I want to tell you a little story about ‘what happened on my way to the forum’, except that I took this journey as a consumer and the beginning of that journey was no laughing matter.

The first half of my story shows how unacknowledged and internalised stigma can get in the way of the actual people who devise mental health promotion, prevention and education programs in developing effective strategies. The second half is about practical strategies that I suggested at such a forum.

I was recently invited to participate at a forum with the Student Counselling team and the Academic Liaison Officers of a major metropolitan university putting together an action plan to deal with student mental health issues. The basis of my invitation was that I am a university student living with a mental illness and the strategies I suggested led to my being asked to return as a consultant on future mental health education and promotion strategies.

The dynamics of the forum were actually quite an eye opener into the realities we all face with stigma and the way it gets in the way of proper mental health promotion, prevention and education. For example, I was asked to participate on the condition that I was not a student of the university. As I am a student of that university I asked why. When I was told in vague terms that they “didn’t want to blur the boundaries”, I was initially confused but soon began to smell the ‘stigma rat’ from a hundred miles away.

“Blur which boundaries?”, I asked ever so innocently. “Um, the boundaries between you and staff” replied the polite gentleman, ever so uncomfortably. Hmmm. “So, would this be issue if I were a student with epilepsy?” We were now entering the ‘stigma vortex’ where people (usually the stigmatisers) get catapulted into uncomfortable orbits.

When I arrived at the University forum I was introduced to another staff member who then introduced me to another person as “This is Carlos Suárez. He’s the student coming to talk about [voice drops to a whisper and eyes dart away] his mental illness.”

Now, here we had a group of well meaning professionals coming together with the very best of intentions to tackle ‘The Mental Health Dilemma’ and as I pointed out to them in the first minutes, we had all just witnessed two examples of stigma before the forum had even started! The significant difference being that they merely had to witness it like onlookers at a roadside accident, whereas I had to feel the full body blow to my guts. But hey, Carlos, get over it. After all, you’re just, well, a…’consumer’. It is a particularly warped and sad reflection of our society that out of propriety, I am expected to leave the said university nameless yet I have to feel that blow.

Squirming in their seats, the participants realised only too painfully that they had not started out on what one would call a politically correct note. And you know what? IT WAS THE BEST THING THAT COULD HAVE HAPPENDED. People opened up and really got down to the nitty gritty of things because the stigma phantom had been brought out of the shadows on an experiential, not intellectual level. The co-ordinator said he had never seen such a fruitful and productive flow of ideas.

Which brings me to how I came to be asked to return as a consultant. I suggested that the greatest problem with mental health promotion is the expression ‘mental health’ itself. While it may be convenient shorthand for mental health professionals, I feel it alienates people in the wider community ie. The people you are actually meant to be helping.

Thus, instead of promoting something like an official “Mental Health Awareness week” at the university, my suggestion was that they move towards a ‘Chill Out’ theme which is student-speak for “Stress Less”. What if, I asked daringly, the main university hall were to be filled with rows of massage tables manned by final year students from the Traditional Chinese Medicine degree who would give free 10 minutes massages that could count towards their clinical experience quota? Why not throw in a ‘showbag’ which would include such treats as sherbet bombs, movie discounts and information checklists along the lines of “Are you feeling crabby a lot lately, can’t sleep, lost your appetite, not enjoying the things you used to, etc?”Then come up for a free confidential chat at Student Counselling.

This technique doesn’t once mention that the person might either have an ‘illness’, a ‘mental illness’ or worse still, strike fear in the student that he may be ‘mad’, ‘bad’ or ‘crazy’. Yet it gets the student to the service provider via the backdoor. With a few lollies in his showbag to boot!

My fear that the idea might be considered somewhat left-of-field was dispelled by being invited back as a consultant on mental health promotion.

In last year’s NESB Mental Health Forum sponsored by the NSW TMHC, I read somewhere that a successful promotional technique for older NESB men was to hold a forum, not on ‘mental health’, but on fishing of all things. There they could introduce ‘life style issues’ which naturally led on to ‘stress management’ which then led to ‘signs that might show you are depressed’. Suddenly, you were educating older NESB men about ‘mental health’ – surely an impossible exercise! It was savvy marketing to hook them in with fishing because fishing is a relaxing activity. The peace one experiences while fishing on a lake in the company of mates and a few cold beers interlocks snugly with what mental health promotion is ultimately aiming at – inner peace.

Similarly, a recent successful public forum with the Croatian community was promoted something along the lines of “How to Deal with Life’s Problems”. Have you ever wondered why forums that are advertised as “Looking After Your Mental Health” hardly attract anyone? The medicalisation of emotional distress is one thing. The medicalisation of public relations strategies is quite another.

People out there are in desperate need of information. Yet they will not access it if is couched in terms of ‘mental illness’, which raises the image in popular culture of the ‘mad psychiatrist’ with uncontrollable grey hair in a white lab coat. When someone is living in extreme distress on the abyss between sanity and insanity (don’t worry, its OK, I’m allowed to use that word), they don’t say to themselves “I think I am experiencing a mental illness.” They think, “My God, I’m losing it”.

It was the famous North American psychiatrist Harry Stack Sullivan who said he treated people who had “difficulties in living”, not a “mental illness”. It is no surprise to me that he was both highly esteemed as an extraordinary clinician and that he lived with his own mental illness, which (surprise surprise) didn’t do his reputation much good in the eye of his colleagues. While it may be valuable in some cases to medicalise people’s “difficulties with living” into a “mental illness” from a clinical point of view, it is absurd to use the same approach for promotion, prevention and education.

Just ask anyone who has worked in an advertising agency for 72 days.

Prior to becoming the Consumer Project Officer at the NSW Transcultural Mental Health Centre, Carlos won a graduate traineeship with a multinational advertising agency under the auspices of the Advertising Federation of Australia. He experienced his first psychosis while at the agency and wishes to make it abundantly clear that working in advertising and the onset of psychosis were in no way related.