10 October marked World Mental Health day with the overall objective of raising awareness of mental health issues around the world and mobilising efforts in support of mental health. The day provided an opportunity for all stakeholders working on mental health issues to their share knowledge, lessons learnt from their work in the field, and to discuss the improvements needed to take place in order to make mental health care a reality for people worldwide.
According to the World Health Organisation (WHO) there are two common mental disorders that have an impact on millions of people’s ability to live and work productively: depression and anxiety. More than 300 million people suffer from depression around the world, and more than 260 million are living with anxiety disorders. Many of these people live with both illnesses. In South Africa, mental illnesses and mental disorders is a debilitating phenomenon that affects approximately 16.5% of the population (that we know of).
Unfortunately, the stigma surrounding mental illnesses coupled with the intersections of race, class and gender frequently silences the conversation about mental health and how best to cope with it. Too commonly, mental illnesses are perceived as demonic possession cured through prayer and exorcism, ‘white people problems’, or a millennial fad. Cross-cutting the aforementioned, mental illnesses are largely understood as women’s issues; women are more likely to be diagnosed with a mental illness than men, even when both genders have similar scores on standardised measures of depression or display identical symptoms.
Gender stereotypes regarding propensity to emotional problems in women reinforce social stigma and constrain help-seeking along stereotypical lines. Social stigma remains a barrier to the accurate identification and treatment of a psychological disorder. Unfortunately, the intersection of mental health stigma and sexism is all too common in our culture. Women are often represented as ‘crazy’, emotionally unstable, overly sensitive, or hysterical. In fact, the Hysterical Woman was once an actual medical diagnosis reserved exclusively for women. Those women considered to have had it ‘exhibited’ a vast range of symptoms including faintness, nervousness, sexual desire, insomnia, irritability, and ‘a tendency to cause trouble’. While it is no longer recognised by medical authorities as a medical disorder, the legacy of understanding femininity as flawed remains. The Hysterical Woman stereotype was and continues to be used to debase and disregard women’s ideas, feelings, and opinion, while also denigrating mental illness and those who suffer.
On the one hand, the Hysterical Woman stereotype ridicules and condemns women who express their emotions. On the other hand, it portrays mental illness as a defect that can be used to dismiss and reject mentally ill people altogether. This stereotype functions to classify both women and mentally ill people as flawed, powerless, incompetent and inferior to social majority groups, such as men and neurotypicals.
Historically, mental illness has been constructed as a mental flaw or as a lack of ability to function in mainstream society. Neurotypicals have set the standard for how ‘normal people’ should function in everyday life, and as such mentally ill people, by definition, are perceived as dysfunctional and abnormal. While social views about mental illness are rarely articulated explicitly, they still remain deeply entrenched in our cultural consciousness. Mentally ill people are stereotyped as emotionally unstable, incompetent, lazy, weak, dependent and dangerous. Not only does this stigmatisation of mental illness create prejudice against mentally ill people, but it makes mentally ill people more likely to be discriminated against in larger social institutions, like schools and the workforce.
Feminist disability theory illustrates that disability and womanhood are not natural states of inferiority, but culturally fabricated myths, similar to the construction of race. Women have traditionally been labelled as dependent, frail, unintelligent, and submissive. Like mental illness, the state of womanhood is similarly conflated with being flawed or inadequate. According to Simone de Beauvoir’s The Second Sex, men are constructed as the default gender, whereas women are constructed in relation to them and almost always as inferior. De Beauvoir argues that masculinity represents both the positive and the neutral, whereas femininity represents only the negative. Additionally, feminine-perceived behaviour is also stigmatised. For instance, women are frequently stereotyped as being too emotional or hypersensitive. People perceive women, relative to men, as being more prone to and experiencing more distress, embarrassment, fear, guilt, sadness and shyness. On the other hand, men are considered to be more rational, logical, and in control of situations. Aside from being linked to a hierarchy of superiority and inferiority, gendered ideologies surrounding femininity specifically rely on negative cultural stigmas surrounding mental health. Women, regardless of mental health status, are often labelled as crazy for simply expressing their emotions. Overall, women receive more mental health-related diagnoses than men, and these diagnoses often use gendered criteria that may disproportionately target women. Ironically, most women who complain or show signs of mental illnesses are, also, often dismissed as over-exaggerating their pain.
The hierarchy of gendered behaviours posits feminine-coded responses as symptoms of mental illness, whereas masculine-coded reactions are set as the default for mentally healthy behaviour. Therefore feminine coded behaviour is not only linked to a hierarchy of masculinity and femininity, but is also attached to a completely separate hierarchy of ability and disability that devalues the mentally ill.
It is a sad fact of contemporary society: stereotypical masculine traits are glorified and encouraged, while stereotypically feminine traits are shamed and suppressed. This is an outlet of patriarchy; vulnerability is likened to weakness and, by extension, the feminine. Efforts have been made to challenge archaic gender norms and beliefs, but there remains constant pressure on all genders to express stereotypical masculine traits- independence, (blind) courage, and strength. The traits themselves are not inherently bad, but can result in damaging mental health issues when not expressed or practiced constructively. It is time that society does away with gendering mental illnesses and ascribing mental illness to those who express themselves in way that don’t follow the patriarchal script. Mental illness affects everyone, and the socio-cultural stigma attached to it serves to shut down conversation, and block healing. SA.