Let's Stop Mental Health Gatekeeping

“I am not a mental health professional and always encourage you to seek professional help when possible, especially if someone’s life is in danger. All experiences are my own but reflect a set of skills I have acquired while handling my own list of illnesses.” This disclaimer used to start just about every piece I wrote. I got so repetitive with weaving it in some shape or form that my editor had to ban me from doing so. “We get it. You’re not a professional. If people don’t know that by now, what are they doing reading your stuff,” he added for last time.

While it’s not relevant for every piece, I am always nervous to leave this little bit out. Not because I think my readers are stupid and don’t know I am writing interwoven biographical, research-intensive pieces. It’s more to avoid criticism, a fear of which is fueled by my impostor syndrome.

Wouldn’t you believe it, the criticism came anyway.

I never fancied myself a doctor, not without earning it through years of intense schooling. I never pretended to know more than I do. Yet, here I was being told just that. I got scared and began to reconsider writing all-together, wondering if maybe I shouldn’t be telling my story or offering any research or education at all, since it “wasn’t my place.” I was ready to discount everything I knew from experience. How could it matter if an accredited university hadn’t double checked all of my work at some point?  It’s terrifying to think you’re not in your right place. That is until I asked myself the ever-critical question, “oh yeah, how so?”

Upon further questioning, the people calling me out were often just worried about misinformation. They had seen so much of it (as have I), that they were convinced people outside of the mental health community were too ignorant to know not to follow blindly what someone might say.

And this is where we differed. I believe most people are capable judges, particularly those who are looking to learn by seeking out sources of information that offer a particular insight they have been looking to get. Those who take information at face value will do so no matter where it appears to them. Meaning, if you’re seeking bias, you will find it reflected and discontinue the search at that point. Those looking for good sources will do the work to double check what they read.

After confronting my own insecurity, it was clear that the real problem was truly others projecting their concerns about how the sensitive subject of mental health might be popularized. Period.

For every cause or event we support, there is the extreme opposite or sometimes even a parallel cause that may force us to reconsider our participation. Better known as gatekeeping, it is the notion that someone must be there to stand guard against those who threaten to muddle the consensus.

As an example, there are gatekeepers in the video game and movie industries. Those who believe that only true fans can understand a certain franchise. Basically, these are individuals with usually extensive knowledge (sometimes degrees) on a subject who take an extreme stance on a set of rules for that property. Usually, gatekeepers focus on upholding old traditions as they start to fall apart in the face of modernism or the introduction of a new generation.

I am particularly troubled by those who guard the gates of mental health knowledge.

I have a few reasons, but it is mostly it’s the fact that gatekeeping is based on intense fear. And the last thing those who face mental health stigma need is more fear. As much as I understand that people’s health is on the line, pushing for only a certain elite to be able to unlock the doors of this subject is unrealistic in our modern health system, particularly in the face of the huge population of people who are currently experiencing symptoms without access to help. The WHO estimates that about 300 million people are now living with depression (an 18% increase in 10 years, not counting other illnesses) and has even called mental illness a global crisis.

It is a tough topic which has just recently begun to slowly move out of the shadows and into the public eye. In this transitional time, we’ll inevitably have people who are looking for help that are not sure what credible sources and stories look like. If not careful those people might end up following false claims. In this post-Dr. Phil and Dr. Oz era professionals have grown weary of people preying on other’s fears to gain popularity, and rightfully so.

However, this is different. I am not talking about someone claiming to be a doctor to sell diet pills. Most mental health advocates are not people who would even dare to outwardly advise which medication someone should be taking (although outliers certainly exist and can be kindly advised of the issue). But someone sharing their story is offering a clear implicit bias: “I experienced, therefore here is what I think.” I believe that most people are smart enough to know that. Whether they follow that advice depends on whether they trust this source’s judgment. And that cannot be changed by any professional. That’s the issue. Once someone has decided that Yeezy knows all about Bipolar disorder, it will take more than doctors pushing away well-meaning advocates to change that person’s mind.

 

What we should be doing is providing better education on these topics.

There is also this little known concept called the scientific method whereupon there is no progress unless we question every finding we have. Assuming an authority over a subject just because one has studied it immensely is something no true scientist would do. I will let Niels Bohr elaborate: "An expert is a man who has made all the mistakes which can be made, in a narrow field." Other than knowing that the answer to the universe and everything in it is 42, most great specialists are always ready to admit that they don’t know everything.

Our pitfall with this particular topic is similar to one we are experiencing culturally overall: people are no longer allowed to say: “I don’t know,” so they don’t, and I believe it’s much scarier to blindly follow someone due with a proclaimed authority on a subject. Degree or not.

Once professionals are comfortable and even encourage discussion by those outside of the profession, those who pray on fear will have less power. There will be more access to good information, so following bad sources will not be the only choice. The goal is to eventually make extremists, like those who advocate never taking medication (no link because I will not be advertising their point), or those who claim that receiving a diagnosis is dangerous altogether—completely irrelevant. They will sway less folks if there is enough information and (and yes that includes) personal experiences to counter their points.

Our healthy future depends on being able to discuss mental health openly and with whoever needs it. Mental illness treatments include medication, therapy, and support. People will avoid treatment as long as we don’t discuss the issue as openly as we do with our hearts, livers, and pretty much any other illness.

No one encourages someone who is not a professional to begin open-heart surgery or set a bone back into place, but someone needs to be there to drive a person having a heart attack to the hospital. We need those helpers and we should be encouraging them. Someone needs to know how to apply a splint until a doctor determines whether a cast is needed. We need those intermediaries. And those intermediaries cannot be pushed away by gatekeepers.

As long as we promote the idea that people should only go to professionals to get help we’ll continue to have Anthony Bordains and Kate Spades to watch in the news. Even if you are seeing a professional, the time in the week between appointments can feel like an eternity.  

It’s on all of us to be open to conversations, whether they be private or in the public sector so that no one has to think their issue is so extreme that only a doctor can fix it.

Stigma and misinformation go hand in hand. Silence—whether caused by gatekeepers or fear of being an imposter, upholds every stigma imaginable. I refuse to believe that people will not find some semblance of comfort, even if it’s just enough to get them even through one more day, by talking to others. Knowing that these strange thoughts they have are not unique, that someone else has lived through as well is incredibly powerful.

Let’s fight misinformation to fight stigma together by shedding all possible light on the subject. Everyone wants to be a hero. Everyone wants to save a life. Let’s make sure the door to misinformation stays closed by propping up and keeping open those who wish to open up the floodgates for conversation.

 Photo by  Evan Kirby  on  Unsplash

Photo by Evan Kirby on Unsplash