When your teenager receives a diagnosis for a mental health disorder, one thing you realize is that you need all the support you can get. Support from your spouse, co-parent, or partner. Support from your own parents, siblings, and friends: from wherever and whomever, every little bit counts. You may tough it out at the beginning, without telling anyone what’s happening. However, most parents of teens with mental health issues soon realize it can be stressful, overwhelming, and tough to handle alone – so they reach out.
Sometimes when you reach out to your extended family, you get the opposite of what you need. You get resistance rather than support. You get judgment rather than compassion. Family members might tell you things you know aren’t true. They may tell you they think mental illness is not real, treatment doesn’t work, and wastes time and money. They may offer a thousand suggestions about what they think your teenager needs, aside from what you know they need: evidence-based treatment for mental illness from trained and licensed mental health professionals.
That’s a difficult position to be in.
It’s not impossible to overcome, though.
The first thing we want to tell you is that if you’re the legal guardian of your teenager, you’re the boss of the situation. You get to decide how to handle your child’s mental illness. You decide the what, when, where, and how of treatment for your teen.
That’s the bottom line – but that doesn’t solve the situation. It doesn’t make handling family members who think your entire approach – the evidence-based treatment works approach – is the wrong one.
You may feel like it’s a no-win situation.
There’s one way you can begin to restore balance, though.
You can try to understand why.
Why don’t they think mental illness is real?
Understanding the Origins of Stigma
The easiest answer to why is that your family members are simply uneducated about mental illness or unaware of the benefits of treatment.
But there may be a problem with that position. In some cases, it may be too reductive.
It may be too easy an answer.
Assuming a lack of education or awareness can – in some cases – be an oversimplification that may or may not bring you and your resistant/denying family members any closer to mutual respect and support for you and your teen – which is your ultimate goal and endgame. Think about it this way. If you question the validity of someone’s perspective on something, and all the person you question has to say in response is you don’t know what you’re talking about – you may not have the most positive reaction.
Granted, you may say “Please help me understand.”
If you have deep, firmly held beliefs on the subject, you might not react that way. You might get your back up and dig in deeper – which is what your family members might do.
That’s why we recommend you engage your family members who deny the reality of mental illness or question the validity of treatment in open and honest conversation. We suggest you talk to them about their position, with the perspective that you genuinely want to understand where they’re coming from and why they think what they think.
And before you have the conversation, take the time to consider the following five factors, which we summarize from this peer-reviewed journal article and this helpful explainer webpage.
Five Sources of Stigma Around Mental Illness Treatment and Diagnosis
1. Social Status
In many cultures, acknowledging a mental illness is seen as a sign of weakness on more than one level. People raised in some cultures view mental illness as a moral failing. Others view it as a failure of the family to successfully care for their loved ones. In these cultures, the shame associated with loss of status – resulting from the perception of weakness or inability to manage family matters independent of external support – often prevents people from seeking treatment for mental illness or recognizing the value of treatment.
2. Gender Roles
In many cultures, powerful and pervasive norms prevent men from acknowledging any form of emotional or physical weakness. Men, and the boys who will become men, are supposed to be strong, silent, independent, and capable of handling anything – physical, mental, emotional, or otherwise – without anyone’s help. In these cultures, people often consider a mental illness such as depression or anxiety a weakness. Therefore, acknowledging a mental illness and seeking treatment or support undermines gender norms and identity. These norms form the basis of their resistance to both treatment for and diagnosis of mental illness.
3. Healing Practices
The Western medical tradition is not the only approach to healing and medicine on earth. Contemporary science, medical technology, and medication are revolutionary and have changed the world. No one disputes this. Modern medicine has eradicated many deadly diseases and allows people to recover from conditions or injuries that would have been fatal fifty years ago. Nevertheless, that does not change the fact that there are cultures with healing philosophies and approaches to physical and mental rehabilitation that date back thousands of years. Expecting a person raised with these traditions to abandon them immediately is unrealistic, and borders on being patronizing and disrespectful. Before talking to them about your teenager’s mental illness and treatment, we recommend taking the time to understand their understanding of medicine and healing, and why it prevents them from acknowledging a mental health diagnosis and a Western approach to treatment.
4. Age
This one is simple: younger people who grow up or live in a country or culture that embraces Western medicine are more likely than their older family members to acknowledge mental illness and seek support and treatment for mental illness. The older they are, and the more recently they’ve arrived in a country that applies Western medical principles, the more likely they are to resist things like psychiatric medication or approaches like talk therapy. This is not universally true, but it is common enough for us to mention it here – and it’s important for you to understand that it’s difficult for someone to let go of the traditions of their culture of origin.
5. Religion/Spirituality
In some cultures, religious or spiritual traditions identify sources of disease and illness that are not recognized by Western medicine. People raised in these cultures may have a wide range of beliefs about the origin of various maladies. They may believe that illness is caused by a lack of harmony with the natural world, disrupted relationships with ancestors or ancestral spirits, or that deeds from past lives play a role in the presence of a mental or physical illness. If this is the case with one of your family members, whether you agree or disagree with them is not the point: what matters is that you understand where they’re coming from, so you can understand how to bridge the gap between where they are and the choices you make for your teenager.
You may have noticed one word that appears frequently above: culture. Culture is often what prevents individuals from accepting the reality of a mental illness or recognizing the validity of the Western approach to treating mental illness, which revolves around accurate diagnosis, evidence-based treatment in the form of individual and group counseling, community support, lifestyle changes, and medication when needed.
When trying to achieve harmony between family members of different cultures – and generations – mutual understanding is the first and most important step.
What You Can Do to Help the Situation
In the end, it’s likely you’ll need to set firm boundaries, which may be difficult. On the other hand, after initiating an open and honest dialogue – with the facts you learned above in mind – you may end up closer to agreement than you thought possible.
Getting to that place starts with respect.
If your goal is for them to respect your point of view and your choices for your teenager, then an effective strategy is to mirror those expectations. Learn about and respect their point of view and their choices, as well. Your position on their beliefs is unlikely to change them. The conversation about mental illness and treatment should not turn into a culture clash. That won’t help anyone.
Here are valuable points to keep in mind when seeking an accord with a family member who denies the validity of a mental illness or treatment for a mental illness for personal or cultural reasons.
Bridging the Culture Gap
- Find areas about mental health conditions/illness where you do agree, and focus on those
- Make sure neither you nor your family member takes a position that:
- Stereotypes attitudes or beliefs around mental illness
- Trivializes or belittles people with mental health illness
- Offends people with mental health illness
- Patronizes people with mental health illness
- Find a way to agree that everyone in the family shares a common goal: the health and wellness of your teenage child
You may notice an anagram in that second bullet point: STOP. The idea is to stop judgment and criticism of what your child is going through, and start supporting one another on the path to overall health. At the same time, if they disagree completely with your approach to your teen’s mental illness, you can stop judgment and criticism of their point of view. While you can make it clear to your denying/skeptical family member that you plan to pursue the Western, evidence-based, integrated approach to treatment for your teenager’s mental illness, you can do that without stereotyping, trivializing, offending, or patronizing their point of view, their cultural traditions, or their spiritual/religious beliefs.
When you take that approach, you’re likely to increase the chances of balance and harmony in your family. And when they see your teenager heal and grow, they may just come around. In time, they may become active and productive participants in the treatment process.
