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“Surprise, Surprise”: Increasing Diversity in YA Novels of Mental Illness by Diane Scrofano

7/25/2018

3 Comments

 
I love people who are industrious. I especially like having a few of them for friends when I am trying to have a summer break that includes a trip to Disneyland, a family reunion--that I was theoretically in charge of--(any of you who are the oldest child with younger siblings no what i am talking about.), helping with aging parents, and trying to take a week of so that Dana and I can take a golf retreat at Bear Lake, Utah. Okay, enough of my whining.

Enter Diane Scrofano. Diane was one of the presenters at the YA Summit in Las Vegas and prepared a blog post on the topic of her presentation. It focused on YA connections to Hamilton and you can find it here.

Like I said, she is industrious and awhile I was wondering what to do earlier this week, Diane sent me this post and asked if I was interested. It goes back to her interest in YA and mental illness, an interest she shares with her new friend,  colleague, and fellow summit presenter Kia Richmond (Kia has a blog post on a parallel topic and about a year ago--look for the book soon.) It many ways these two post are great companion pieces for a class. Diane reminds us that July is National Minority Mental Illness Awareness Month. The following post explores titles that if you don't know them they should soon be added to your "to be read" list. I know I added a couple of titles to mine.
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#CureStigma, #MinorityMentalHealth

“Surprise, Surprise”: Increasing Diversity in YA Novels of Mental Illness by Diane Scrofano

​In the fall of 2014, I was a new mother who had recently completed a sabbatical during which I had gestated both a baby and a considerable amount of research on mental illness in young adult fiction. Eager to prove that I could be both a mother and a scholar, I got myself and my breast pump on a plane and headed across the country to the National Council of English Teachers (NCTE) Conference in Washington, D.C., to give a poster session. The conference was so big that I got lost within the hotel where it was held and nearly missed the window of time during which I was supposed to stand in a small cubicle in the exhibit hall and pin up my 8.5x10” Power Point slide print-outs for people to view. I quickly realized that the hordes were more interested in the free books than in my annotated bibliography, so I took a proactive approach, foisting my handouts on anyone who happened by. It all was worth it, though, when I saw my former professor, YA library history legend, Michael Cart, strolling down the aisle in a humble baseball cap. I effused to him how he might not remember me from UCLA, but here was this work I had done on YA novels of mental illness, and so on and so on, and, at one point, I proclaimed “there’s a lack of diversity in these mental illness novels!” Admittedly, this wasn’t a huge scholarly bombshell, but I was excited. Michael smiled warmly and knowingly, and replied, “Surprise, surprise.”  

