#IAmNotDangerous and the politics of stigma

Abstract

This past June, several mental health advocacy organisations in the USA teamed up to launch the Mental Health for US campaign, spearheaded by Patrick Kennedy and inspired by his own personal story of mental illness and substance misuse. The goals of the campaign are to put mental health front and centre in the US political debate, educate politicians about mental illness, and share the stories of those with lived experience. As recent events in the USA have shown, there is a painfully obvious need for a clear and informed discussion on mental health among lawmakers. Take, for example, President Trump's initial response to two mass shootings that occurred in August in El Paso, Texas, and Dayton, Ohio. The blame, according to him, lay with mental illness and he called for better identification of “mentally disturbed individuals”. Despite mental health organisations providing evidence, almost ad nauseum, that America's gun violence problem is not a mental health problem, weeks later Trump followed up by saying that the USA needed more mental health institutions and that “we can't let these people on the streets”. Blaming mental illness after a mass shooting is a tried-and-true red herring for American politicians beholden to gun lobbyists, as predictable as it is cynical. But perhaps more disheartening is the impact this scapegoating has on the political conversation in America about mental health. Only in the aftermath of a mass shooting do most politicians even bother to discuss mental illness, more generally leaving a vacuum all too easily filled with nonsense and falsehoods. For those trying to fill the void with evidence, their message doesn't seem to strike with enough resonance. As we are reminded with other areas of science, including climate change and vaccines, established facts do not always win the day and the forces of reason are losing the battle for public opinion. Adding to the efforts of campaigns like Mental Health for US, individual advocates are addressing the poor public dialogue on mental health. After becoming fed up with the bogus blame mental health rhetoric surrounding the August tragedies, Cara Lisette, a mental health nurse in the UK, tweeted about her own experiences with mental illness. She mentioned a few simple facts—she has diagnoses of bipolar disorder and anorexia nervosa, and has never considered a mass shooting. She ended her tweet with the hashtag #IAmNotDangerous, summing up in 16 characters the evidence that seems to get too easily lost in the wake of mass shootings in America, and laying a path for others to follow. The response to Cara's tweet and #IAmNotDangerous has been remarkable. It has been widely shared and has encouraged hundreds of others to speak out about their struggles with mental illness, and to point out that despite these struggles they have never considered hurting anyone else. Most of the posts with #IAmNotDangerous, including Cara's original tweet, also come with a selfie, putting a face not only to their statements, but to the abstract numbers that the mental health community often relies on to dispel stigma. Although the importance of advocacy in mental health is well known to many in the research community, the recent events in the USA are a reminder that for those experiencing mental illness, stigma is an ongoing and daily struggle. The research community should not underestimate the importance of this, and the need to address it consistently. Each month, The Lancet Psychiatry strives to publish the best evidence in mental health science—new findings that will improve our understanding of and treatments for mental illness. But even the most exciting results will fail to enlighten the general public if those experiencing mental illness are stripped of their humanity. Innovative new treatments will not mean much if people are too afraid or ashamed to admit they might need them. Therefore, The Lancet Psychiatry would encourage individuals who feel comfortable doing so to share their personal narratives of mental health and mental illness, in whatever medium suits them best. Although facts and figures will continue to be necessary ingredients for improving policy and treatments, there is simply no denying that in our current political environment these alone will not deliver meaningful action to improve mental health. For that we need power, and the stories being shared by groups like Mental Health for US and movements like #IAmNotDangerous are powerful indeed. “These people” are on the streets. “These people” are us. For more information on the Mental Health for US campaign see https://www.mentalhealthforus.net/ For more information on the Mental Health for US campaign see https://www.mentalhealthforus.net/