What, Exactly, is “Agency” in Mental Health?

When you’re diagnosed with a mental illness, one of the very most important things to do is to learn to advocate for yourself. If you’re not capable of doing that, it is my sincere hope that you have somebody to help you until you’re able to take back the reins.

Being your own advocate is crucial to achieving mental wellness, and reaching for (sometimes even fighting for) your agency can be the linchpin to being well. If someone is pulling the puppet strings when you’re capable of being your own best advocate, you are not being a good steward of your mental health (and neither are they).

It should be noted that realizing and coping with a loved one’s mental illness can be extremely stressful and can sometimes mean taking care of even the most minute details of a loved one’s life. In this instance, it can be difficult to let go of the very control that has protected said ill person’s safety – and sometimes even their very life, when that person is dealing with the Beast that is suicidality.

So, how does a person who has a mental illness exert agency? Hopefully, they understand why they are/were unable to be their own best advocate when in the throes of a mental health crisis. That said, it does no one any good to continue to keep a tight control over someone who can manage their illness on their own. Admittedly, deciding when to hand back the reins can be, to put it mildly, difficult. Baby steps can be very helpful to all parties involved.

Now, for the purposes of this blog post, we’ll make the assumption that the person who is dealing with mental health issues is more or less stable and capable of exerting their own control over their life and decisions. Why, exactly, is agency so important? Well, when we make our own decisions, we are active players in our own story. I’ve discussed being a pilot or a passenger – trust me, you want to be the pilot in your own story. It’s what makes you unique.

When you take/retake agency, you need to be prepared for several responsibilities – beyond feeding yourself and taking out the trash. You need to ask questions and educate yourself on your mental illness. Is it worse in the summer? Is there an anniversary date that can throw you for a loop? Are you hiding episodes of mania? What meds are you taking and why? And beyond educating yourself about your illness and its treatments, you need to build trust in your healthcare providers.

In the battle with the Beast, it is crucial to have good working relationships with your therapist and psychiatrist. You should be as much of a participant in your treatment as you are able. You want your relationships with your therapist and your psychiatrist to be working partnerships, built on mutual trust. In that vein, you need to be honest with your treaters – lying or withholding pertinent information from them doesn’t hurt them. It hurts YOU.

Even if you have to tell them something that may have consequences – for example, that you are actively suicidal and not safe on your own (which will likely result in a hospitalization neither of you wants, but that could save your life). You need to remember that the endgame is not suicide.

In order for your treaters to work with you when things are going awry, it is important that they trust you as much as you trust them. (Being passive-aggressive or outwardly aggressive when things go sideways doesn’t help anyone.) Establishing trust takes some time – and effort – on both sides.

As I’ve mentioned, among the things that will help you is learning about your illness and its treatments. Read up on the causes and symptoms of your disorder – as well as the various treatments that are currently available. Always remember: you are your own best advocate. Do your research. Become educated about your symptoms, triggers, and medications (if you take any).

If you don’t trust your treater(s), first take a breath. There are options out there, even if you don’t have resources locally. (Remember, Covid brought us virtual therapists and psychiatrists.) Research who is taking patients, read patient reviews, and ask your peers about their treaters. Find somebody who will be relentlessly in your corner, someone you can talk to about the Beast and your battle to survive, someone who can help you beat back the Beast. And participate in your own treatment – nobody has a better vested interest in your mental health, and no one knows you better than YOU.