On 6 July, one of the world’s most high-profile magazines apologised for its latest issue, which was titled ‘The madness issue’. Vogue Portugal’s July/August issue featured a series of four covers, one of which depicted a naked woman hunched in a bathtub while two nurses poured water on her. To say that using a psychiatric hospital to trivialise mental health treatment needed a more thoughtful approach would be an understatement.
To say that, in 2020, magazines of such power and prestige thought it acceptable to use their international platform to glamourise such insensitive imagery, is very troubling. The cover perpetuates the institutionalised pejorative view of mental health and dehumanises those who have sought, are currently seeking or will seek treatment. It fuels people’s lack of understanding of mental health experiences, and yet, Vogue Portugal got something right here. Let me explain.
In today’s society, global mental health systems remain outdated, ineffective and riddled with injustice. People are right to call out Vogue Portugal for spreading this stigmatised ‘madness’ mental health view, but this blame cannot be fully put on the magazine, because the rest of the world needs calling out too.
Just last month, a United Nations report urged the global community to move away from a “mad or bad approach” when addressing mental health challenges.
People from traditionally marginalised groups are often labelled as ‘bad people’, ‘criminals’ or ‘sick patients’. According to UN human rights expert Dainius Pūras, our global mental healthcare systems “seek to prevent behaviours seen as ‘dangerous’ or provide treatment considered ‘medically necessary’ without consent.”
As a result, life in schools and on the streets turns into life in prisons, hospitals and private treatment centres, where human rights violations are systemic. Help becomes more dependent on how dangerous you are, instead of how much you are suffering.
Furthermore, Pūras stressed that current systems are dominated by a biomedical narrative, which reduces mental illness to a ‘medical’ problem. Despite a lack of biological evidence for mental health conditions, global models tend to use medicine as a means to diagnose and dismiss people. This is damaging, as it totally undermines the fundamental role of the community in promoting wellbeing.
We need to stop sending people miles away from home for treatment and lengthy hospital stays. They’re becoming ‘institutionalised’ and are being sent for inappropriate reasons. This is happening right here in the UK and is called an Out of Area Placement (OAP), which happens when a person with mental health needs is sent for help outside the local trust, often for inappropriate reasons such as bed shortages.
OAPs can harm a person’s recovery, and there have been numerous private hospitals that have come under fire due to failings in care. This includes the case of Dominic Vickars, who took his own life last year in a privately-run mental health hospital.
Vickars was just 25. He was sent almost 100 miles from his family home in Devon. Despite the NHS promising to eliminate these inappropriate OAPs by 2020 or 2021, a deadline fast-approaching, the numbers aren’t so promising. My own rummage through NHS data showed that, between January and April this year, there were 310 inappropriate OAPs in London—only 7 per cent less than in the same 2018 time-frame.
In July 2020, a number of reports showed that more patients are being sent away for unsafe care, including in Norfolk, which saw a significant rise since January this year. Just last month.
So, when it comes to the current status quo in mental healthcare, Vogue Portugal aren’t the only ones living in the past. It seems that the NHS, the UK government, and, oh, the rest of the world, still have a long way to go to adequately and equitably address mental healthcare.
This all begs the question; where do we go from here? In light of COVID-19, which has seen a monumental disruption to mental healthcare around the world, the time for urgent action must be now. Here’s what we quickly need to do:
We need to address human rights violations in mental healthcare systems. Let’s start by investing in rights-based approaches to reconceptualise ‘mental illness’, and develop and embed practices that are non-violent, culturally-sensitive and trauma-informed.
We need to put the community at the heart of mental healthcare. It’s not hard to realise that you can’t monitor quality care for people sent many miles from home. Instead, invest this money locally, such as training community health workers, so that people can access the treatment they need while staying close to the people they need the most.
Move away from a biomedical approach to mental illness, and prioritise holistic alternatives addressing the broader social determinants of health. We need better coordination between health systems and local community partners at national and international levels, and we need it yesterday.
To echo Pūras, “I’m calling for the ultimate elimination of segregated psychiatric institutions that reflect the historic legacy of social exclusion, disempowerment, stigma and discrimination.”
To achieve this, we desperately need investment in these three key opportunities. Only then will we drive forward a revolution. Only then will we stop living in the past.
