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Culture Clash: Facing Up to Mental Health Challenges

I know people with mental health challenges, some of whom are getting professional help and others who cannot afford it, do not want anyone else to know what they are going through, or do not think it would help. I have received phone calls and in-person visits from people who needed immediate assistance. During and after university, I was a live-in youth worker for at-risk women and girls. Before that job, I harshly judged people living in poverty, drug-addicted people, teenage parents, and any number of other people. I had decided that we all get to choose what we do with our lives, and our ability to succeed is completely within our control.

Coming face-to-face with my own ignorance and hypocrisy in a matter of days was nowhere near easy, but it was the most life-changing experience I have ever had. Among other opportunities and challenges, I completed suicide intervention training with a group of social workers. It was long, intense, transformative, and unexpectedly emotional. It reminded me of previous experiences, made me question the way I responded to situations in the past, and committed me to paying attention, asking questions, and listening for what is not being said.

On June 8, Anthony Bourdain was found dead in his hotel room in Strasbourg, France. The host of the award-winning CNN series Parts Unknown who had publicly talked about his mental health struggles died by suicide. Many people, so accustomed to watching Bourdain explore new places and food with acerbic wit, feel like they have lost a friend. They were attracted to the contagious curiosity that led him to ask people what they liked to cook and what they liked to eat, and the honesty that delivered his unfiltered thoughts.

Bourdain was not without success and did not lack money. He was a world-renowned chef and bestselling author. In Kitchen Confidential: Adventures in the Culinary Underbelly, Bourdain went beyond food, telling stories about his abuse of drugs and sex. He consistently proved himself to be a real, multidimensional person, but that he could suffer from depression and exit the world by suicide is still a shock. We have certain expectations of the rich and the famous.

Don’t they have everything they could possibly want and more? Can’t they afford to pay every problem to get lost? And what is there to be depressed about?

Bourdain’s partner Asia Argento described him as her love, her rock, and her protector. He stood by her side when she went public with accusations against Harvey Weinstein and spoke out in support of the women of the #MeToo movement. Bourdain is an example of a person who managed to support other people, but did not manage to save himself.

Are we supposed to save ourselves?

Just days before Bourdain’s death, fashion designer Kate Valentine (previously known as Kate Space) died of suicide in her apartment in Manhattan. Though she had not had a hand in the brand still bearing her name, many people responded to the news of her death with stories of their first Kate Spade handbag purchase.

Both Bourdain and Spade had what most of us are still trying to achieve. They found their passions and ways to share them with the world, and got more than pay checks in return. They each had a fan base. They had families and friends. They were household names. Still, something else they had in common overshadows all of their achievements and possessions and the love in their lives. That may be what is most difficult to understand about depression. It does not match itself to the good in our lives. As large as the sun is, clouds can completely obscure our view of it. We may know it is still there, but that knowledge does nothing to replace the light. At night, when darkness comes, there is no sign that the sun will rise again.

As a child, I heard people talk about suicide. I learned that people saw it as a dishonorable act. A selfish act. A cowardly act. I heard people talk about depression too. I learned that people saw it as a weakness. A demon. A punishment for wrongdoing. A clear instruction to turn to god. Good, god-fearing people, then, did not have depression. Brave, selfless people did not attempt suicide.

To prove I was living my life in the best possible way, I had to ensure that there was never a sign of depression, or even sadness. Even if I experienced them, no one could know. This dictated countless thoughts and actions. This knowledge made it so that I never admitted to anything being wrong, and whenever anything was wrong, I suffered alone. I know that I am not the only one. There are other people who go to battle with parts of themselves that want to be vulnerable and honest, and allow someone else to help. They fight those parts because we are taught that it is better to be strong, smiling, and satisfied with whatever we have.

It has taken me a long time to realize that vulnerability is not weakness, and having challenges does not mean we are, in some way, deficient. It is still difficult for me to treat myself with the same kindness I extend to my loved ones. Maybe it is because I came to my understanding of mental health issues through my role as carer for others that it is easier to acknowledge, affirm, and attend to the needs of others than it is to even sit with my own. Part of it too, of course, is the way I heard people talk about mental health challenges when I was growing up. It is hard to trust people with personal information when it feels safer to keep it secret, even from the closest people to us. The people who are, perhaps, the most judgmental of them all.

