“Okay” and “Not Okay”: The Destructive Binary of Mental Health

Back in 2019, I worked part-time at the local hospital. One of my tasks each evening was to push these large steel tanks containing patients’ dinners to different areas of the hospital, and one of the locations I had to deliver the meals to was the Intensive Mental Health Inpatient Unit. Many of the patients would enter from outside for dinner, and, while it may have not been the case for all of them, they seemed free to enter and leave the unit as they pleased.

Yet, there was a glass wall dividing the adjacent nurses’ office from the recreation room where patients would eat and a door that required a security card to pass through. Seeing this gave me the impression that some patients in this facility were dangerous, which stories from other orderlies corroborated. Though, trusting the security measures, I never felt unsafe, the fact that these measures were even in place often made me feel uncomfortable.

No one’s mental health is perfect, but when I visited this unit, I unintentionally drew a line in my mind that separated the mental health issues of people receiving clinical treatment from the rest of the population. I felt as though there was a clear distinction between me and them. The issues they faced were much more severe than my issues with stress and feelings of inadequacy, and not only did I feel these issues were incomparable, but that they existed on completely different scales.

Previously, feeling bad is something I’ve always felt guilty for, and in retrospect that has led to my past attempts at invalidating my issues. I was distinguishing between normal and abnormal mental health issues. I divided people who were facing common troubles and common symptoms, who were therefore “okay,” didn’t need support, and lacked a “valid” reason to feel bad; from people who were facing troubles and symptoms that the general population didn’t, who were “not okay” and needed medical attention.

Drawing these boundaries was harmful to people on both sides of the glass, including myself.

Back in 2019, I wanted to believe that, despite admitting the imperfectness of my mental health of myself and that of my friends, the issues we faced were not serious by virtue of their commonness. I wanted to believe that being behind that glass wall was what separated people who are fine from people with actual issues, and separated people with mental health problems from people suffering from mental illness.

It goes without saying that the difficulties those patients were experiencing were greater in magnitude than those that most people who admit to experiencing mental health issues might face. But I’ve come to think that one of the issues at the core of the stigma surrounding mental illness is when people believe in a division between the severity of a person’s mental health problems. This belief splits people up into “normal” and “abnormal,” and “sick” and “healthy” — a dichotomy that adversely affects everyone it categorizes.

This dichotomy perpetuates the idea that it is normal and common to have flawless mental health, or at least mental health sufficient enough to be of no concern and require no attention or support. It invalidates legitimate mental health issues by drawing a line between sick and healthy people, with no opportunity to be somewhere in between, which is where I think many if not most people would find themselves. It makes people feel as though, unless they have serious conditions like schizophrenia or bipolar or depressive disorders, their mental health must be adequate, and to seek help or even acknowledge the state of your mental wellbeing could be better would be overdramatic. It also forces you to discount that your mental health is imperfect in order to preserve the coveted “normality” that crossing that glass wall into “actual” mental illness would cause you to lose.

Believing this division exists contributes to the marginalization of people suffering from severe mental illnesses, suggesting that the difference between them and people without severe mental illnesses is black and white, rather than on a spectrum where the majority of people would fall in the gray. Seeing two fixed and opposing categorizations — with those struggling with mental illness on one end and the “healthy” general population on the other — can only isolate people with severe mental illnesses and generate a prejudicial attitude from people who consider themselves as their polar-opposite — and cause these people to look inwards with fear, discomfort, and ignorance from the other side of the glass.

Because we have such a wide variety of support systems available from Harvard Counseling and Mental Health Services, I’m confident they don’t believe in this black-and-white contrast between people who are and aren’t mentally healthy. CAMHS recognizes issues such as Zoom fatigue and anxiety as valid problems that make your mental wellness less than perfect. You have the opportunity to occupy the gray area, rather than feeling you must be opposite to those who receive medical attention for their mental health.

But, on an individual basis, the belief in a glass wall that separates the sick and healthy persists.

Perhaps, as a world, and at institutions such as this university, if the majority of people stopped considering themselves to be completely different than the minority of people with recognized mental disorders, there would be a reduction in exclusionary behavior and an increase in the empathy that reducing this stigma so desperately requires. At the same time, dismantling this binary might convince the “okay” majority to not feel as though their mental health problems are insignificant, encouraging them to seek support.

James M. Heffernan ’24’s column appears on alternate Thursdays.

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