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Diverse Views Give New Meaning to Mental Health Experiences

A cross-cultural exploration of meaning-making in mental health journeys.

Key points

  • Level of support can be key in recovery after a first episode of psychosis.
  • Different cultures assign all sorts of meaning to mental health challenges that we can learn from.
  • One study suggests that post-traumatic growth is experienced by as many as 83% of people with mental illness.

I learned about the Neurodiversity Gifts initiative through an international professional organization on psychosis. Learning about Neurodiversity Gifts led me to meet its creator Joshua Roberts, a scholar with an MA in theology and BA in psychology, a peer support specialist helping create the next statewide exam for California, and a person who experienced six involuntary hospitalizations before his recovery from Bipolar I disorder. Joshua spent much of his formative years in South Africa and carries a multidimensional mental health perspective. I was intrigued.

A First Episode

I met with Joshua to discuss his ideas and learn of the meaning he made in his journey. He shares about his initial episodes of psychosis, which occurred while he was surrounded by people close to him. In those times, though his experiences were extreme, he found himself in a state of safety. He reflects, "They were able to kind of dance with me until I came out of it."

Indeed, research shows that how a person is greeted in their first episode of psychosis often makes a major difference in recovery. A study following individuals in early psychosis through 18 months found that perceived emotional support correlated positively with remission (Tempier et al., 2013). The Open Dialogue Approach, an intervention that focuses on resourcing an individual's support system through intensive intervention, often at home, has had remarkably promising initial outcome results in Scandinavian countries (Seikkula et al., 2006).

Finding Meaning After a Dark Turn

Yet his third encounter with a mental health episode was in the United States and proved to be starkly different. Mania and psychosis wisped away from him thousands of dollars in a spending spree. He found himself arrested for what police falsely believed to be behavior influenced by LSD. He shares, "I was being told, sorry man, it's called Bipolar I, you have a lifelong disability, you may want to lower your expectations about what's possible. And so I trusted the authorities and I believed them and I lowered my expectations, which became a self-fulfilling prophecy. Life started sucking and I had to quit my job because I couldn't work; I had to drop all my classes at school. And really it was just a downhill spiral. Until I discovered, wait a minute, there may be some different ways to see these kinds of things."

Tragically, bleak messages like this have been common within our mental health system, particularly when an individual faces serious mental illness. A rapid change in one's capacities followed by a discouraging prognosis can be immensely dispiriting.

Still, this was not the end of Joshua's story. Through his studies and interests, Joshua made meaning of his experience. He shares, "And as I started investigating these alternative perspectives on mental health, it gave me a sense of meaning and purpose and allowed me to go back to school, where I wrote all my papers on these states of consciousness. I was able to turn my mess into a message.”

Joshua's South African heritage proved to be a particularly useful strength. He shares about traditional South African conceptualizations of extreme experiences. “South Africa has 11 official languages. There are the Zulu people and the Xhosa, the Afrikaans, and the English people. It's also a melting pot of fresh ideas and fresh perspectives that meld old-world understanding and traditional concepts with new-world, cutting-edge understandings as well. And so one of the modules in Neurodiversity Gifts is ‘Beyond Culturocentrism,’ learning what we can from different cultures. We explore the Japanese perspective, the Filipino Babaylan, and the South African Sangomas."

Capturing jewels from these diverse viewpoints freed Joshua to move toward his recovery. Indeed, a qualitative study of 15 participants diagnosed with serious mental illness found that many experienced post-traumatic growth. Interviews showed that many achieved discoveries toward self-acceptance and fulfillment (Wang, et al., 2019). As with other kinds of suffering, finding meaning in one's experiences appears often key in healing.

A Place for Treatment and Community Support

As remarkable as some of these gains may be, mental health conditions are still often associated with intense pain. Treatment including psychiatric interventions like medication and psychotherapy are often necessary. Joshua shares, “Medication may well have saved my life when I was in the throes of my psychosis. I was doing things like jumping from white line to white line in the middle of moving traffic because I thought it was all a game. And so the right dose and type of medication can really ground you so that you're connected to the physical world.” With the support of his psychiatrist, Joshua has since been able to taper off all his medications and replace them with other approaches.

Still, he recognizes that many continue to benefit from medication longer-term and emphasizes that recovery is open to everyone.

Through his initiative of Neurodiversity Gifts, Joshua is seeking to assist others in creating communities of hope and peer support for individuals living with mental health conditions. True to Joshua's own path, the platform explores diverse constructs on mental health reaching across multiple cultures and schools of thought. Community support is a key component in recovery for many. While many struggle in isolation, connection is strongly linked to well-being. Research shows that community integration correlates with several markers for mental health recovery (Jun and Toi, 2020).

Joshua remarks, "I think we need community-based mental health, where people have the time, they have the resources, they have these mutual projects they can engage in together through collaboration and a creative space that allows people to discover their own gifts, to learn to work in teams in our social ecosystem.”

Post-Traumatic Growth

Post-traumatic growth encompasses the gems one may discover after a traumatizing experience. A qualitative study found that 83% of participants who had faced significant mental health challenges reported aspects of post-traumatic growth (Slad et al, 2019). This included a renewed appreciation for life, self-discovery, a greater sense of well-being, and relationship changes. Research shows that alongside the great trials mental illness brings, many emerge stronger just as has been reported by individuals who have experienced other types of trauma, such as cancer survivors. Celebrating this is not meant to glorify the conditions and associated suffering, but to capture opportunities for growth.

Mental health recovery is possible; growth is possible. The experiences of mania, depression, and psychosis can be immensely painful and dangerous. As well, many find meaning. Through their experiences, many re-emerge stronger than before. Joshua's story grants us hope.


Jun, W. H., & Choi, E. J. (2020). The relationship between community integration and mental health recovery in people with mental health issues living in the community: A quantitative study. Journal of Psychiatric and Mental Health Nursing, 27(3), 296-307.

Seikkula, J., Aaltonen, J., Alakare, B., Haarakangas, K., Keränen, J., & Lehtinen, K. (2006). Five-year experience of first-episode nonaffective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies. Psychotherapy research, 16(02), 214-228.

Tempier, R., Balbuena, L., Lepnurm, M., & Craig, T. K. (2013). Perceived emotional support in remission: results from an 18-month follow-up of patients with early episode psychosis. Social psychiatry and psychiatric epidemiology, 48, 1897-1904.

Wang, X., Lee, M. Y., & Yates, N. (2019). From past trauma to post-traumatic growth: The role of self in participants with serious mental illnesses. Social Work in Mental Health, 17(2), 149-172.

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