After reports of suicide or attempted suicide, there is always an influx of positive messaging around mental health. Social media is flooded with posts encouraging people to seek the help they need. Talk to someone. Call a hotline. Text a friend. See a psychologist. There are numerous barriers to what seems like a quick and easy solution. To talk to someone, we have to trust them and be reasonably certain that they will only do what is in our best interest. To call a hotline, we probably want to be assured that we can maintain anonymity, and that the person on the other end is a trained professional. To see a psychologist, we need money. And not a small amount of money. To ask for help, we have to admit that we do not always have it all together, we are not always as happy as we look, and our strength sometimes wavers.

We have a great deal of work to do. We have to earn the trust of the people around us. We need to understand mental health and recognize that it is just as important as physical health. Depression and anxiety are public health issues and should be treated as such. Health care needs to include mental health care.

We have to do more than pray. As family members, friends, coworkers, and club members, we need to pay attention, be willing to listen, and hear what is not being said. We need to advocate for policy change. We need to check on our people, and not always expect them to ask for the help they need. Suicide is not a choice, and it is not selfish. Limiting lifesaving options through stigma, however, is a choice. Give your loved ones the chance to cope, to overcome, and to live. Do research, start conversation, and demand mental health care services.

Published in The Tribune on June 13, 2018.

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Culture Clash: Time to Face the Reality of Mental Health

Last weekend, I spent several hours at a book club meeting. We chose Kei Miller’s The Last Warner Woman as our February read, and it gave us more to think and talk about than we expected. Half of us did not even expect to like the book, but quickly realised it was a reflection of some of our own experiences, far-fetched as it seemed at first glance. Mental health was a dominant theme and it was easy to talk, at length, about the stigmatisation of mental health issues and the urgent need to address the inadequacies of health services, family support and often debilitating stigma.

What is mental health?

Mental health is the level of emotional, psychological and social well-being and our ability to manage stress. Like physical health, it can change over time, and conditions can be transient or chronic. They are sometimes biological, but can also be triggered by life experiences or trauma.

Two conditions resulting from life experience or trauma are post-traumatic stress disorder (PTSD) and postpartum depression. Many people heavily and personally impacted by recent hurricanes now deal with PTSD, some of them triggered by the sounds of rain or wind. Experiences of postpartum depression are not often shared, but in recent years, celebrities have shared their experiences to help women going through it and to sensitise family members and community members to the experiences of new mothers who must also contend with a condition they cannot control on their own.

Crazy talk

We are quick to call people “crazy,” and make assumptions about their lives, particularly when their mental health conditions do not allow them to fully function, or they are homeless or under-housed. Maybe worse, some of us use neuroatypical people as a source of entertainment, recording videos of them and sharing them on social media.

People’s everyday lives become a joke, and we ignore their humanity. We forget they are people with histories, families and daily challenges to overcome. To us, they are just “crazy” and we assume their situations are their own fault.

In our careless commentary and self-serving entertainment, we can unknowingly alienate and offend people who may be high-functioning while dealing with mental health challenges. Even worse, when made aware of the offensive nature of our language — and interpretation of what have become common words and phrases — our reaction, far too often, is to become defensive, or reject the idea that we could ever unintentionally harm someone.

It’s difficult to change the way we speak, but becomes easier when we work on one thing at a time. With a few years of practice, I’ve taken “crazy” out of my vocabulary. It was not easy, but it was important to me, especially as a human rights supporter, a family member and friend of people with mental health challenges and a person who is not vaccinated against mental health challenges.

Support loved ones

Videos have been circulating of a man named Jeremy. Members of his family have said his life changed as a result of a laced joint. He walks the streets and, every now and then, they are able to get him to return home, but never for a long time. He has tried to get professional help, but like many patients, he does not like the way the medication makes him feel.

