The way we perceive mental health and illness is vital in terms of making it more acceptable for people to access help when they are struggling with mental health issues, whether acute or chronic. An estimated one in five people has a diagnosable mental health condition. Sadly, in spite of suffering often debilitating symptoms, many people are much less likely to talk about or seek help for mental health concerns than for physical health conditions. Stigma, embarrassment, fear, and lack of information are common barriers to people getting the needed help for mental health issues.Recently I found information on the “Campaign to Change Direction” in the USA, where various stakeholders work together to raise awareness and create a new narrative about mental health, mental health awareness, and wellness. The campaign is a coalition of non-profit, government, business, faith community leaders, and many others, led by “Give an Hour”, an organisation that provides pro bono mental health services to military members, veterans, and their families.The then First Lady of the USA, Michelle Obama, said at the campaign launch in Washington DC, “It is time to flip the script on mental health in the country. It is time to tell everyone who is dealing with a mental health issue in this country that they are not alone and that getting support and treatment isn’t a sign of weakness – it’s a sign of strength.” The campaign grew out of discussions at the White House National Conference on Mental Health in 2013, held in response to the Sandy Hook tragedy. On December 14, 2012, 20-year-old Adam Lanza shot and killed 26 people, including 20 children, between six and seven years old, and six adult staff members, including the principal and psychologist at Sandy Hook Elementary School in Newtown, Connecticut, USA. Before driving to the school, Adam shot and killed his mother at their Newtown home. As first line responders arrived at the school, Adam committed suicide by shooting himself in the head. The investigation provided evidence that he was diagnosed with Asperger’s Syndrome (high functioning Autism), had poor social skills, was a loner and had been suffering from anger problems, anxiety and depression for many years. He often posted how he hated humanity and reported that he had no need for people or relationships. After this event a diverse group of leaders from the Campaign to Change Direction set goals which included to:Free us to see our mental health as having equal value to our physical health.Create a common language that allows us to recognise the signs of emotional suffering in ourselves and others.Encourage us to care for our mental well-being and the mental well-being of others.An expanding list of non-profits and businesses joined the effort and made pledges to deliver educational tools and programmes that will help change the national conversation about mental health. Over the next five years, these efforts would collectively reach more than one million Americans with particular target audiences to include military personnel, veterans and family members, students, teachers, school officials and coaches, first responders, and members of faith-based communities.The American Psychiatric Association (APA) and American Psychiatric Foundation (APF) aimed to build upon several programmes to support the Change Direction campaign. APF has had a long-standing effective collaboration with Give an Hour to help provide care to service members. APF is also working, through its “Typical or Troubled” programme, to train school personnel to recognise signs of mental distress among students and help refer them to appropriate mental health services if needed. A major focus of the Change Direction campaign is to help people recognise early signs of mental distress and encourage them to reach out. This includes identifying five signs that a person may be experiencing mental distress and may need help:Personality changesUncharacteristic anger, anxiousness, agitation, or moodiness Withdrawal or isolation from othersPoor self-care or engaging in risky behaviourBeing overcome with hopelessness and overwhelmed by circumstances.This mental health awareness approach includes encouraging anyone who sees a friend, co-worker, or loved one suffering to reach out, offer help, show compassion and caring, and be willing to find a solution. “We know that mental health is just as vital as our physical health, so it’s time we started treating it that way,” Michelle Obama said at the launch. “And that’s going to take courage from everybody – courage to reach out and have those tough conversations with a friend (or family member). The courage to listen, and seek help for ourselves when necessary.” Mental health conditions are no different than cancer, diabetes, or any other illnesses and our approach to treating them should reflect that.Here in South Africa, we, including government, can learn from our own experiences as well as from other countries and their tragedies. May we realise that mental health problems are real and if not treated, can have devastating effects on children, families, communities and the like. Mental health starts at home and we need to create more resources for parents to seek help for themselves and/or their children. May we break the stigma of mental illness being a sign of weakness or madness and realise that we can all suffer in this way, that our minds and psyches are impacted from a very young age and that mental health problems are as common as the common cold and nothing to be ashamed of. Untreated mental health illnesses often have far reaching negative effects, including impaired parenting capacity, child development, academic achievement, social skills and relationships, as well as impaired capacity to work, sustain a job and make a valuable contribution to society. Carin-Lee Masters is a clinical psychologist. Write to her at [email protected] or send a WhatsApp message or SMS to 082 264 7774.