Could the idea of a ‘mental health day’ just make the stigma around mental health worse?

1024 683 Mandy Freeman

Published on Health24, 4 June 2018

In 2017, a mental health story went viral.

Madalyn Parker, a web developer in the USA, emailed her boss to say she would not be coming into the office – she was taking a mental health day.

The world applauded her courage and gave her boss a standing ovation when he told her to take the day. “You are an example to us all, and help cut through the stigma, so we can all bring our whole selves to work,” he said.

News24’s Facebook audience was less forgiving, however, and comments ranged from “Let her take a day, i don’t want to be a working with a psycho [sic]” to “Would tell her to go work at a mental institution [sic]” and “Request admittance letter to asylum”.

But in a world where more than 300 million people suffer from depression and close to 800 000 people die by suicide every year, should we be able to take a mental health day as opposed to a sick day?

The answer might surprise you – it’s a resounding no from experts. And with good reason.

Mental issues remain health issues

Although Dr Renata Schoeman, a Cape Town psychiatrist, believes that the idea of taking a mental health day is a good move because it creates more awareness around mental health, she (and other psychiatrists) strongly believes that mental disorders should not be treated any differently from other illnesses.

“If you have to take sick leave for a mental health condition, it should be sick leave. It is still a medical disorder like any other disorder and it should not be treated separately,” says Dr Schoeman. She adds that trying to say that you must take mental health leave adds to the discrimination.

“Why should we distinguish between anxiety or depression or hypertension or diabetes?” she says. “We are concerned about calling it a mental health day because that’s almost stigmatising it more.”

The other issue is where one draws the line. “Is it just someone waking up blue in the morning?” Dr Schoeman asks. “Or is it someone who is actually depressed?

“As psychiatrists we are objecting to the idea of a mental health day. We believe there should be more compassion towards leave for any type of compassionate needs.” She says there needs to be an increased awareness of employees’ need to take care of their mental health.

But, she adds, “Part of the stigma of mental illness is that people treat it differently – it’s a biological condition.”

The dangers of extended sick leave

Dr Schoeman says we should focus on prevention and manage our mental health before we reach the point of needing sick leave for a mental illness.

People are often booked off for longer periods of time because there is no work accommodation. “Take for example if you’re going through a depressive episode – during that acute, depressive episode, your concentration may be impaired, the medication you are taking may make you feel unwell and you may not be fully functioning for the first week.”

Dr Schoeman believes that you do not necessarily have to be booked off and spend three weeks in a hospital.

She also points to alarming research that shows if you’re away from work for three to four weeks, your chances of returning to full capacity at work is only 50%.

“So the longer we book people off, the less likely they are to become fully functional [at work] again. While you’re away from the office recovering, your work just piles up and you will probably return to stressors that make the problem bigger.”

Suicide is not a cowardly act – here’s what you should know

1024 683 Mandy Freeman

Published on Health24, 6 August 2018

Suicide is often labelled a cowardly and selfish act – for those who are left behind to pick up the pieces. But it’s not. I know this because I’ve found myself having those dark thoughts, and coming close to calling it a day on life.

To someone on the outside, it may have seemed like “the easy way out” when I contemplated suicide, but you have to understand that it was an incredibly difficult decision I was faced with. And the last person I was thinking about was myself – it was the people in my life who love me who were number one in my mind.

Yes, depression affects me first and foremost, but it also has a devastating impact on my husband who rides the emotional tides with me. He knows when my mood starts to dip and I know how it affects him, how I bring his mood down with mine.

He lives with the exciting weekend plans that we have to cancel because getting out of bed is too much of an effort. He has to find the right words to console me on the nights I sit crying on the couch for no conceivable reason. He has to convince me that I’m not a failure when a project I’ve spent months on has turned out (in my mind) to be rubbish. Perhaps this seems trivial, but it’s not. It’s exhausting, it’s frustrating and it’s called depression.

When you reach a point of contemplating (or planning to commit suicide), you believe that ending your life is the single easiest way to bring peace to your loved ones, to end the suffering that you cause them. Following that, it’s also about finally finding your own peace – depression is exhausting. It consumes you on a daily basis. The ‘Black Dog’ constantly reminds you you’re not good enough, you’re a failure… It’s completely irrational but it’s also completely real to the person who is suffering.

When suicide is newsworthy

We’ve lost so many well-known people to suicide over the years and every single time the news breaks, the world stops to mourn, to show anger and to throw judgement against the person, labelling them a coward and calling them selfish.

Chester Bennington.


Anthony Bourdain.

Professor Bongani Mayosi.

All of them immensely talented individuals who committed suicide. Suddenly mental health takes priority and we start to have conversations about it. But soon those conversations come to an end and the next big thing happens – protests, the petrol price, the unemployment rate…

What you need to know about suicide

1. Should it really take tragic celebrity suicides to shine the spotlight on mental health? 

Health24 writer Mandy Freeman reflects on the recent suicide of Linkin Park’s Chester Bennington. Why does the world only take notice of mental illness following the suicide of a celebrity?

2. What to do and say when someone wants to commit suicide

Celebrity chef Anthony Bourdain’s recent suicide sent shock waves through the world. Here are ways you can recognise somebody who’s contemplating suicide.

3.  ‘I Googled how to kill myself’

Suicide is not a cowardly act. It’s also not an easy decision to make. Health24 writer Mandy Freeman opens up about wanting to commit suicide.

