Returning context to mental illness narratives

By Shelley Cheng

In this post I discuss what it means to exist as a woman of colour experiencing mental illness and receiving treatment that individualises and pathologises our grief.


My parents migrated to “Australia” because of the narrative that life would be better here. They left their families and cultures. My father had to start work straight away, and as a result, never learnt English. He worked cash-in-hand jobs that paid $7 an hour. Our family of four lived on around $350 a week – we survived below the poverty line. Growing up poor meant feeling guilty for existing. It meant knowing that I was a mistake my parents could not afford. It meant getting a job as soon as I could. It meant skipping meals to save money. It meant being the punching bag for all the frustration and exploitation my parents faced. It meant I grew up with the burden and anxiety of “achieving”, to lift my parents (and myself) out of poverty, which, under capitalism, is a futile pursuit.

I was bullied at school for my home-job haircuts, my over-sized uniforms, my lunches, my stained teeth, and everything else a kid could attach to my being poor or Asian. It stopped, when, in order to survive, I relinquished anything that tied me to my ethnicity. Racism meant I lost most of my connection to culture and language. It meant not knowing how to write my Chinese name until I was 11. It meant hating myself and wanting to disappear because the feeling of loss and shame was too overwhelming.  

My family was dysfunctional. My father was violent, controlling and manipulative. In many ways, this was a result of having to assume a predetermined hyper-masculine role – to exert control wherever he could – as a response to his predicament. Being removed from family and having few friends here meant there was no one – who was not dependent on him – to hold him accountable for his actions. As a child, I knew that calling the police, relying on the laws around domestic and family violence, sexual violence, public housing, and child “safety” would be punitive for all of us. So I suffered in order to survive.

“Treatment” will not work for me, because it was not designed for me

By the time I was 13 most of my days consisted of suicide ideation and panic attacks. For reasons of safety and money, I had to access “treatment” very late and in secret. I clung onto the idea that my condition could be cured upon receiving a clinical diagnosis, that a specific label would inform the exact path I needed to take. However, the “treatment” available to folks like me is ineffective and often damaging.

Unfortunately, the way that psycho-pathology has unfolded means that professionals have to match people and symptoms to very limiting descriptions in a manual to ensure their legibility. But just like studies of dentistry and medicine, psycho-pathology and the DSM are based on white (usually male) bodies and experiences, which presents a plethora of problems. Essentially, whiteness and the violence that has caused many to suffer poor mental health is also what dictates whether those people get to access care, and what kind of care they receive. At least in Queensland, a person is placed on a mental health care plan – and gains access to a psychologist under Medicare rebates – only after they are considered to have a clinically diagnosable mental disorder. For many of us, this means we can only access treatment if we exhibit or co-opt enough of those symptoms observed on white bodies and experiences. Even if we pass as ill or needing treatment, being put through the mental health care system can often be re-traumatising.

To be a woman of colour existing in “Australia” is to be constantly drained, and re-drained

Most of the discourse around the racism that Asian people face is generic and limited to “discussions” that don’t address the power dynamics of the racism faced by Asian-“Australians”. These discussions – while addressing our right to not be discriminated against because of race – do not acknowledge that we are beneficiaries of colonial dispossession. We generally do not experience racism to the extent that First Nations folks do; we usually do not experience shorter life-expectancy, low literacy, deplorable living conditions, diseases, trauma, criminalisation, police brutality, rates of incarceration, state intervention and state violence. However, our histories and our lives are still impacted by white supremacy and its violence. I will acknowledge that as a fair-skinned, East Asian, cis-gendered, able-bodied woman who has grown up here and has had access to education, my privilege protects me from some disadvantages that people like my non-educated, non-English-speaking parents face. Still, for us, moving through life is more about self-preservation and strategic survival than it is about the pursuit of success.

I cannot be apolitical when my being is politicised.

People like to point to Pauline Hanson or “bogans”, whenever the word “racism” is brought up. We like to abstract racism into distant or caricatured figures because it absolves us from tackling it as a system. It is too disheartening to think about the inescapability of whiteness, racism and coloniality, so people disengage. But I do not get to choose when or whether to engage in politics. While racism remains invisible to many, I feel it everywhere, all the time. Every time someone like Hanson cries of an “Asian invasion”, it makes my blood boil, but at least some others also acknowledge racism in that context. Growing up as an Other, having my presence constantly questioned, having my achievements reduced to stereotypes, turns the stove up even more. These racial microaggressions are even more infuriating because this racism is invisible, ignored, or justified as a compliment. Every time it happens, I think I have reached boiling point, but I realise, there is not a point where I can change form, float away into the air and disappear. I am here. To be aware of racism and to suffer its many forms of violence is to be devastated, and gaslighted over and over again. Essentially, to exist as I am is to constantly feel grief and distress, and to suffer poor mental health as a result.

