Most people with mental health diagnoses live “behind a mask” of whatever their community calls “normalcy.”
Last year, I interviewed for a 20-hour job at a mental health nonprofit. The part-time, benefit-free position offered a paycheck comparable to what a hospital in the same city paid its switchboard operators, but since everyone seems to consider me overqualified to run a switchboard, I keep applying for more challenging positions in line with my experience.
I made it to the second interview and found the team quite concerned that I might not offer a 24/7 supporting role to their organization.
I’ve worked before in organizations where my paycheck was expected to buy round-the-clock engagement: news media, which were expected to be politically “impartial” back in the day, and a large engineering company, which was so often the presenting consultant at local meetings that I could not participate as a citizen in public hearings. In the case of the engineering firm, the paycheck was big enough to buy almost anything; in the case of the news operation, the honor of the profession (at that time) allowed me to walk proud even under constraints on my citizenship.
But the idea that I should never express a view about mental illness different from that of my part-time employer in exchange for less than $15,000 a year — I found that staggering. I didn’t think it would be a problem to present their program to potential funders, but it would definitely be a problem to limit myself to their perspectives during the remaining 7,696 hours per year. Especially since I didn’t even live in the community where they provided services.
A board member suggested that the concern was not just for the organization but for me: Wouldn’t I find it stressful to present a view that is not fully representative of my own opinions, he wanted to know.
I’m not sure, but I think I was hearing him express a kind of concern that people don’t express toward professionals without diagnoses. Would he ask a “normal” if they would find it “stressful” to self-conceal or would he assume that self-concealment is normative? According to Tom Corley’s Rich Habits blog, 94% of wealthy people (like the board member) avoid just “saying what’s on their mind” while more than two-thirds of the poor will let ‘er rip. Was he making a judgment based on my openness during the interview or on my diagnosis, about which I was straightforward, since this was a mental health nonprofit.
And I also had to ask myself: Does this board member have a clue about what it is like to live with a mental health diagnosis? Because the “stress” of self-concealment is part of everyday life in a world where letting a diagnosis be known subjects you to all kinds of discrimination. For example:
Job applications: Who else has faced the OMB-CC-305 “Voluntary Self-Identification of Disability” in a job application? If you are uncertain whether you have a disability, the form defines “disability” for you:
a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition
Of the listed “disabilities,” 28% are psychiatric diagnoses, including depression and obsessive compulsive disorder. So if you have “a history or record of such … medical condition,” the OMB considers you disabled for purposes of federal contracting.
To get a sense of just how silly this definition is, the National Institutes of Health find that in just one year, more than 1 out of 6 adults in the U.S. experiences some form of mental illness. So if everyone with a history of one of the listed diagnoses checked the “yes” box, employers would be absolutely flooded with “disabled” applicants.
Still, how likely do you think you are to get a job if you check “Yes, I have a disability” or “I don’t wish to answer”? Feels risky, doesn’t it? You want to self-conceal. You check, “No, I don’t have a disability,” no matter how challenged you may feel at times.
Automobile license renewal: I don’t know how it is where you live, but in North Carolina where I recently lived, the DMV asks as part of the license renewal process whether you have a mental illness. Imagine my shock when, after I had just walked the DMV clerk through the details of my change of address, she starts reciting a sing-song litany of conditions that could separate me from my driving privileges … including mental illness.
I won’t question that keeping oneself under wraps can be an intense psychic demand. At the same time, I want to remind people — especially those who think they spend their lives “fighting the stigma of mental illness” — that most of us with diagnoses do wear masks every day. If we take our mask off in front of you, don’t use our openness as grounds for discrimination against us. As long as mental health organizations readily discriminate against people with diagnoses, the biggest problem we have with “stigma” is our own.