Mental health vs. mental illness: the conversation at Mac


Abe Asher

Content Warning: Matias Sosa-Wheelock’s death affected all members of the campus community differently, depending on individual experiences that night, in the days following or with mental health and mental healthcare at other points in their lives. This special report includes in-depth reporting on the response to Sosa-Wheelock’s death as well as the state of mental health and healthcare on campus more broadly. While we have refrained from including graphic details, it may nonetheless be difficult to read. Before beginning, please be aware.

For a list of support resources on and off campus, visit this page.

Most at Macalester are familiar with the broad components of mental healthcare: exercise, eating right, getting sleep and so on. But for a number of students, there’s an important distinction between everyday mental health and diagnosed mental illness.

“Mental health is how we as individuals navigate our day-to-day decision making [and] how we choose to look at the world,” Dean of Students DeMethra LaSha Bradley said. “Our sleep, eating, all that stuff. And then there’s mental illness.”

Macalester students, staff and faculty are largely familiar with mental health. Mental healthcare is the front-facing emphasis of the Health and Wellness Center, and, per Director of Counseling Ted Rueff, it is vital for everyone regardless of their mental health status.

“Just as you can have good mental health as a person with a mental illness, you can have poor mental health as a person without,” Rueff wrote in an email to The Mac Weekly. “We need to be attending to both.”

Bradley expanded on that point.

“There are a lot of individuals who have mental illness but manage their mental health really well. Just because you have a mental illness does [not] mean that your mental health is inadequate,” she continued. “And then we have some individuals [who don’t have] mental illness who still need to learn ways to strengthen how they manage their mental health.”

That said, the conversation at Macalester is slanted towards mental health – often at the expense of diagnosed mental health disorders.

Voices on Mental Health co-chair Kendall Dickinson ’18 pointed to Health and Wellness Center programming, which remains targeted to all students at a general level.

“I feel like there’s a stigma about saying certain words, about being, like, ‘this practice is meant to help you with these symptoms, with this mental illness that you might experience,’” Dickinson said.

“I think people are scared to say that a mindfulness workshop is meant to help you with your depression or your anxiety,” Dickinson said. “Even with borderline personality disorder, the treatment that I go to has an entire section on mindfulness. So it’s not just a trendy thing, it can actually be very helpful for these very serious things that you’re dealing with.”

That may, in part, be a product of a culture that is exceedingly careful and frequently indirect when discussing mental health diagnoses like bipolar disorder or borderline personality disorder even where it has grown comfortable in discussing mental health challenges like anxiety and lack of sleep.

“I think that conversations about [mental health] are pretty lacking, and I think that the conversations that do happen are sort of sugar-coated,” Dickinson said. “People aren’t afraid to say ‘I deal with depression or anxiety,’ but other than that, people don’t really want to talk about it – especially if there are other diagnoses that they have.”

“[Even in] most very liberal, very progressive insurance policies, the language in insurance is always about mental health, or a mental health issue,” Ian Doyle Olson ’19 said. “It’s mysteriously in 2018 not a disease, or a brain disease or a medical issue – it’s a wellness challenge, a mental health struggle.

“Whether you’re a Republican senator or a student at Macalester, it’s very likely that someone will shut down the term ‘mental illness’ and say, ‘don’t use that,’” he continued. “To refer to the ‘mentally ill’ is a slur.”

Olsen would like to see that change. Rueff, who said that he defers to the American Psychiatric Association in using the term “mental health disorders,” was sympathetic to both sides of the debate around the language regarding mental illness.

“The jury is out on this one,” Rueff said. “You could argue by labeling it mental illness it further stigmatizes people with mental illness, because the term sounds scary to people. On the other hand, maybe people need to get used to [the term], so it doesn’t feel so damn scary.”

The question of stigma is important – as is the question of how what we talk about effects how we act.

“I’m not going to expect that anyone at Macalester is going to be supportive of someone feeling marginalized about a mental illness,” Olson said. “But I know that for the person who is having a bad mental health day, they’ll get 20 extra minutes with their professor and they’ll get to reschedule an exam.”

“It’s 2018,” he continued. “I have higher expectations for racial justice, and certainly for gender equality, than for mental illness… it’s a complicated issue, and I see that it’s complicated to get it on campus and understood.”

For Olson, who entered Macalester in 2010 without a mental health diagnosis, the breakdown between the treatment of mental health and mental illness became particularly pertinent when he got “explosively sick” after his first year.

Since then, Olson has withdrawn from the college five separate times. The last withdrawal came earlier this semester, just weeks after Matias Sosa-Wheelock’s death – a decision he explained by touching both on the schism between mental health and mental illness and how Macalester fails to handle the latter.

“My mental health is really good, I’m taking really aggressive care of myself, but I’m having a lot of depression and [I’m] not able to be around while all these people who are really well paid and all have all these great internships are saying ‘we don’t know what to do about suicide and mental illness,’” Olson said.

“I pretty much will go crazy if I have to hear people talk about mental health for another minute,” he continued. “That the students who are worst off need a new place made for them for the first time on campus feels obvious.”

Olson’s view is that if the college were to invest in providing the best possible care to the most severely ill students, the standard mental healthcare for everyone would necessarily improve.

“The lady who we just met who is interviewing for the Disability Services provision, she just said, if you build it, they will come,’” Olson said. “When you support the most disadvantaged and most diagnosed people, services everywhere improve.”

The issue, of course, is cost. Olson said that, were he in charge, he would be fine with the college losing money for the next five years to dramatically improve its mental healthcare infrastructure.

But with the possibility of such a heavy investment so remote, Rueff said that he is comfortable with the limited scope of the Health and Wellness Center’s ability to care for students.

“We’re not in a position to manage someone who has a more chronic, persistent mental health concern that is going to require a level of specialization or longer term care,” Rueff said. “I’m OK with that. I want folks to get the best kind of care they know how to get, and that’s not always the most convenient kind of care.”

One smaller goal Olson has is for the college to hire more counselors and administrators with mental illness, and giving those people more prominent roles in campus conversations around health and care.

Rueff, for his part, said that his office has hired applicants with mental health diagnoses and is open to hiring more.

“The whole world is high-functioning strugglers,” Olson said. “But we can all benefit so much from muting the conversation led by people who have normal [mental] health challenges and listening to the people who have abnormal [mental] health challenges.” •