Mental health has a lot of stigmas attached to it, and for many of us, speaking out freely about our struggles can be difficult. Somehow, over the years, young people started looking for comfort through memes on social media, which allow them to speak about their concerns with a little more ease. But why is it that, for many of us, it is easier to share our issues through jokes and humour?
Instagram is a paradoxical place. It is no secret that social media platforms are immensely harmful to our wellbeing, and, surprise, surprise—according to a study conducted by the Royal Society for Public Health in 2017, Instagram was proven to be the worst social media platform for our mental wellbeing. There are endless reasons for this, be that the constant anxieties of ‘keeping up’ or comparing ourselves to others.
But users on Instagram are slowly changing the scene, all the while trying to make the platform a better place—whether it’s influencers taking a pledge to be more transparent, or people advocating for Instagram to remove the ‘like’ feature. The platform also serves as a home to an ever-growing online meme community, one that is driving the conversation around mental health, and de-stigmatizing it one meme at a time.
Mental health is a heavy topic, but it doesn’t have to be. “I think there is a lot of great support and conversation, but it is on a more serious tone. And while I think that is necessary, I also think that the seriousness and the weight of it sometimes add to the pressure and the stigma of the illness itself,” @thementallytrillest told Screen Shot. @thementallytrillest is one of the few Instagram accounts prompting the conversation around mental health, through funny, witty and self-loathing memes.
Cori, perhaps better known as @manicpixiememequeen, started her meme account as a way to cope with her own struggles. In 2017, she was experiencing some mental health issues, and her uncle had just tried to commit suicide. “I did what any other person would do: I made an anonymous ‘finsta’ to shout my personal problems out to the void of the internet in the form of memes. The creation process made me feel productive, rather than feeling like I was wallowing or pitying myself,” she told Screen Shot. “@manicpixiememequeen has given me so many incredible opportunities to generate discussion about mental health,” Cori added. She went on to speak at Stanford University, and she even had several therapists message her, thanking her for posting the memes. “Some of their patients have used my memes to start a conversation in private sessions,” Cori explained.
For some members of the older generations, memes do not carry as much cultural significance as they do for the new gen. Of course, depicting our personal struggles through memes may seem like an unconventional coping mechanism, but when it comes to mental health, our generation is the most outspoken one. Memes make difficult conversations easier to have—somehow seeing somebody go through the same struggles as you, and still be able to laugh about it makes you feel like you can relate to people, and in the end, it makes you feel a bit better.
“Mental health issues can feel and be incredibly alienating, and memes that address these issues help people feel less alone and may even encourage them to speak and seek help,” Alia, also known as @memesturbationation on Instagram, shared with Screen Shot. She explained that memes not only help her process her feelings, but help her acknowledge them as well. And this ability to feel less isolated, and to relate to other people online is what creates such a wonderful community, one that is safe and welcoming, and one that uses memes as a unique language for today’s century, driving the growing conversation around mental health.
Odie, known as @not.yr.boyfriend online, has been ‘meming’ since early 2016, and has built a helpful community since then. The purpose of their work is to “embody the work I am doing on myself and in my community.” They explain that they wouldn’t describe their account as a mental health page, but instead as a project of self-work that aims to shift humanity towards a culture of accountability. Memes have the potential to drive a conversation and shift opinions, be that for political or social reasons, meaning that disregarding them or the work that meme creators do would be unfair.
And yet, memes about mental health are still met with a lot of criticism. For example, @memesturbationnation previously received some criticism for her work, accusing her of romanticising and trivialising mental health, to which she responds “I think that’s bullshit. It’s just more people trying to shame and silence those who experience mental health issues. I’ve received way more messages thanking me for sharing my experience with mental illness through memes.” Is it really fair to silence creators who predominantly create a safe space as a coping mechanism of their own, and who are helping so many people online?
Mental health is a sensitive subject, and it is understandable why some people don’t engage with memes depicting subjects of their personal struggles. But Instagram can be used as a tool that many people use to reach out to others who are experiencing the same thing, to let them know that they are not alone, and to show and receive support. The beautiful thing about meme pages on Instagram is how many of them there are. Be it astrology memes, political memes, art memes or mental health memes—there is content for everyone, and a community for all. Mental health meme pages on Instagram are a reminder that it’s okay not to be okay, and they’re accessible for everyone, at any time.