Medication for mental health conditions alter the chemistry of the brain. It can sometimes cause people to feel numb, or like they are losing parts of themselves. It is rare for a person to be prescribed the best possible medication the first time around. It can take a few tries to find the medication that helps a person to function without making them feel less than human, or even making their condition worse.

There is little support available for people facing mental health challenges, especially if they do not have the money to pay for care. Imagine having a health challenge, saving enough money to see a doctor, then saving enough money to purchase medication only to find that it is not the right one for you. You have to go back to the doctor, pay for the visit and purchase another medication. It is already not easy to get well. Think about how much harder is it to navigate all of this without support, or while seeing and hearing discriminatory remarks that aren’t even meant to hurt you, but they do anyway.

We all know people with mental health challenges. We may not know it, or know exactly what those challenges are, but they exist. The stigma around mental illness is more than inconvenient or sad. It can keep us from seeking the help we know and feel we need.

Because it so difficult for people to admit to struggles with mental health, seeking professional help and asking for support from family members and friends, it is important for us to pay attention to our loved ones. We often notice changes in people or the way they interact with us, but find easy answers to our own questions. “She got problems,” or “He got a bad attitude,” become our diagnoses. “Something wrong with them.” Unfortunately, we don’t see it as a health issue, but assume people have made conscious decisions to behave differently.

Seeing the signs

We need to learn to see the signs of mental health challenges and how to address them. Pay attention to changes in eating and sleeping patterns, energy levels and interest in hobbies. Listen to the ways loved ones describe how they are feeling. If they feel numb, hopeless, helpless, like nothing matters, or think about harming themselves or others, do not ignore or conclude that they are being dramatic. It’s time to listen. It’s time to find the necessary resources to help your loved one to get well.

Seeing a general practitioner is a good start as they are able to make referrals and, if you have a relationship with your GP, they may have a better idea of your personality and which psychologists and psychiatrists would be able to work best with you.

Mental hygiene

Mental health, like physical health, is not static. It does not stay the same over the course of your life. Just as important as recognising and addressing mental health challenges is practicing good mental hygiene. Take time to take care of yourself. Conduct regular mental scans. How are you feeling? Are you tired? Unmotivated? Wanting to be alone more than usual? Diving into work to avoid thinking or feeling? Pay attention to your coping mechanisms.

A lot of us find ways to take care of our mental health, whether through unscheduled days off, exercise, or regular practices like yoga or meditation. Some of us, however, need help with maintaining our mental health – and it does not mean we are “crazy.” It means we are self-aware and willing to commit to improving our lives.

Whether weekly therapy sessions or medication, there are options available to us, but mostly to those who can afford it. If you’re interested in group therapy, reach out to The Family – People Helping People which offers free sessions in communities all over New Providence. While we work to combat the stigma around mental health challenges, we also need to raise our voices to ensure it is included in national health initiatives. The mind is no less important than the body, and it needs care too.

Published by The Tribune on February 27, 2018.

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Culture Clash: Yugge Farrell

Yugge Farrell. That is the name echoing in St. Vincent and the Grenadines, and throughout the Caribbean. It is the name of a young woman being vilified and victimized by a powerful dynasty desperate to make her disappear. Hers is a terrifying story of what happens when corruption runs rampant, nepotism is the order of the day, and court decisions can be bought. Yugge’s story is one we need to hear and remember, and she is a woman we need to defend.

Who is Yugge Farrell?

Yugge Farrell, 22, was arrested on January 4, 2018 on an “abusive language” charge. It is alleged that she calle Karen Duncan-Gonsalves — wife of Minister of Finance Camillo Gonsalves a “dirty bitch.” She appeared in court the next day and pled not guilty. After her plea, the prosecution made application, without supporting documents, for psychiatric evaluation. Magistrate Bertie Pompey ordered her to the Mental Health Center for two weeks.

Why the drama?

It is no secret that many politicians, and others in positions of power, groom and prey upon young women. Youth and poverty are just two characteristics that make women more vulnerable to those of means. In most of these cases, relationships are kept quiet — at least out of the spotlight — so the powerful maintain airs of superiority, family life stability, and moral high ground. If threatened, they exert their power in hopes of silencing the people who know their secrets. If they cannot succeed one way, they try another, and another, and another. This is why a father and son seem to have done all they can to lock Yugge away.

