Opinion: do we fully understand the significant differences between mental health challenges and mental illness?

In recent times, the discourse on mental health across Irish society has become a topical issue for people, which has further been exacerbated by the pandemic. The feelings of isolation and reduced level of connection during the lockdown had significant ramifications for how people coped with the everyday challenges of life.

The concept of mental health became a key focus across all forms of discourse. Discourse simply refers to all forms of communication and how it has been constructed to describe a certain reality of events or experiences. Examples can include basic conversations between individuals, how the media has interpreted a story, or how policy documents have been interpreted.

At this juncture, it is important to note that the struggles of people in society with their mental health is very real. But what, if any, impact has this had on the reality of those in society who are living with a mental illness?

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From RTÉ Radio 1's News At One, long-awaited new €200 million Central Mental Hospital finally opens

During the pandemic, in discussions with people living with a mental illness, they reflected on the experience of 'normal' people’s struggles of lack of connection and isolation as representative of their lives prior to the pandemic. Their frustrations related to how those deemed 'normal’ in our society struggled and were heard during the lockdowns. However, their experiences of struggles throughout their lives prior and during the pandemic continued to be absent or overlooked within the dominant discourses of society.

There were many other groups which experienced further marginalisation during the pandemic. These included nursing home residents, family carers, those living in direct provision and people living with disabilities. Consequently, there were certain people and groups in society whose voices and experiences were heard, but for our most vulnerable and disadvantaged, this was not their experience.

The pandemic further highlighted the inequalities and issues faced by people and groups within our society. Focusing specifically on mental health, the motto "it is okay to not be okay" has become a key phrase in recent times. From young people, to adults, and even celebrities It is great that people are beginning to talk and challenge the stigma around mental health challenges.

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From RTÉ Radio 1's Morning Ireland, CEO of St Patrick's Mental Health Services Paul Gilligan on continuing stigma around mental health

In our society, these shifts in attitudes and culture around talking about our mental health challenges have led to many positives for those deemed 'normal' in our society. However, there are significant differences between mental health challenges and mental illnesses. This leads to an important question which should be asked of our society; do we fully understand the difference between both?

In mental health policy and service delivery, there is a focus on delivering recovery-orientated support. In a mental health service context, recovery refers to the idea of supporting someone to live the best life they can lead following a diagnosis or an episode where they have spent time as an inpatient. In theory, it is a liberating concept, whereby services should provide the appropriate supports and resources for someone to re-enter society and participate in ‘normal’ life with ‘normal people’.

However, it can be very challenging for people re-entering society and returning to normal activities. For individuals, the stigma attached to having a mental illness can impact on all relationships. This includes family, friends, work, education, and other social interactions. For many, disclosing their illness can lead to society and people struggling to view them beyond their identity as someone living with a mental illness. Consequently, people will refrain from disclosing this identity. Instead, if they can conceal or mask their illness, then they will be much more likely to be accepted and reintegrated into everyday situations and activities.

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From RTÉ One's Six One News, psychiatrists call for overhaul of mental health services

For many people, the definition of 'recovery' is a journey back to full health. This is very different to recovery in a mental health context. People will speak of their mental health challenges and how they overcame them. Celebrities especially, have become a key driver of people discussing such challenges. However, there is a significant difference between recovering and living with a mental illness and experiencing a challenging period with your mental health.

The major concern surrounding this argument is that those living with a mental health diagnosis have become even more isolated within society due to the discourse surrounding mental health. Stories of people overcoming periods of mental health challenges and returning to normal living is not the same reality as living with a mental illness.

Essentially, the dominant social discourse is that every person has suffered with their mental health. However, there is not the same exposure given to the stories and experiences of people living with mental illnesses. We must ask ourselves as a society, have we taken for granted the real-life reality of living with a mental illness?


The views expressed here are those of the author and do not represent or reflect the views of RTÉ. If you have been affected by issues raised in this article, support information is available online