My experience is not purely psychological, pathological, or individual.

The causes of mental illness are plentiful: genetic predisposition, loss, poverty, trauma, living under capitalism and other forms of violence produced by colonisation, the “justice” system, and the white-supremacist-cis-het-patriarchy. For me, my experience of poor mental health is a product of all these things. I personally avoid using the term “illness”, but I acknowledge that the term can be extremely important for some people, especially those who experience psychosis. However, it is often necessary to name an experience as an illness to have it taken seriously, to access medical treatment, and to push back against dialogues that trivialise or reduce these real and serious experiences to overreactions, pessimism, or even hysteria.

The violence that produces mental health crises is replicated in our mental health care system

Different people need different forms of care, but the treatments most are subjected to have been constructed under a neo-liberal, capitalist state, where people who do not fit the designed criteria will always fall through the cracks. Treatment is often administered by those who have been able to access education and employment, and who often do not understand the impact of racism, colonisation, border violence, classism, ableism, poverty, gender and other hegemonic systems of oppression. This is because professionalism serves to distinguish between those who ‘belong’ in professional care roles and those who don’t. Professionalism keep workforces “in their place” – this place being defined in opposition to people of colour, women, queer folks, disabled people and the working class. As a result, those most qualified and suited to provide care are not in these roles. Instead, we are treated by people who benefit from and uphold these structures, who replicate these many forms of violence in their practises.

Treatment such as therapy and hospitalisation often isolate the person and cast their experience as an individual problem. This form of treatment ignores history and context, and minimises the impact of systemic issues. The focus is directed to the individual to “fix” their own thinking or behaviour, which is often not the real issue. The goal is to “fix” the person back into a “productive” individual. I do acknowledge that some strategies proposed by past therapists have been useful for survival, but simply changing the way I think about things that distress me is a band-aid. For example, I spoke to a therapist about a heated interaction with racist, violent white person. He – also a white cis-gendered man– told me it was unhelpful to think of all white people as racist and violent. I do understand that train of thought, and how it can “help”, but what about all the other people who are distressed about the same thing, who have not been able to access “help”? What about recognising the activating event as the issue, rather than seeing our response as something that needs to be changed?

My therapists did not understand the forms of violence I suffered. They reproduced the violence and gaslighting that contributed to my experience of mental illness. When I talked about my sleeping issues, I was told to “do more work around the house to tire [my]self out.” When I talked about feeling empty and unmotivated, I was met with disbelief – “but you do so well at school?”, “but you are functioning at a level much higher than your peers.” When I talked about wanting to die, I was made to feel guilty – “you are in a much better place than a lot of people your age.” Treatment invalidated my grief because it was not understood, because most professionals have never attempted to understand it, because these systems that cause me grief ultimately create commodified roles of care, which generate profit for those who maintain and benefit from these systems.

As someone who can hide behind their “high function” and pass as mentally well, there are many things I can avoid. My anxiety means I do well academically. It means I overachieve in many areas. It means my mental wellbeing is never questioned. It means I present as an intelligent, organised, talented and productive person even if I do not see myself as one most of the time. But it also means having the severity of my experience minimised, because it is illegible to others. I do not fit the narrative of a mentally ill person; I have never been hospitalised because I could not afford to miss school or work; I had to get out of bed because staying home was unsafe; I could not go home, or take a break from work after a panic attack. I had to, and I have to, “just get on with it.”

 

Re-imagining care work

We need to create different ways to provide and receive care, because what we have now is not working. We can start re-imagining care work as a responsibility rather than a job, an exchange rather than a service, and a community task instead of an individual one. Instead of relying on the current model of individualising and pathologising experiences of harm – which often puts people into our very limiting mental health care system – we can find different ways to respond to these experiences. We can envision and create systems that do not isolate, abandon, and imprison people. We can abolish a mindset, framed by the prison-industrial-complex mode of thinking, that economic, social, and political problems are solved through professionalised "services". The violent, carceral approach to problems is replicated in our mental health care system, which carries over into our interpersonal relationships. Instead of relying on professionals to intervene, we can learn and teach each other how we can provide and receive care. We need to return context to mental illness narratives, and create care-giving practices which support and provide space for people. We need to be open about each other’s needs, and the levels of care we can provide. We need community accountability, and we need to take responsibility.


Shelley Cheng is sometimes an artist and lives on the stolen Aboriginal land of the Jagera and Turrbal peoples. She is currently completing her undergraduate studies and is interested in critical race theory, decoloniality, transformative justice and community building.