I walk with a cane. Not all the time, but most of the time, because I’m weak from being ill for so long and it makes life much easier if I have something to lean on. 

Since I started using my cane, I noticed how much the attitude of strangers changed. At first, I was embarrassed. What were people thinking of me? Often, they would ask outright what was wrong with me, and I’d have to haltingly explain my illness. I felt weak, and needy, and like a fraud, because I’m not “properly” or permanently disabled.

But what I mostly noticed is this: people are kinder when I have my cane. Cars will slow down and let me cross. Strangers will hold open doors. They’ll talk in softer voices. They’ll offer to carry things. If I complain about something, they’ll listen more closely. I find this a bit disturbing, a bit wonderful, and very interesting.

Physical disability and mental health challenges are not the same thing – but they can have a very similar debilitating effect on us and our lives. It’s just that only one of them is always visible.

Last night, I had a nightmare that someone was chasing me. I am acutely aware that my physical disability, and my mental health challenges, make me a vulnerable member of society. I’m the weakest in the herd. I’m the most likely to be picked off. I dream about being attacked often. It’s a very basic response to my illnesses.

My cane is one way of asking people to be gentle. They don’t always listen, but 99% of the time they respond positively to the visual cue.

If everyone who had a mental health challenge carried a cane – how would we treat them? Maybe this is a stupid thing to say. But the response to Charlotte Dawson’s illness during her life, and the response now to her death, shows in incredibly stark relief the systemic misunderstanding and total lack of compassion many people have for mental health challenges.

In December last year, a few days before I went into a Respite house and during a time when I was self-harming routinely and openly talking about ending my life, the NZ Herald published a column by Bob Jones in which he prided himself on having encouraged a man to commit suicide. I wrote a response about the human cost of the lack of understanding of mental health in New Zealand – What is the Cost?

Please read it. Everything I said then stands now. The cost is life.

The World Health Organisation predicts that by 2020 depression will be the most significant illness in the world, accounting for 15% of the global burden of disease.

Based on Ministry of Justice statistics, we lose approximately 10 New Zealanders to suicide every week. The latest figure (for June 2012 to June 2013) was 541 people.

The most significant illness in the world. 541 people. And one of our major newspapers publishes a column by a man who gloats that he encouraged someone to kill themselves.

Unfortunately, the Herald learned nothing from this and continues to host columns filled with the sort of gross vitriol and total lack of compassion that reinforce the stigma that causes so many deaths.

On Saturday I saw many people online encouraging others to “reach out” for help if they needed it. I’m very very glad for such vocal support. However, I have some issues with this statement.

1. It implies it is easy to “reach out.” This is absolutely not the case. Asking for help is one of the hardest things I have ever had to do, and it’s not something you do once. You do it every time you tell someone you have a mental health challenge. You do it every time you ask for compassion. You do it every time you go to a doctor’s appointment, a psychiatrist’s appointment, a psychologist’s appointment. You have to ask over and over and over and it does not get any easier, because by asking you feel like you are “admitting” that you are “broken.” The stigma tells you to keep silent. The stigma tells you it is wrong and unattractive and needy and weak to ask for help. This is socialised stigma you have to fight every step of the way. It is not easy to reach out.

2. It implies you know you need help. You may not know. You may think that these are just “your demons.” (Ugh, horrible phrase). You may think you should just, or can just, “tough it out.” You may have an illness that is so strong it convinces you that you are fine. This is incredibly common.

3. It implies you want help. When you are very depressed, it can become almost a comfort blanket. Fighting for good mental health is hard. Letting it rule you can be easier. Sometimes, you don’t want help. The illness tells you you don’t deserve it, that it’s not worth the effort. How can you “reach out” if you are so ill you don’t want to, or feel like you can’t, change?

4. It puts the onus on the ill person. What would it mean if we talked about “reaching in”? What about if we stopped blaming people for their brain chemistry, and offered them support?

5. “Reaching out” does not necessarily mean you will get help. Mental health services are massively underfunded and oversubscribed in New Zealand. If you’ve never needed to, or asked for, help, you may not realise this. You may think that, as soon as someone puts their hand up and bravely says “Me. Yes, I need help” – they get it. No. They don’t. I know, because I’ve been that person. I have several friends right now who are that person. First of all, you have to be an acute case to access any services. I told my doctor for months that I was seriously depressed. It took me walking into his office and saying the words “I want to kill myself. I’m going to do it” to finally get the referrals I needed to survive. I know people right now who need those referrals too, and they can’t have them, because the services can’t provide.

You know what makes me even more furious and devastated and totally, utterly dismayed than suicide itself? The response –  to people who share their struggle, and to death if that’s what happens . The complete lack of understanding and compassion. If people can understand that I need to use a cane to walk, and treat me with respect because of that (even if they have never experienced my illness) – how can they not understand that brain chemistry can be just as debilitating and fatal, and act as gently with their words as they do with their hands? Words hurt. Words are abuse. Words may be the one thing that change the journey for someone who is suffering.

Think about yours before you use them.