Since her detention, videos have circulated online with Yugge saying she had a sexual relationship with the Minister of Finance. While SVG Prime Minister Ralph Gonsalves has made comments on radio stations about the case, he advised his son, Minister of Finance, to hold “dignified silence.” The Prime Minister is also Minister of Legal Affairs, and insists that a magistrate can order a defendant to a mental institution based on information provided by the prosecutor outside of court.

#Iamcrazytoo

While under evaluation at the Mental Health Center, Yugge was given antipsychotic drugs including Risperidone and Lithium. Her pro bono lawyer Grant Connell addressed this matter in court on January 23, 2018, drawing attention to the difference in her behaviour. At her first court appearance, Yugge was composed, but on the second, she made howling noises — clearly affected by drugs forcibly administered to her. Connell noted that the report provided to the court was not signed by a psychiatrist, and suggested the facility is not equipped to handle patients “with the allegation of some mental instability.”

The report from the Mental Health Center stated that Yugge was unfit to stand trial, and she was sent back to the facility. Outside of the court, Yugge’s sister insisted that her sister is “not crazy.” She suggested that Yugge was being victimized by more powerful people who want to keep her from talking. She also said she suspected Yugge was given medication the night before her court appearance because when she saw her on January 21, she was fine and not presenting as she did in court.

People are responding to the vilification of Yugge, especially under the premise that she is “crazy” — an overused, ableist word meant to discredit. To fight back, people in SVG and around the region are using #iamcrazytoo to express their support. A group of people held signs with messages included “I too am crazy” in protest of what was happening with Yugge’s court case and her detention. While politicians and the court work to make us see Yugge as separate, different, and “crazy,” the people choose to see commonalities and recognize that this injustice can be done to anyone.

Dirty business

A number of issues have been raised regarding this case, not the least of which being abuse of power. There have been arguments about information being shared with the magistrate, but not in open court. Specifically, the information that led to Yugge being court-ordered to the Mental Health Center was not presented in court, and not made available to the defense. In addition, the application for her psychiatric evaluation came after she entered her plea. The legality of this has been questioned, and no answer thus far has pointed to legislative support. One of the most recent issues is that the report from the institution was not signed by a psychiatrist. The prosecution claims none of this of any import.

Lawyer and human rights activist Kay Bacchus-Baptiste spoke out against the handling of Yugge’s case. She referred to Yugge’s detention at the Mental Health Center as “a human rights issue that should be properly investigated.”

On January 29, 2018, Yugge was released on bail, and her case has been put off until December 2018.

#JusticeForYugge

Your first instinct may be to find everything that separates you from Yugge Farrell. You’d probably like to think this could never happen to you, or anyone you love. Even if you’re right, Yugge does not deserve to suffer. She has been hauled before the courts to face a charge of “abusive language” because a government minister’s wife was insulted. She has gone through undue stress and had her rights violated because the Minister of Finance and Prime Minister of St. Vincent and the Grenadines are afraid of her and what her story could do to their political careers, family, and legacy.

Since they don’t, it’s up to us to recognize and affirm that Yugge’s life is more important than their reputations. It’s up to us to take action, support Yugge in word and deed, and push for a system that would not leave room from others to be victimized, dehumanized, or silenced. With the next court date at the end of 2018, we need to be vigilant, steadfast, and vocal in our support of Yugge and her rights. We know this is not the end, and this may not be their final attempt to silence her. Use #YuggeFarrell and #JusticeForYugge to read more about Yugge’s story and the work being done to help her through this case, both legal and otherwise. It will take community to keep her safe and strong, and prepare her for her next day in court. Look for the petition on thepetitionsite.com and the empowerment fund on gofundme.com. If it could happen to her, it could happen to someone else, and that’s not the kind of world any of us deserve. We don’t have to settle; let’s agitate for the change we need and support the people making it happen. Yugge’s could be the case that changes more than a law.

Published in The Tribune on January 31, 2018.