The clinical language of “mental health” is not a new phenomenon. The National Institute of Mental Health, for example, was established in 1949. But the rise of Mental Health as an object of discourse in the public sphere is a relatively recent phenomenon. The top four national newspapers by readership—The New York Times, The Wall Street Journal, The Washington Post, and USA Today—published a total of 43 articles referencing the term “mental health” in 1990, compared to 575 articles on mental illness. By 2022, there were 577 articles about “mental health” written in those same publications (an increase of 1,242%), while the number of articles covering mental illness remained almost constant at 668 (technically an increase of 16%). While a dramatic increase in the number of articles about Mental Health occurred after the emergence of COVID in 2020, there was already a steady increase during the decades prior.
Today it’s common to see people proudly carrying their water bottles everywhere, thanks to both the pervasive myth that people need to drink 8 glasses of water per day as well as the myth that bottled water is safer than tap water. While hydration is important, its performativity has also become a status symbol for the health-conscious. This article in Bustle, in which an influencer, Tay Lautner, talks about making Mental Health “sexy,” makes me realize that Mental Health, like performative fitness (including hydration, self-care, gym membership), has become a status identifier, reinforcing boundaries between white, privileged people, i.e., those who have access to resources to practice “good mental health,” and othered people who lack access or are experiencing mental illness. It makes me realize that we live in two worlds when it comes to understanding Mental Health, as mainstream coverage of Mental Health continues to center nondisabled, white people while excluding the complexities of people with “poor mental health” and chronic mental health issues. This contributes to the stigmatization and marginalizing of the people who most need to be part of these conversations.
While it’s important to acknowledge that everyone can struggle, no matter their class or identity, and that no one’s mental health struggles should be minimalized, talking about making Mental Health “sexy” is really out of touch when rich, white people are practicing mindfulness in their gated mansions while the media and politicians are demonizing poor and unhoused people every day. It’s therefore also important to acknowledge that Mental Health awareness campaigns’ deliberate exclusion and vilification of people experiencing “serious” mental illness do not move the needle on stigma but rather reinforce ableist delineations between those able to practice “good mental health” versus those who have “poor mental health.”
Most Mental Health advocacy is also complicit in reinforcing narratives about dangerousness, which have historically been weaponized against different marginalized communities. In the article, Lautner talks about meeting the mother of one of the victims of the serial killer, Bryan Kohberger, implying not so subtly that “poor mental health” led to the killing of the University of Idaho student. Revealingly, Lautner also mentions an upcoming Mental Health Summit that she is hosting at the Calamigos Ranch, a 250-acre private luxury resort in Malibu, underscoring again how “good mental health” has become the exclusive privilege of the wealthy while marginalized people struggle with the conditions that make “good mental health” almost impossible to achieve.
The data reveal this disparity in striking clarity. A recent poll by Hopelab and Data for Progress “shows two different paths, with over half of respondents reporting good mental health, though that state of well-being strongly correlates with income and LGBTQ+ identity.” In other words, LGBTQ+ people, poor people, and negatively racialized people experience inequities leading to “poor mental health” and then are often blamed and criminalized for their “poor mental health.” Just as racialized communities continue to experience food deserts, barriers to healthcare, and lack of access to safe drinking water—resources associated with physical health and fitness, and which are glamorized and flaunted by rich, white people—they also experience overpolicing, discrimination, and other barriers to education, employment, and housing—resources associated with mental health. As Elie Mystal wrote in The Nation yesterday, “Black folks are survivors. LGBTQ folks are survivors. Immigrants are survivors. We’ve lived our whole lives around and among people who wish us harm, and we keep living anyway.”
Because “good mental health” can only be practiced by people who have access to resources, and because Mental Health discourse dehumanizes and blames people who do not have access to those same resources, it is reasonable to conclude that Mental Health campaigns mostly help to rationalize today’s obscene levels of inequality by framing people’s struggles as individual problems, and also allow the performativity and practice of Mental Health to function as a proxy for discrimination. While we cannot legally discriminate based on a protected status, we can and do often discriminate against people who practice “poor mental health,” people who are largely from marginalized communities. And in the same tradition of discrimination against such marginalized groups, including Black people, Muslims, and LGBTQ+ people, people with “poor mental health” are widely framed as “the problem” and as dangerous, thus further justifying their exclusion and criminalization.
There’s much to be learned in the similarities between current Mental Health advocacy, which centers mostly white, nondisabled people, and the anti-homophobia campaigns of the ’90s and ’00s, which centered mostly white cisgender males, and which pushed marginalized sexualities and gender identities further to the margins. Through the 2000s, gay representation in the media largely focused on presenting the “respectable queer,” a gay, white, cisgender, middle class person who was allowed to appear on screen only as long as they weren’t too openly gay, or were such a caricature of queerness that they were rendered nonthreatening to heteros.
Like the earlier politics of gay marriage equality, Mental Health awareness campaigns seek not liberation but inclusion within “a system of hierarchy and domination grounded on distinctions between the respectable and the degenerate,” with respectability conferred mostly upon the subset of white, nondisabled people. As the legal scholar, Yuvraj Joshi, observes, there is a difference between respect, which “connotes acceptance of difference,” and respectability, which “connotes acceptance of the norm.” Just as early gay activism sought respectability over respect by upholding white, cis-heteronormative values, Mental Health advocacy entrenches ableist values and beliefs by placing the burden on disabled people to “cease to be unacceptably different.”
Today, the privilege to practice “good mental health” has become a way to resegregate white people from the historically marginalized communities that disproportionately experience “poor mental health.” Mainstream narratives about Mental Health not only reinforce inequality, but also uphold white supremacist notions of meritocracy by pinning the blame on individuals who have “poor mental health” (“you didn’t practice mindfulness,” “you weren’t in treatment,” etc.) rather than addressing discrimination, lack of access, climate change, policing, lack of housing, and other systemic inequities.
Current Mental Health advocacy is not disability-centered as it routinely ignores the voices of those with “severe” psychosocial disabilities, routinely endorses medicalization and pathologization, and rarely advocates for people’s self-determination. Anti-stigma campaigns are very much interlocked with the medical model of disability, in that it’s ok to talk about not being ok, but it’s not ok to talk about people for whom medication has not helped; it’s not ok to talk about suicide; it’s not ok for people living with psychosis, dissociation, or personality disorders to live openly; and it’s definitely not ok for people to live with “untreated mental illness.”
Much like early anti-homophobia campaigns made gay inclusion conditional on the degree to which gay, white men could perform straightness (and thus tacitly excluded non-white, LBTQ+ people), Mental Health campaigns continue to stigmatize people who cannot perform “good mental health,” especially if they are behaving in ways that people find disturbing or upsetting. Because inclusion is conditional on “acquiring a respectable social identity,” this ends up widening the divide between respectable (those who can, who are mostly white people) and non-respectable (those who cannot).
Note: This essay is a revision of a draft I first published here in 2023.