We all try our best, we believe that others do so too, and we act accordingly – if there is a mistake we try to point it out, and we look for reparation. For reform. I recently learnt the etiology of the word Repent is from Hebrew, and later Greek, and it essentially means to alter ones thinking after. I like that; I really like the idea that repenting isn’t about atonement or demonizing, but about change, about transformation through reflection. Beautiful.

I have recently had cause to wonder what it is like to say sorry without understanding – to apologize without repenting, without reflecting. A search of #MHmasks will bring you in-line with an online debate that has been running for some days now – centralizing on Robert Gordon Uni’s usage of prosthetic masks to enhance mental health role-play scenarios.

With the best of intentions they put the masks to use, but the response was once of concern, and even disgust – service users, advocates, charities, and social workers alike took to social media in an attempt to show the University that people felt stigmatized by the masks, that they were offended.

Much has been said on the topic, including a great piece by Nurse with Glasses. To their credit the University withdrew the use of the masks, released a second statement, and this has been reflected in the media. Success, social justice and advocacy in action.

But then the next day came, and a curious thing happened. The # became alive again, and in doing so it highlighted The Backfire Effect phenomena – whereby the action of correcting someone can lead him or her to become further entrenched in their belief, increase their Bias. Those from the University, in favor of the masks, took to twitter and used the #MHmasks to strike back at the outcry, to attempt to justify their use – despite the University itself acknowledging the concern.

So in relevance to the above, in acknowledging that mental health has come a long way from the well intentioned Victorian era, I would like to talk about Stigma:

Mental health is currently making a transition away from the vestiges of mental illness, and into the paradigm of wellness. We are literally coming to an understanding that wellness, including mental health concerns, is a universal issue. It effects and affects everyone, collectively.

There is no characteristic, no look, no behavior, no trait, no signifier that can be universally applied to mental health; it is literally a spectrum upon which people may or may not fall at certain times of their lives. In an attempt to bring reason and measure to the spectrum, we divide it up into sections, into umbrella terms that highlight certain behaviors which indicate that a person may be experiencing a mental health issue – but these are not complete, they are not certain, and we (as professionals) are trained to understand the crossover between exhibiting symptoms, to look beyond the superficial and to keep digging to find the individual truth for each person. This is how we help people.

Terms like crazy, nutter, wacko, psycho, etc. are harmful, they are gross generalizations, they elicit painful responses and reactions in people, and they are misleading. There is no truth to them. Equally there is no truth to being able to tell what is wrong with someone simply by looking at them, we might witness some of what is happening – but without taking into consideration their culture, their medical history, their recent experiences, their circumstances – we are oppressive.

So the masks, to the idea that mental health can be represented through applying prosthetics. It doesn’t follow through; of course characterization can be represented through a masks – that is literally what they are for. To play out the form of an-other. But otherness is dangerous. Otherness has no place within mental health.

I work in a psychiatric hospital; I have been in the field of social work since 2003. I trained both in the UK (co-training with nursing staff) and in the USA – we utilized role-play, recorded interventions, acted videos, documentaries, live placement, and visiting service user lectures. We worked and studied in partnership, taking leads from our service users; from their expertise in their own lives. The greatest skill I have fostered (aside from listening and compassion) is the ability to read subtle indicators in faces – to hone in on the experience of another human being by not only listening to what they say, but also watching how they say it. It is the action of witnessing a person, of truly seeing them. I could not do that if they were wearing a mask. Of course, it is possible to conduct work over the phone, to listen and to be present, but it is not the same, it is not authentic. Authenticity is the backbone of mental health intervention, if you are not authentic, if you are not present and truly observing a client, then you are doing them a disservice. In a practical sense, it is not possible to be present with someone wearing a mask – because they are not present with you.

The practice issues aside, if service users, if advocates, if social workers, nurses, and charity workers are largely unified in a cause – the probability is that the cause is just. In the simplest terms of it: if you as a practitioner are doing something, engaging in a practice that others (that colleagues and service users) find upsetting or offensive – then you have a duty to listen, and to consider what can be done to change it, to listen, to repent. The first line of the credence we all ascribe to is Do No Harm.

Taking that forward, reflecting upon it, and putting it to use benefits us all. Because we are all in this together, or we are falling apart.