In Oprah Winfrey’s bombshell interview Sunday with Meghan, the Duchess of Sussex, one takeaway was that help for mental health is still hard to get — even if you’re part of the British royal family.
In Meghan’s first public comments since she and her husband, Prince Harry, the Duke of Sussex, stepped down as senior royals, she described herself as a victim of a Buckingham Palace that suppressed her personal freedom and worried about how dark the skin of her son Archie would be. She said these experiences severely impacted her mental health, resulting in suicidal thoughts that made the Duchess feel she couldn’t be left without supervision.
“I was really ashamed to say it at the time, and ashamed to have to admit it to Harry especially, because I know how much loss he’s suffered,” Meghan told Oprah. “But I knew that if I didn’t say it, that I would do it. And … I just didn’t want to be alive anymore.”
The Duchess said she had informed the palace she needed to go somewhere for professional help, but was told that she couldn’t because “it wouldn’t be good for the institution.”
“What comes with status, as it does with others, is a sense of shame, is a sense of this stigma that might come with being perceived as something’s wrong with, less than, that somebody is tarnished,” said Helen Neville, a professor of educational psychology and African American studies at the University of Illinois at Urbana-Champaign.
Stigma “impacts everyone, and probably the people we least expect it’s going to impact, it impacts,” said psychologist Hector Adames, a professor in the department of counseling psychology at The Chicago School of Professional Psychology. “It’s like when we get sick with the common cold: We’re all susceptible to it.”
Because a high-profile, public figure like Meghan was vulnerable about her difficulties, some people may become more willing to talk about their pain, stress or feelings of being trapped or losing hope, Adames said. What Meghan’s interview did reemphasize is that some of the challenges to getting support are universal, regardless of status.
Barriers to mental wellness
Mental health stigma that can prevent people from getting help prevails because “we’re socialized to believe that anything that’s different is bad, versus really celebrating our differences,” Adames said. “We see that with race, we see that with gender, that anything that’s out of the ‘norm,’ which tends to be Whiteness, that it’s deficient, it’s wrong. I think that also extends to mental health.”
Shame — another potential deterrent to seeking support — also stems from the lack of education about mental health, which can make these conversations on mental problems confusing, Neville said.
Some may think that their mental issues are their fault or within their control. Being uneducated can also mean people don’t know how to recognize that their experiences may indicate a deeper problem. For example, someone may think his constant anger is a personality trait, when anger could be evidence of depression or trauma.
Like the Duchess of Sussex, some people struggle in silence because they don’t want to burden other people with their pain — especially if loved ones are dealing with their own pain or stress, Neville said.
Additionally, some people lack health insurance and therefore access to mental health care. People with health insurance sometimes don’t have coverage for mental health services, can’t afford them or can’t find professionals who are sensitive to their race, ethnicity, culture, gender or sexuality.
People of color — Black, Latinx, Native American and Asian — face greater challenges in this respect. Because these groups have endured so much, they’re often told that they need to be strong. “While those messages might help us, on one hand, to survive pretty stressful situations,” Neville said, “on the other hand it can prevent folks from seeking out assistance.”
How we talk (or don’t talk) about suicide
When someone is crying out for help, we tend to want to understand and be supportive, Adames said. “But the unique thing about suicidality and people who have suicide ideation, is that it actually moves us to fear,” he added. “That fear paralyzes us, which in turn doesn’t help the person who’s calling out for help, and then it becomes a vicious cycle, increasing the chance of the person carrying out those thoughts they’re having.”
Sometimes those confessions about people wanting to hurt or kill themselves can remind us of our own pain or suicidal ideation, Adames said. One societal attitude toward suicide is that it’s selfish. If you’re having suicidal thoughts and want to tell someone, though, know that you’re not trying to cause other people pain, Adames added.
Having at least one person with whom you can be vulnerable is important, even if it doesn’t feel good. Tapping into the psychological strengths of your heritage, spiritual beliefs or connections with children or pets is also helpful.
If someone comes to you about suicidal thoughts, listen without distraction or jumping to a solution, Adames said. Trying to solve the problem is a natural response because you care, but people with suicidal thoughts need to feel heard and validated in terms of why they think suicide is the only way out.
“Oftentimes we run to like, ‘OK, what can we do so that you don’t kill yourself?’ Of course, we need to try to help the person not hurt themselves,” Adames said. “But I would encourage folks to become curious and empathize with their wish to die,” which doesn’t mean supporting that wish, but rather attempting to understand the reasons why from that person’s perspective.
“In that listening, we might be able to, with the person, create ways for them to feel less trapped” and more connected, Adames added. Suicide prevention is crucial, but the ideation stage is “our window of opportunity” to empathize and “help them create alternative ways that are more life-affirming.”
Where to find help
Meghan shared her story “because there are so many people who are afraid to voice that they need help,” she told Oprah. “I know, personally, how hard it is to not just voice it but when you voice it, to be told no.”
If you express your struggles and needs to loved ones but they rebuff you, Neville said, continue to reach out to others until you get the support you need. Government and nonprofit organizations in both the United States and the United Kingdom have multiple resources for mental health support, such as specialized help lines and treatment locators.
Additionally, several organizations offer support to those facing insurance or financial barriers, including the US-based National Queer and Trans Therapists of Color Network, Black Minds Matter UK and Mental Health America.
Believe in yourself, and that you’re not alone and what you’re experiencing isn’t your fault. “It will get better,” Neville added. “It won’t always be this difficult.”