Recently at Haverford there’s been a trend to use the phrases “mental wellness” and “mental wellbeing” as a replacement of more direct phrasing such as “mental health” or “mental illness.” This trend comes from multiple angles, such as the desire to take a more holistic view on “mental wellness” that encompasses not just the “medical” aspects of wellbeing but also subjective individual experiences and habits that extend beyond illness and disorder. This can include issues of stress, coping, grievance, sleep, mindfulness, exercise, and more. In general, this conversation intends to go beyond “mental illness” and discuss issues of mental wellbeing that affect individuals with or without specific diagnosed mental disorders.
Haverford’s Director of Counseling and Psychological Services (CAPS), Philip Rosenbaum, Ph.D., is a strong proponent of this line of thinking, arguing that “mental health” relegates issues of mental wellbeing to the realm of the medical, where there is a tendency to think of these issues as a black-and-white dichotomy between the healthy and the unhealthy. Rosenbaum sees mental wellbeing as more of a spectrum of personal experiences and behaviors, rather than something than can be understood purely as a medical phenomenon. He further explains his issues with the phrase “mental health” in a paper he co-authored for the Journal of College Student Psychotherapy. As director of CAPS, a regular staff counselor, and the coordinator of the Advisory Committee on College Student Mental Well Being, Rosenbaum has had a significant impact on the nature of the campus-wide conversation regarding all things related to mental illness and mental wellbeing.
In some ways, Rosenbaum’s opinions regarding the language used to describe mental phenomena such as illness and health, to no fault of his own, have become hegemonic among Haverfordians. Students have adopted the phrases “mental wellness” and “mental wellbeing” in order to be more progressive, accepting, and holistic in their approach to the conversation, likely under the presumption that those phrasings are more politically correct. This trend has coincided with an increased interest in the topic of mental health throughout the student population. Just this year, the Peer Awareness Facilitator committee, responsible for training PAFs and providing material for the upcoming year’s multitude of PAF sessions, instituted a new session entitled “Mental Wellness.” This session, as presented to PAFs-in-training (such as myself) by the PAF committee, highlighted the holistic approach to mental health, which meant that it only marginally touched on mental illness. The activities focused on issues of stress and coping, mindfulness and yoga, and ways of maintaining one’s mental wellbeing in a broad sense. Don’t get me wrong—mindfulness, mediation, and yoga are great tools for stress reduction and wellness in general. But there was only one activity that I felt touched on the stigma of mental illness, which focused on misconceptions and harmful language. Nonetheless, throughout the training, I felt that there was little to no room for a discussion of the stigma attached to mental illness or space for me to discuss my own struggles with mental illness. I came into the training hoping to delve into the societal stigma, institutional barriers, intersectional issues of access, and marginalization involved with mental illness. I came away from the training very disappointed, and felt cheated of an opportunity to discuss a social identity that affects me deeply.
This approach to mental health was justified as the only way to make it relevant to everyone involved in the conversation. Not everyone deals with mental illness, so we must focus on issues of mental wellbeing, which everyone deals with at one point or another in their lives. This brings me to the question, why must we universalize every issue in order to justify its significance? Must an issue of oppression affect every member of a community in order to be worth considering? Must every Haverford student be a victim of racism in order to care about it? Must every Haverford student struggle financially in order to care about class issues? Must we find a way to relate to every social identity, even when we hold privilege in that particular area?
The problem with the approach of “mental wellness” is that feeling stressed is not the same as having a mental illness, and having a mental illness is stigmatized, marginalized, delegitimized, and silenced in ways that superficial issues of mental health never are. PAF sessions are opportunities to engage in conversations that we don’t normally engage in due to a societal stigma, taboo, or controversy. We don’t normally go up to people and ask if they believe in God, because that might be considered a bit too personal. We don’t go up to people and ask about their thoughts on racism, because disagreements become uncomfortable and divisive. PAF sessions encourage these discussions and emphasize that discomfort is okay. It’s natural to feel initial discomfort at the idea of discussing something that seems so controversial or taboo, or relevant only to a select group. But that’s the point. We’re working past it. And we can’t all relate to believing in God or experiencing racism, but that’s not the goal. PAF sessions are not about relating to your peers; PAF sessions are about being aware of your peers and their social identities.
When we have race PAF, we don’t look at our majority-white group of first-years and say, “hmm, I want everyone to relate to this, so I guess we’ll have all the white people talk about their experiences with racism.” This is because PAF sessions are an opportunity to engage in rare conversations, and they’re also a time to empower voices that are ignored or heard the least in society. In the case of race PAF, this means empowering the voices of people of color, who are socialized to remain silent about these issues. Not everyone has a strong tie to their racial identity For example, as a white person, I have rarely had to reflect on my racial identity because society does not force me to do so. That’s okay. We don’t all have to relate personally to a topic in order to benefit from a conversation about it. PAF conversations are about becoming aware of social issues and identities–it’s not about relating to all of them. When this space appears to be coopted in favor of a discussion of stress and mindfulness, I feel cheated. I feel as though the societal stigma perpetuated against those with mental illness is being extended into a space that is meant to be accepting, safe, and honest. I feel that there is no space for my social identity in the conversation on “mental wellness.”
