“I’m strong and I don’t need your help. I just want to go home. I’m fine…” I sat next to my new patient, who had just been admitted to the hospital after a suicide attempt. His dark brown eyes avoided my concerned gaze as he quickly rolled down his sleeves, hiding fresh bloody streaks across his wrists. He was far from fine.
“I have no doubt you are strong,” I said.
As a psychiatry resident, I spend just as much time—maybe more—convincing people that mental health treatment does not equate to weakness or some societal flaw, as I do in the actual psychiatric treatment. Stigma around psychiatric illnesses runs deep and is ingrained in our society, from horrific tales of shrinks passed down in communities to negative and inaccurate portrayals of mental illness in the media.
In fact, TV characters living with mental illness are significantly underrepresented, with a recent study showing that less than 2% of film characters and less than 10% of TV characters have psychiatric illnesses.1 The characters with mental illness are often portrayed in stigmatizing and inaccurate ways, associated with words such as “crazy” or freak.”1 As such, I have my work cut out for me when I explain to patients that psychiatric treatment should be viewed the same way as any other medical treatment. According to the media, and even amongst healthcare providers and students2-4, psychiatric illnesses are different–in a bad way.
For this reason, I was disappointed, but not surprised, to read Skip Bayless’ statement towards Dak Prescott, the quarterback of the Dallas Cowboys. Dak bravely revealed his struggle with anxiety and depression during the pandemic and after the suicide of his brother and football inspiration, Jace Prescott. On FOX Sports’ “Undisputed,” Bayless questioned Prescott’s ability to be a leader after his self-disclosure of mental illness. Not only was this comment insensitive, it is inaccurate.
In fact, Prescott’s decision to discuss his own mental illness struggles likely resulted in others seeking care. More than 7% of Americans have suffered a major depressive episode, and more than one-third did not receive treatment.5 Self-disclosure of mental illness is a powerful form of storytelling and has been shown to reduce stigma and increase normalization of mental illness, increase education and awareness, inspire others to seek care, and encourage advocacy.6-8 In fact, in my recent paper with Jessi Gold, MD, we argue that psychiatrists should work with the media to promote positive portrayals of mental illnesses.9
Bayless’ comment further illustrates this widespread notion that being a masculine leader of football does not allow for mental illness, which I believe is far from the truth. A meta-analysis showed that individuals who upheld masculine societal norms were less likely to pursue mental health treatment10, and this needs to change. Prescott explained beautifully that not being truthful about one’s struggles is being a “fake leader,” and his strong statement will join those of Dwayne Johnson, The Rock, Kevin Love, and Michael Phelps in encouraging men to seek mental health treatment.
Amanda Calhoun, MD, MPH