April 28, 2020

What is mental health?

What is mental health?

This is a question I ask often in workshops that I lead, in my classroom, and even in casual conversation. Because this is one of the most important questions I think we can ask, of ourselves, of others, of our social world. Because we think the answer is simple and straight-forward, until we actually try to parse it out, and we realize that our answers are full of contradiction and are different from others' answers, including those of so-called experts and even people we entrust to care for us. I ask this question as a way to begin inquiry into mental health because how we—and others—answer shapes so much of our lives. So many structures tell us, directly and indirectly, what mental health is supposed to be—how we are supposed to be and feel and act. We rarely stop to reflect on whether what we're being told actually helps or harms us. And we cannot intentionally strive for better mental health, individually or collectively, if we don't know or agree on what we're striving for. 

So, what does mental health mean to you? What are its elements, and what does it look like to be mentally "well"? Jot down some notes answering these questions. Try to come up with a list of 7-10 things. This may seem like a lot, but when I do this in workshops, we're able to collectively fill a white board! You can do this activity by yourself or with others. Generating this answer collectively in a small group is its own kind of fun—there will be unexpected answers, and it'll open conversation between you in great ways. 

Please do this initial activity before reading on!

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Kai Cheng Thom asks us to think about definitions of mental health in her essay "The Myth of Mental Health," which opens my DSM: Asian American Edition in Open in Emergency. This is the most widely taught piece of Open in Emergency, as far as I know. (You can download and read the full essay here—it will change your life.)

In my workshops, I take inspiration from Kai Cheng, holding up the World Health Organization's definition of mental health to close read together:

Mental health is defined as a state of well-being in which the individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

So let's close read the WHO definition now: What are the main elements of mental health according to WHO? What does this definition seem to emphasize? What are its assumptions?

Further questions to ask:

  • What are "normal stresses"? (Are we under "normal stresses" now? What about in the before-times?) What makes something "normal"—and to whom? Who gets to say something is "normal"? For example, is racism is a “normal stress”? Is queer- and transphobia?

  • What is "productive" and "fruitful" work? Do you agree that the ability to be productive is an indicator of mental well-being?

  • What does it mean to realize one's potential? According to whom? How do we measure this?

  • What does it mean to make a contribution to one's community? What counts as a contribution, and, again, to whom? 

  • So, how does one "measure" mental health using this definition? By one's proximity or distance in each of these categories from a standard set by...who, and how?

Now, compare: How does the WHO definition compare to yours? Similarities, differences? Did work appear in yours? Did feelings appear? What about community? What relationship do you imagine and want between you and your communities? What concepts or language appeared in yours that doesn't exist in the WHO definition? In other words, in what ways does your definition not only differ from but actually exceed the bounds of WHO's conceptualization of mental health?

Students' answers always, always look completely different from the WHO definition. There is usually very little mention of work. There are always mentions of belonging, of feelings, of support systems, of reciprocal relationships and healthy boundaries, of having meaning in their lives. Of feeling loved and valued. Of safety. Of agency. Students' ability to imagine and develop language for what they want for themselves, outside of what they have been told to want, is breathtaking.

(Then I ask them what kind of mental health their university invests in. That is a whole other conversation.)

To end: Reflect more on the kind of mental health you want for yourself and your communities. Amend your original list if you need. Then, think about what it would take to nurture that kind of mental health. I end my workshops and many of my talks with these final questions: What structures would we need to build to nurture the kind of mental health you want? And how do we ask, demand, our communities and institutions to invest in this kind of mental health?

I hope you found this exercise thought-provoking, and I hope it gives you tools to begin (or continue!) building the structures of care you need in order to foster the kind of mental health you want. 

Wishing you so much more than "coping" and "productivity" in your life.

mimi

NEXT: Failing in the time of COVID-19