Things I Need Mental Health Advocates to Stop Saying: A Thread 🧵

By: Sam. Me! Hello, hi.
(1) Even if you have experienced suicidal thoughts literally every waking second of your life, please stop telling other people with mental health struggles that “suicidality is forever, it just varies in intensity.” Or anything to that effect.
WHY? Because normalizing suicidality isn’t okay.

It conditions people to accept it as a state of being and suggests we are powerless to do anything about it.

We should not be telling vulnerable communities that suicidality is an acceptable norm.
I speak from experience. I have spent most of my life with suicidal thoughts, and other advocates I was reading told me it was like a song that would fade in and out of my life.

They were WRONG.

I was misdiagnosed & not getting proper support. Today, that “song” is silence.
Which isn’t to say that there aren’t people who have had long, chronic battles with this.

But blanket statements that suggest suicidality is forever are leading very vulnerable people to believe there isn’t hope or help for them.

It’s irresponsible. Stop it.
(2) “People with personality disorders are all abusers.” Or any variation there of.

I see this in survivor advocacy communities.

It’s stigmatizing.

And worst of all, many folks with PDs are actually more likely to be victims of abuse than perpetrators.
We can talk about surviving particular forms of abuse without suggesting that a disorder is synonymous with that abuse.

We owe it to survivors living with these disorders, if nothing else, to ensure they have access to support.

The English language is vast. Be thoughtful.
(3) “That medication doesn’t work.” “That type of therapy doesn’t work.”

For you, it didn’t. For someone else, it might.

You can be honest about your experience without assuming it will be the same for someone else.

(This exempts treatments that are legit dangerous, though.)
An example as of late is how many advocates are speaking as though they are the definitive voice on online/virtual therapy because they tried it for two months.

You cannot make blanket statements about a form of therapy because ONE clinician on ONE platform didn’t work for you.
You can totally say, “I had such a discouraging experience because my therapist was so disengaged and I couldn’t get used to the app.”

You really shouldn’t say, “Online therapy is such a waste. Steer clear for sure.”
In this example: There is a difference between reviewing a type of treatment, a clinician, and an app.

Similarly, with any review, be realistic about scope and the way you present your thoughts.

Otherwise, you could steer people away from something that could truly help them.
(4) Statements that assume everyone has access to a particular kind of support.

Not everyone has money, transportation, insurance, or access to culturally competent care.

Please don’t forget this when you talk about mental health.
This applies to ability, too. I started online therapy because I was agoraphobic and couldn’t leave my home.

All while advocates were demonizing online therapy, bc they somehow assumed that everyone had a choice between in-person and virtual therapy.

Not everyone has choices.
(5) “Well, the DSM says...”

The DSM is like a key that opens doors to certain kinds of treatment and information.

That’s all.

There’s a reason we’re on the fifth version.

So please don’t position it as the final word on what a disorder does and doesn’t look like.
Lived experience matters a lot & is instrumental in improving diagnostic criteria.

We can talk about the DSM without positioning it as a higher authority.

It supplements our growing knowledge of mental health. It doesn’t represent the breadth of that knowledge by any stretch.
(6) “I’m a mental health advocate.”

Bear with me on this last one.

What does this mean to you?
This is less of a “stop saying this” and more of a “pump the brakes and consider why you’re saying it” point on this list.

There are a lot of people self-identifying as advocates, and yet when they share about their struggles, they don’t have any consideration of impact.
I love when people open up about their experiences. But when you put “advocate” by your name as a title, you are communicating to others that there is a lot of weight behind your perspective.

You are advocating. For what, for whom, and why?
If you want to have a raw, vulnerable conversation about your struggles, that is incredibly courageous and I’m grateful to you.

AND: if you do so in a public space, remember that when you call yourself an advocate, you are asking people to trust your perspective.
You can and you should be honest about your struggles.

You can and you should ALSO be honest about what your intentions in doing so are.

I’ll give you an example.
There is a difference between these two concepts:

“This is what OCD is really like.”


“I was misdiagnosed. Here’s my story.”
It comes down to who you are speaking for, and what the takeaway is.

When you share your experiences as an advocate, ask yourself:

1. Am I speaking on behalf of myself or my community, and why?

2. How will a struggling reader receive what I am saying?
In my example, if I’m trying to talk about what OCD is really like, I’m setting people up to expect an authoritative voice on the experience of the entire community.

Is it fair to take that point of view? It could be. Be intentional, inclusive, & responsible if you do.
If I come from a first-person point of view, I’m ensuring readers have the expectation that this is my own personal story.

I could even weave both concepts together, as long as I am thoughtful about the language that I use.
A lot of people identify themselves as advocates, but then speak for the entire community or as an authority on an issue without considering how it impacts the person on the other side of it.

That really scares me.
And that’s ultimately where points 1-5 come from — conflating personal experience with authoritative perspective. When you call yourself an advocate, you are asking people to trust that you know the difference.
Which is all to say... I want people with mental health struggles to speak out, and yes! Advocate!

And I want them to do it responsibly. Know when to speak from experience, and when to speak with authority — and know your intentions behind each.
Remember when you’re sharing your feelings and when you’re talking about facts, and put yourself in the shoes of the community members who will be engaging with you.

What are you offering them? What is the value of what you’re sharing? What is its impact?
“I’ve dealt with suicidality for a long time” is different from “suicidality is forever.”

“My abuser had unaddressed borderline disorder that made it especially toxic for me” is different from “people with BPD are all abusers.”
“Online therapy with this platform wasn’t great for me because of these reasons” is different from “online therapy doesn’t work.”

“Here are options if you have insurance and here are options if you don’t” is different from “everyone should get this one particular thing.”
And yes, “The DSM outlines this disorder in this way, but many people have shared this other symptom” is different from “here’s the only valid way to describe this disorder.”

Openness. Nuance. Inclusion. Thoughtfulness.

Someday I’ll write something a little deeper about all this (like an article!), but the gist:

If you are a mental health advocate, remember who you’re advocating for.

There is value in sharing your experiences, but not if it negatively impacts someone else’s recovery.
I’m going to eat some ice cream now! ♥️

Please tag some advocates for me to follow that you think are doing a stellar job & share what you like about them! There are so many out there that I’m sure I’d love to connect with.

🎉 Cheers the folks doing the good work:
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