October is Mental Health Awareness Month and each year I’m reminded of the terrible state of black youth’s mental health. The month has seen a lot of people share their stories on social media and on television and there’s a common thread I noticed among many, particularly black South Africans. It’s important to recognise the road to mental health as something that isn’t all that simple for a lot of people to even embark on. Achieving optimum mental healthcare isn’t a feasible reality for most, even for reasons outside of money. Agents like gender presentation, language barriers, stigma and historical predisposition to low standards of living make it increasingly more difficult to speak about mental illness, much less get any help. I’ve thought a lot about the aforementioned intersectionalities and how they make mental health seem far out of reach.
There are two main branches of shame. There’s the “good” shame that aids as a compass in deviating away from bad and towards good behaviour. This shame kicks in when you’ve done something objectively wrong and makes you feel bad, ashamed of yourself, like you should probably never do it again. It’s an accountability measure. The second kind of shame is the kind that’s incessantly drilled in by external prejudice, bullying or being on the wrong side of society’s widely-held, exclusionary standards. This kind of shame makes you feel ashamed of things that are intrinsic to your identity which are, reasonably, unthreatening and personal.
It’s no secret that, under the latter, queer bodies have a much harder time trying to find spaces that don’t threaten their existence. Whether you’re openly queer or not, the fear that comes with seeking external mental healthcare in a body that’s a crime scene of cis-het society’s abuse is one that’s often crippling. When you’ve moved through umpteen spaces in your life that were meant to serve as a positive catalyst for your formative years – school, church, recreation – and each place proves otherwise, based purely on your intrinsic queer identity, it’s very difficult to then trust that a meeting with a mental healthcare professional won’t carry the same fate. The idea in itself, can surface feelings of anxiety. The search for a psychologist that is completely professional, queer or queer-friendly and is understanding, is a tedious one and sometimes unsuccessful for a lot of black queer youth. It’s more than a matter of finding one nearest to you. It’s important they are able to thoroughly engage in your internal conflict in a way that doesn’t prove offensive and damaging, particularly because of the widely-held misconception that homosexuality, in itself, is a mental illness. Predisposition to prejudice and abuse makes it harder to trust, to express and to feel safe – essentially, to gain access to good, queer-friendly mental healthcare and this is something the South African healthcare space can better facilitate.
Language barriers are still one of the most pervasive segregators in South Africa’s social context. The English language, although spoken by many, isn’t one that’s spoken by all. In fact, nearly 60% of South Africans don’t speak a word of English. When dealing with a mental healthcare professional who speaks your mother tongue, it’s very difficult to adequately describe emotively or unpack the complexities of our mental framework because a lot of us have never had to. We haven’t developed the speech to describe things like manic episodes or dysmorphia in indigenous languages, thus making it difficult to even identify that there’s something wrong. Often when the media is informing us, an older example would be the government funded television show, Soul City, it isn’t always delivered in all 11 official languages nor does it really go into the depth or variety that it ought to when trying to educate and inform, particularly regarding mental illness. This is also a burden that certainly can’t be placed on one platform. The confidence one carries in their ability to explain and express effectively is a determining factor in whether or not they seek help.
Stigma is probably one of the biggest deterrents to people of colour seeking mental healthcare. The Oxford dictionary describes stigma as “a mark of disgrace associated with a particular circumstance, quality, or person”. The stigma around mental illness or mental challenges in black communities is closely related to the aforementioned intersectional factor: language. Mental illness is often stigmatised as a threat on the mind by the evil spirits, something that is self-inflicted and therefore self-reparable, it’s seen as something that can only exist when you lose functionality so if you’re still functional, the illness doesn’t exist, it’s seen as laziness, lack of gratitude, “a white people thing” or you’re gaslighted with no offer of treatment and sometimes met with the tragic fate of being kicked out of your home. These stigmas manifest themselves into a big lump at the back of one’s throat, making it impossible to speak on our sadness, traumas or difficulty coping. Living under stigma makes you feel embarrassed, it’s an extremely lonely place and it often leads to destructive coping mechanisms and self-loathing.
The World Health Organisation stated that poverty is one of the most “significant risk factors of suicide attempts”. Being historically predisposed to a low standard of living is a reality for almost every single black South African. Coming from an extremely impoverished background means that your mental health doesn’t even make the top ten list of your priorities. I recently watched the TED MED talk of German social scientist, Johannes Haushofer. He speaks about how obtaining mental healthcare isn’t only adversely inhibited by a poor economic background, but how mental illness is often caused by it. He breaks down a theory known as the ‘psychological poverty trap’. The theory suggests that poverty, for obvious reasons, causes stress, anxiety and depression – the inability to feed or put a roof over yourself or your dependents, the physical distress of being limited to strenuous labour for little reward as a means of getting by and constantly being reminded of luxuries you’ll probably never afford are all things that take their toll on the minds of black people and poc. Thus, when your mental illness is caused by poverty, it taints the relationship you have with money for the rest of your life and this tainted relationship with money is often what reproduces a poverty cycle: having never had money and thus access to good money management, makes it almost inevitable that you’ll make the wrong decisions with the money you get your hands on. This is when the mental illness becomes cyclic and begins to feel like a ‘trap’. He also goes onto say that financial lack is a huge determinant of one’s happiness and that money can, to a fault, buy a happiness that living in poverty would make impossible. So what do these intersectionalities, which many of us live under, mean for our future with mental illness?
An answer to such a question is difficult to quantify but it’s one that may sound cliché to some. A piece of advice that I’d once received was to give it all you’ve got: in terms of doing research in your community, among peers and older council in your space. Find someone you can trust and be open with a friend or family member. The small steps we take towards keeping ourselves clean, healthy and functional are to be celebrated and recognised as healthy efforts in self-betterment. Finding a non-destructive escape in mediums such as music, reading, writing, making art or committing to a sport or other recreational activity can often lead to the discovery of a talent or skill or it could just prove to be a safe space for you to cope. There’s no proven cure for mental illness but the battle is one worth fighting, even with baited breath, it is a fight we owe to ourselves and a necessary resistance to the systems and structures in place that try to do away with us and what we have to offer.