I was surprised by the obvious again, this time more recently, when I found out that July is Minority Mental Health Awareness Month and that it has been since the U.S. House of Representatives declared it so in 2008. As a NAMI volunteer and a co-advisor of my community college’s chapter of NAMI on Campus, I knew about the annual May Mental Health Awareness Month and the Mental Health Awareness Week which happens annually in October—most NAMI Walks across the country happen in either May or October for this reason—, but Minority Mental Health Month gets less attention. As Michael Cart might say, “Surprise, surprise.” So, to do my little part this July to help build awareness of Minority Mental Health Month, I’d like to consider my research on YA novels of mental illness in terms of diversity—ethnic and otherwise.  As NAMI says, “Mental health conditions do not discriminate based on race, color, gender or identity. Anyone can experience the challenges of mental illness regardless of their background….In many communities, these problems are increased by less access to care, cultural stigma and lower quality care.” It’s important that teens of color and teens of varying sexual orientation and gender identity see themselves represented in the YA literature of mental illness. So that you can recommend such books to teens, I’d like to provide an overview of some of the titles featuring diverse characters with mental illness and what gaps in coverage will hopefully be filled by promising YA authors of the near future! 
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​Serendipitously, the idea of Minority Mental Health Awareness Month comes to us from the literary community! The inspiration for the annual July awareness campaign is renowned African American author Bebe Moore Campbell, whose 2004 novel, 72 Hour Hold, remains one of the few portrayals of a non-white person’s experience with mental illness. While not marketed as a YA novel, probably because it is narrated by the mother, it chronicles the experiences of an African-American teen suffering from bipolar disorder. Campbell’s narrator draws interesting parallels between mental illness and slavery—they both inflict wanton violence on whole families. Of the few other mental illness novels with African-American characters, none really referenced the African-American heritage the way that Campbell did. (The only exception might be in Karen Fortunati’s The Weight of Zero, in which Catherine, of Polish ancestry, is inspired to fight her mental illness as she researches a female African-American World War II soldier’s life in a museum directed by her best friend’s mother. Best friend Krystal and her mother are African-American, and Kristal has an eating disorder.) Furthermore, 72 Hour Hold was the only novel I found in which characters went beyond treatment and also got involved in mental illness advocacy. Campbell, herself the loved one of a family member with mental illness, founded the NAMI Urban Los Angeles chapter and was active in the national organization until her death in 2006. 
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​In Brandy Colbert’s Little and Lion, white teen Lionel suffers from bipolar disorder. His step-sister, Suzette, is African-American and bisexual. The whole family is Jewish. While I was worried that this novel was trying too hard to feature diversity, the novel is set in Los Angeles and the whole thing felt organic, not tokenistic. Mental illness figures into the plot because Lionel has gone off his medication and Suzette doesn’t want to rat him out to their parents. So, while the non-white character doesn’t have mental illness, she is definitely affected by it as a family member struggling to provide the right kind of support to her brother. Overall, Suzette struggles with whether to be honest about both Lionel’s medication non-compliance and her sexuality. 
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​In I Will Save You, Matt de la Peña alludes to his main character’s dark skin without naming any ethnicity specifically. Protagonist Kidd has recently run away from a treatment facility and his schizophrenia symptoms begin to threaten his relationship with a wealthy white girl whose family vacations at the California beach campsite where Kidd works. In Ball Don’t Lie, de la Peña’s main character, Sticky, who has OCD, is a white foster child living in an urban African-American community. Because disadvantaged Sticky wouldn’t have a name for his condition, the diagnostic term “obsessive-compulsive disorder” never appears in the narrative; one can find it only in the Library of Congress subject classification terms listed on the verso page of the novel. 
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​In John Green’s most recent novel, white, middle-class Aza struggles with obsessive-compulsive disorder and medication noncompliance. Aza lives in a modest single-family home with her mother. Her best friend, Daisy, a Latina, lives with her parents and siblings in an apartment. Initially fascinated by the local news story of a voracious businessman who has disappeared after charges filed against him, Daisy and Aza befriend the business tycoon’s son, Davis, at first hoping to solve the mystery and collect the reward money. When the friendship turns real, Davis gives Aza and Daisy $100,000, an amount equal to the reward money, so that, as the friendship continues, Davis can be sure they stay around because of him and not because of the prospect of gaining the reward money. However, Daisy and Aza’s use of their $50,000 each brings up a curious intertwining of mental illness and social class. Part of OCD can be scrupulosity, and Aza immediately feels guilty about taking the money because all of the businessman’s assets were supposed to have been seized by police (Davis has given them the money out of a hidden stash). Daisy can sense this, and she tells Aza off, implying that Aza’s scrupulosity is made possible by privilege, as Aza’s single mother always planned to send Aza to college while Daisy can go only if she keeps this money. Daisy also immediately buys a car and a laptop, for which Aza chides her and cautions her to save her money instead. Daisy resents this as well and points out that Aza already had her own car and laptop while Daisy writes her trademark fanfiction on her cell phone. The fanfiction is another source of contention between them. Aza, often consumed with her own problems, does not read Daisy’s years’-worth of fiction, and so there’s an unlikeable character just like Aza floating around cyberspace in these stories. Aza must learn to overcome the self-centeredness which sometimes results from mental illness. 
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​The Memory of Light, by Francisco X. Stork, is unique in that it doesn’t just have one ethnic-minority character but rather features a cast of almost entirely Latino characters near Austin, Texas, with varying life experiences reflective of the multidimensional Latino community in the U.S. Vicky Cruz, whose grief at the loss of her mother to cancer has turned to depression, struggles to fit into her ambitious, upwardly mobile family. Her successful real estate mogul father, Miguel, and Harvard-student sister, provide a stark contrast in social class to Gabriel, a gardener’s son, who Vicky meets in the hospital after her suicide attempt. Thoughtful and well read, Gabriel is in the early stages of schizophrenia. Vicky feels defeated by her parents’ plan to send her aging nanny to retire in Mexico while Gabriel worries about who will take care of his aging grandparents if he becomes permanently unable to work. Emilio, another blue-collar patient staying in the psych ward with Vicky and Gabriel, introduces himself by calling Vicky out as weak and privileged since she couldn’t deal with her problems and tried to kill herself. Vicky struggles whether to tell on Mona, a recovering addict who has stopped her medication for bipolar disorder.
 
Mona was one of the few characters I found in YA novels of mental illness who had the quite common “dual diagnosis” of mental illness and substance abuse. To find more dual diagnosis stories, I suspect that I’ll have to search the YA novels of drug abuse. The problem novel about drug use has been a widely acknowledged subgenre in YA fiction since the 1970s’ Go Ask Alice, and I wonder if many books marketed as stories of drug abuse will also include a character trying to self-medicate for mental illness. The possibility that a book about a mentally ill person who self-medicates with illegal drugs would be marketed as a drug novel instead of a mental illness novel brings up a variety of interesting questions: is drug use more socially acceptable, even glamorized in the media, and less stigmatized than mental illness is? Will a drug book sell better than a mental illness book? (If this turns out to be the case, then it’s probably significant that Rainbow Rowell’s Fangirl, which I will bring up again later, focuses on the anxious nerdy character rather than the party girl. Wren, who has a drinking problem, takes a back-seat in the narrative to protagonist Cath, who suffers from anxiety.)
 
