One of the most important lessons I learned from the passenger seat of my best friend’s recovery journey is the saying "you are only as sick as your secrets."
The adage from Alcoholics Anonymous is something we talked about a lot, the idea that telling our truths could be healing for ourselves and others, and that conversely, shame and secrecy only fuel addiction and mental health issues.
Since my friend and longtime community and arts leader Rahwa Habte’s death on Aug. 27 after a long battle with mental illness and addiction, I have grappled with how to make meaning from the incomprehensible. How could some good come from the heartbreak and grief?
One way we can honor her legacy is to begin to break the silence and have a long overdue public conversation about the reality of mental illness and addiction, a conversation Rahwa started herself with her many public posts about her experiences and her work within the recovery community.
Of all the things I am proud of her for — and there are so, so many — her openness and transparency around her struggles with her recovery top of the list. Because as a society, we have a denial problem when it comes to mental health and addiction, especially in these pandemic times.
Increase during pandemic
Even before the pandemic, the Washington State Department of Health said that for every person with mental health needs who receives treatment, there are more who don’t, and now COVID-19 has only made that worse. The state estimated in August that 3 million Washingtonians will experience "clinically significant behavioral health symptoms" over the following two to five months, and predicted a significant increase in self-medication and substance use over six to nine months as well.
For people of color, low-income people and essential workers — often the same group — the impacts are even worse, the DOH said. Those groups are experiencing some of the worst health and economic effects of the pandemic.
This dismal forecast isn’t helped by the abrupt halt to many of the usual avenues for recovery support — such as in-person groups — due to COVID-19.
Joshua Wallace is the CEO and president of Peer Washington, an organization to provide peer emotional support for people impacted by addiction, mental illness or HIV and AIDS, and the parent organization to Peer Seattle, where Rahwa found a recovery home.
"What we know is that isolation is the biggest cause of the degradation of our disease," Wallace said. "Stigma is really what pushes that because the embarrassment of it oftentimes has us sitting at home alone, not talking about it, not admitting it, not being honest about it with those who care about us and love us."
He said that people in recovery internalize societal messages that if you are struggling with mental illness you are broken and if you are struggling with addiction you are a moral failure. Being in a community of people with the same lived experience helps to break down those messages, he said.
Yet COVID disrupted the crucial safety net Peer Seattle and many organizations built. Because of the coronavirus, Peer Seattle had to shut its doors to in-person support group meetings and groups moved online.
Jonathan Cunningham, a longtime friend of Rahwa’s (and mine as well), has nearly six years of sobriety. He said while online recovery support meetings work great for some, they can be a poor substitute for many people. Some don’t have the necessary technology — internet and a device to access it — and others miss personal connections and the "meeting after the meeting" in the parking lot or out for breakfast with someone who needs extra support.
"[Online vs. in person is] the difference between transactional and relational," Cunningham said. "Being able to regularly go to meetings is a very relational experience." People know and recognize you and can help lift you up when needed, he said.
"The places where the disease thrives — like liquor stores and cannabis shops — are alive and well," Cunningham said. "The places where recovery can happen are shut down."
Storytelling as a tool
What would it take for us to change the conversation around mental illness and addiction? How could we begin to normalize caring for our mental health as we do physical health? How could we approach people who are struggling with compassion instead of judgment?
At Asian Counseling and Referral Service, trying to shift attitudes toward mental health and addiction has been a decadeslong project. ACRS Behavioral Health Services Director Yoon Joo Han said while stigma exists everywhere, within some immigrant and refugee communities it can be especially hard to break through entrenched belief systems around mental illness.
To combat that, Han said ACRS uses storytelling to teach clients and families that mental health and physical health should be treated the same. Just as you should not be discriminated against for having high blood pressure, you should not be treated poorly when you have mental illnesses, she said.
To break the stigma around mental illness and addiction, "we need more brave Asian people or immigrants or people of color talking about their experience openly, honestly with people and encourage other people to talk about it," Han said.
The more we talk about it, the more we will understand that mental illness and addiction touch all of us, and that stigma only makes the problem worse.
"If people were able to put their hand up and say, ‘hey, I need some help’ and we were more of a warm, welcoming society, I think a lot of changes could occur," Cunningham said.