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When Health Care Professionals Think Support Will ‘Encourage’ Mental Illness

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Editor's Note

If you struggle with self-harm or experience suicidal thoughts, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741741. For a list of ways to cope with self-harm urges, visit this resource.

In my experience (and many other people’s experience, I’m sure), mental health is still stigmatized. Unfortunately, this stigma seems to be worse in the health care system than it is in society.

There seems to be two common misconceptions. The first one being that mental health patients want attention. They “act out” for attention. They seek medical care for attention. They make more appointments than is necessary — for attention, of course. The second major misconception is that by offering support (often mislabeled as attention), you are encouraging the patient, both in their pursuit of attention and in the continuation of their mental illness

There is so much wrong with these ideas. What’s worse is that educated people not only accept these misconceptions, they perpetuate them. I have heard health care professionals tell staff not to be too kind, otherwise they’ll “never be able to get rid of (insert name),” or “ignore them, it’s just behavioral, don’t encourage them.” Sadly, I’ve heard of some health care professionals telling patients they will not be seen within 24 hours of self-harming. After all, they don’t want to “encourage them” by giving them attention. If they are given attention, they’ll just keep self-harming.

These strategies are in place to “manage self-harming behaviors” or to manage “manipulative patients.” The professionals must believe (I actually hope that they believe) that this is providing patients with some kind of structure or that they are setting boundaries. However, what would happen if you replace the mental health patient with another patient with a physical illness? What if the support given encouraged that patient to neglect their health? Withholding care or support in other circumstances would be considered neglect or medical malpractice. These symptoms and conditions simply cannot be ignored.

In my opinion, the likelihood of a mental health patient faking symptoms for attention is unlikely. Unfortunately, they are not afforded the same, stigma-free healthcare as other conditions seem to be. There are certain assumptions that come with each diagnosis, each symptom and each “behavior.”

Providing support to someone with schizophrenia is not going to “encourage” them to have hallucinations. Providing support to someone with depression is not going “encourage” symptoms of depression. Withholding support from someone who self-harms isn’t going to stop them from self-harming; they will just suffer alone like they were before they engaged in self-harm. However, failing to provide support in these situations isn’t neglect. It’s “managing behavior.”

I am a human. I have feelings. Real feelings. I’m fragile. I may already be broken. Don’t be scared to offer me support. I’m not unwell to get your attention. I wish that’s all there was behind it, but behind it all is some real, heavy, darkness. Fear. Sorrow. Pain. Unbearable pain. The things nightmares are made of. When you imply all I want is attention, you are implying that the darkness, the fear, the sorrow, the pain, aren’t real. And that hurts.

Please see me as a person and not as a management plan. Managing my “behavior” isn’t going to cure my mental illness. Managing my “behavior” isn’t going to stop my self-harming. Managing my “behavior” is going to stigmatize me. Managing my “behavior” is going to isolate me. Worst of all, managing my “behavior” is going to steal that last little piece of self-worth that my mental illness hadn’t yet stolen.

Photo by Pars Sahin on Unsplash

Originally published: March 24, 2021
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