The ugly face of depression

Depression is real and affects so many people differently. Don’t assume that because someone you know seems happy, full of life and always smiling, they are not secretly suffering. Chester Bennington’s wife, Talinda, tweeted this following his death:

You cannot know what demons a person is battling with internally. And in many regards, suicide is brave. When life is good, it’s good. But for someone with depression, when the dark cloud arrives, life gets pretty damn impossible.

Show compassion

So all I can ask is that we show a little more compassion to those who suffer from mental illness. The journey they’re on is not an easy one – it’s an emotional roller coaster day in and day out. And when a person finds themselves at the point of suicide, know that they have analysed every possible aspect and they believe this is their only way to find peace, and allow their loved ones a happier life.

Do you need help?

For a suicidal emergency call the South African Depression and Anxiety Group on 0800 567 567. Their 24-hour helpline is 0800 12 13 14. 

‘I Googled how to kill myself’

1024 683 Mandy Freeman

Published on Health24, 17 November 2017

My story didn’t end in a hospital bed having my stomach pumped, my wrists stitched or someone grabbing my waist before I jumped. But still I have survived a suicide attempt.

I found myself on Google.

I typed: “How to kill myself and make it look like an accident.”

Google pulled up a large number of results, and quickly.

Today, I just typed in those same words – Google spat out 937 000 results in 0.75 seconds.

On the first page I read – “Making suicide look like an accident”; “what’s the best way to kill yourself but make it look like an accident”; “making a suicide like some random accident”; “top 20 suicide methods: fastest and painless suicide methods…”
My hands are sweaty and my stomach is twisted in knots. I have to close the browser now.

But back in 2014 I didn’t. I started down a very dark rabbit hole. For hours I searched for the perfect solution. I wanted to take my life, to end the pain, to release those who loved me from the torment I presented them with every time I had a depressive mood.
But it had to look like an accident so that they would mourn for me and remember me for who I was rather than the way I had ended it.

That they would never know that I had decided to take my own life.

That they wouldn’t see me as the failure I was convinced I was.

That I wouldn’t be remembered as a coward.

Life didn’t make sense. I was tired. I was angry. I was frustrated. I felt worthless. I was a failure. I was in pain and ending my life would take away that pain. But most importantly, I was depressed.

Still I kept searching for the answer I was so desperate to find. Slitting my wrists would be messy. An overdose of pills doesn’t always work and I couldn’t find any mention of exactly what to take and how many. Hanging would be a logistical nightmare.

But a car accident would be easy. I could drive off Chapman’s Peak and into the ocean… “She lost control around a bend,” they’d say.

It was convenient too as I could do it at any time.

Then something snapped. Why was I choosing this way out when I had so much to live for? I quickly shut down the 20 browsers I had open. The next day I found a psychiatrist and booked my first session.

Today marks International Survivors of Suicide Day and I find myself remembering that awful night in February 2014. I am one of so many people who have come close to suicide.

Once again, I turn to Google but this time to find stories of survival. I find many. And what surprises me most is how similar they all are to mine.

Surviving life

In September 2016 The Mighty, a digital health community created to empower and connect people facing health challenges and disabilities, asked suicide attempt survivors what they wished people knew about their experiences.

Here are some of the responses that resonated with me:

“For me, it’s less about death and more about ceasing the pain. It’s difficult to explain how death would make you feel more alive than ever. I wasn’t running from my problems. I was desperately searching for a way to conquer them.” – Kacie S.

“It wasn’t really about dying. It was about escaping unbearable pain when I couldn’t see any other option. And I was convinced everyone would be happier if I was gone, that I was doing them a favor by unburdening them. This is why guilt trips like ‘think of what you’re doing to your loved ones’ don’t work for me… I’m so grateful to still be alive today. The pain did fade. I found other options. And I want to stick around, to see how this life of mine will play out.” – Erin L.

“My attempt had nothing to do with how ‘good’ or ‘bad’ my life is. It came from being tired. Tired of being me, tired of pretending, tired of being depressed.” – Valerie S.

“I shouldn’t be made to feel ashamed for what I did. I tried the pills, exercise, getting out more, I worked through the lists of the ‘acceptable’ courses of action. It felt like my last resort.” – Lindsey G.

“I wish people knew that it didn’t mean I didn’t love them. At the time, I honestly believed I was doing everyone a favor. I wish people knew the thoughts will always be there for some, and we deal with it day by day. It can be a lifelong process, almost like a recovering addict. I don’t think I’ll ever fully heal. I wish people would stop calling it selfish. Stop acting like it is something we’re doing to smite you. It’s. Not. About. You.” – Moranda J.

“Some people ask, “how could you ever give up on life?” They don’t understand the fact that the will of a suicide is more than just a simple desire. Even though you try not to think about it, even though you don’t want to do it, there is this strong and hopeless feeling of just… doing it.” – Daniel S.

(You can read all 41 experiences here.)

‘I am not a coward’

Suicide is not a cowardly act. It’s also not an easy decision to make.

Coming back from that dark place was a difficult journey. And there are still days when I think back on it – it brings me to tears to look at how great the last three years of my life have been. How much I actually did have to live for. What I would have given up.

Am I worthless? No.

Am I a coward? No.

Am I crazy? No.

Am I depressed. Yes.

I still battle my Black Dog every day but I know how to manage him.

Today, I choose to fight those dark thoughts but that’s all they are – thoughts. I choose life.