are so reductive, and they rob us all of the nuance and richness of the human experience.

It’s understandable that you may worry about saying the wrong thing if someone talks to you about their mental health (or ill health). However, it’s far better to say the wrong thing than to say nothing at all. Indeed, perhaps one of the kindest, most helpful things you can do for an unwell friend or loved one is to work really hard at consciously putting aside assumptions and, instead, to listen to them without fear or judgement.

It would take more than one hand for me to count the relationships that I lost when I first became mentally unwell and that I’ve continued to lose in the years since. It’s hard to admit this, not least because in many ways I understand it. Let’s be honest: mental illness, like any illness, can hamper your ability to be a good friend. Could we be willing to make more effort with someone we know who isn’t themselves, or who may have withdrawn a bit? It might feel frustrating or difficult but, in the kindest possible way, maybe it’s not really about us. Our friend is still there, they are just unwell.

Finally, I can’t talk about discrimination without considering a particularly cruel manifestation of stigma. I’m referring to self-stigma; the process by which we internalise various negative beliefs about our own mental health. For my part, my self-stigma often looks like trying to be the most palatable version of mentally ill that I can manage. There’s no doubt that I’m much more open about my mental health than I’ve ever been, but I can’t claim to be honest about how it shows up for me in daily life. My own prejudice and self-stigma leads me to carefully choose what I share, and to edit myself and my experiences in front of others and in conversation with people, even medical professionals. If I can’t accept my mentally ill self in all my messiness, then how do I allow others to accept me as such?

Now, on the one hand, that’s absolutely fine: none of us owes anyone else our own lived experience. However, there is a tension here too, because I absolutely believe that sharing our stories is perhaps the most powerful tool we have to reduce – even end – stigma. Stories start conversations and conversations can drive change. And isn’t that what revolution is all about?

So, what could change could look like? Is there a particular tweak that you could make to how you view yourself, or view a friend, loved one, or co-worker? Or perhaps a change in the language that you use? I truly believe that if enough of us make enough tiny changes, then we could all play a part in making it easier to be mentally ill in Scotland in 2023, that we could rid our society of the stigma that still dogs mental illness. It seems as if the path to this revolution will be built by how we view ourselves and how we view each other: with honesty, acceptance, and love.

Rachel Alexander is a Talking Heads volunteer who lives in Edinburgh. Interested in writing, feminism and mental health, she’s an English teacher to trade, and passionate about learning as well as teaching. She loves stories of all kinds, and believes they are a uniquely powerful way of changing the world. Tweets at @rachalexwrites and Instagrams at @rachjanealex.

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