Since PAF Committee introduced the “Mental Wellness” session for the first time this year, they expected and welcomed criticism of the session and adjustments to it. I reached out to PAFCO for their thoughts and reflections on the Mental Wellness PAF and received some insightful responses. Kim Conrad ‘16, a member of PAFCO, discussed the possibility of “splitting the session into two in order to give space for a mental health conversation that does focus on deconstructing sigma.” She also said that because the session was new, “we hoped and expected that each team would make it their own within the context of the needs, experiences, and dynamics of their hall.”
Ali Lamacki ‘16, one of the Co-Heads of PAFCO, in retrospect expressed dissatisfaction with the committee’s decision to name the session “Mental Wellness.” Nonetheless, she still sees the benefit of beginning the conversation with a discussion of mental wellness.
“Our goal was that through the lens of, ‘everyone needs to take care of and consider their mental health maintenance,’ we could get to, ‘If everyone needs to address their own mental health, then why do we have this stigma surrounding more concrete mental health issues such as anxiety, depression, and so on?'”
Lamacki continues, offering a more in-depth look at PAFCO’s decision-making process:
“When considering what to call this session and how to shape it, you have to keep a lot of different types of people in mind. I’m not so concerned with the people who have little experience talking about mental health and would not voluntarily engage in it; these are the very people that need a PAF session on this topic to start engaging with it and realizing their privilege in this sense. I’m more concerned about the people who have dealt with mental health problems in their past and/or present. While some are very open and willing to talk about their experiences, I also know some people who have entered college and told almost no one about their experiences in hopes to leave that part of their identity behind: Would a session specifically about mental health and mental illnesses be triggering or difficult for these people? I hope that talking about mental wellness is a more accessible topic for all sorts of people and that it can still get to the conversations we need to have on our campus and in our society about the stigma surrounding mental health.”
Evidently, as next year’s PAF Committee is assembled, there will be more room for conversation and adjustment of this particular session. But this trend does not apply only to PAF sessions. Conversations across campus dedicated to issues of mental health are being reformulated as discussions of “mental wellbeing.” Issues of mental wellbeing are important, in the same way that issues of nutrition and exercise are important, but they’re not the object of oppression and stigma. When we focus on “mental wellness,” we lose the space we desperately need to discuss the struggles of those with mental illnesses. And when I say desperate, I mean desperate. Mental health affects every aspect of my life. My actions, beliefs, and feelings are constantly delegitimized. Society as a whole and the people around me refuse to recognize my illness as a truly debilitating disability. Often, they see it as a reflection of my character or my inability to “deal with things on my own.” People even use mental disorders as adjectives in casual conversation, as if bipolar disorder and OCD were trivialities of daily life like the weather. There is a huge difference between feeling sad and being depressed; having mood swings and being bipolar; feeling stressed out and having general anxiety disorder; or feeling shy and having social anxiety. Replacing the conversation on “mental health” with the conversation on “mental wellness” only reaffirms the conflation of universal difficulties like stress with psychological abnormalities like anxiety. And when we assert that “mental health” should not be relegated to the medical realm, we deny that mental illnesses are as serious as other medical issues.
I would like to make a call to action. The Haverford student body desperately needs to discuss the most pressing issues affecting mental health and its stigmas. For instance, students have various complaints about CAPS, such as the difficulty of scheduling appointments and the need for more staff to accommodate the growing need for counseling on campus. When CAPS fails to provide for students who lack the financial resources to go off campus for mental health care, they are stranded without the treatment they need and deserve.
Though few are aware of the process, taking medical leave for mental health reasons can lead students into a secretive, bureaucratic process in which they are virtually powerless. “I took a leave after a crisis in the very beginning of last year,” says Chris Bechen ‘18. “I made it clear from the beginning that I was going to return for the spring semester, however, I was soon told that I had to go through some process of re-admittance. The decision to allow me to come back (one I thought had already been made, and was determined by me alone) was done in a weird level of secrecy. I didn’t know who my dean was discussing it with, what criteria I was being evaluated on, or how information about me (mostly gotten through phone calls and emails) was being presented.” Students deserve more transparency from the administration, especially in the case of a voluntary leave.
Many stigmas against mental illness permeate the collective consciousness of students at Haverford College. Whether it’s stigmas against reliance on psychiatric medications, or a lack of sensitivity regarding mental health crises, or the inability to understand mental illnesses as legitimate medical issues, Haverford has a lot of learning to do. These stigmas can add to the difficulties of living with a mental illness, often worsening the common symptoms of negative self-talk and low self-esteem. They can make people reluctant to obtain treatment, leaving important medical issues untreated until a crisis inevitably occurs.
These are the pressing issues we need to deal with. By focusing on mental wellness, we ignore them, or at the very least push them to the sidelines, and do injustice to all individuals who suffer from mental illness.
Special thanks to Ali Lamacki, Kim Conrad, and Chris Bechen for contributing their thoughts and experiences to this article.
References:
Rosenbaum, P.J. & Liebert, H. (2015). Reframing the conversation on college student mental health. Journal of College Student Psychotherapy, 29 (3), 179-176.