Or does the separation of the drug subgenre from the mental illness subgenre stem from a bias in the other direction, against the drug user? Does the reading public, who publishers are marketing to, still see drug use as a lifestyle choice more than a mental illness? Are characters with genetic predisposition to mental illness more sympathetic than those who are genetically predisposed to addiction but nevertheless must make a choice to try illegal drugs?
 
Getting back to The Memory of Light, a kindly psychiatrist, Dr. Desai, helps Vicky see that she can make a place for herself and take an active role in solving seemingly insurmountable problems. We find another Indian mental health professional in Matthew Quick’s Silver Linings Playbook. Pat, white, is less than sensitive or politically correct when he’s surprised to see his Indian therapist and several friends at the Philadelphia Eagles football games. The therapist and his friends know they might be looked at askance, so they flaunt their differences by painting their bus to say “Asian Invasion.” The American Psychological Association reports that, although the psychologists of the U.S. are over 80% white, according to 2016 data, (Lin et al., 2018), the profession has been diversifying over recent years (2015). The psychiatrist in Teresa Toten’s The Unlikely Hero of Room 13B wears dread-locks and has a Caribbean-sounding last name. So, perhaps the ethnic representation of psychiatrists in fiction is starting to mirror the increased diversity in the profession, and non-white psychiatrist characters in fiction can also underscore the importance of cultural sensitivity in medicine, which can often be achieved when a young patient of color is able to see a therapist of color. 
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Another Latino-focused novel of mental illness is Erika L. Sanchez’s I Am Not Your Perfect Mexican Daughter. Julia is the ambitious daughter of Mexican immigrants living in urban Chicago. Julia’s parents are nervous about her plans to move out of state to go to college; can’t she be more like her “perfect” older sister Olga, who works as a receptionist, dabbles in community college, and spends lots of free time with their parents? The accidental death of Olga exacerbates Julia’s preexisting depression and anxiety, resulting in a suicide attempt halfway through the novel. At the hospital, Julia is educated about mental illness: “I’m not surprised—I always knew something was wrong; I just didn’t know what it was, that it had an official name” (219). While Julia is the daughter of a factory worker and a housecleaner, they have “insurance through the state” (218), so Julia gets quality care and continues to see her expensively attired psychologist after her release from the hospital. In addition, Julia’s parents send her to stay for a few weeks with relatives in Mexico to recuperate, though times are tense with drug traffickers’ presence constantly hovering in the village. Despite the hardships she witnesses in Mexico, Julia wonders if her family’s cramped Chicago apartment and her parents’ dead-end jobs were worth the dangerous, illegal journey to the U.S., especially after she learns that her mother was raped along the way. On the other hand, knowledge of her parents’ hardship, that the U.S. “isn’t the promised land for everyone” (339) is, in part, what drives Julia’s ambition, the ambition that is ironically misunderstood by her parents. Julia says of her desire to leave her family to go to New York: “What a waste their journey would be if I settled for a dull, mediocre life” (339). Over time, Julia comes to understand that her parents’ overprotectiveness results from their desire not only to maintain their family-centric Mexican culture but also from their fear that they will not be able to guide or protect her in this new country. By the end of the novel, Julia’s parents become more at peace with her independent personality and allow her to go when NYU offers her a full scholarship.
 
Also on the topic of Latino characters in novels of mental illness, it may also be worth noting that two of the boyfriends in Rainbow Rowell’s Fangirl are Latino. In that novel, sisters Cath and Wren struggle with anxiety and alcoholism, respectively. Rowell points out, though, that there is a sizable Mexican population in Nebraska, where the sisters grew up and went to college. Realistic setting details or token minor characters of color? You decide. 
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​Wild Awake was the only novel I found featuring an Asian protagonist with bipolar disorder. Kiri seeks to solve the murder of her older sister, an artist struggling with addiction. Along the way, Kiri develops a relationship with a young man with schizophrenia. She’s ok with him taking medication, but she’s not sure she’s ready to go that route. 
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​In this novel, Lily (formerly Tim) is transgender while Dunkin (Norbert’s nickname, after the donuts) has bipolar disorder, as probably did his father who recently committed suicide, prompting Dunkin and his mother to move to Lily’s neighborhood in Florida to stay with his Jewish grandmother. So, while we have mental illness and gender identity in one book, they do not reside in the same character. There seem to be fewer stories where one character has multiple conditions that make him/her different from the mainstream than stories where multiple characters are each assigned some single quality that makes them different. In real life, a person can differ from the majority in more ways than one at the same time, and that should be reflected in fiction. One possible example of a book with a gay and depressed character is Fans of the Impossible Life, by Kate Scelsa. 
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​In this novel, Sebastian (Sebby) and Miranda (Mira) have stayed best friends after their release from the psychiatric ward. Both had made suicide attempts. Mira’s mother and father are an interracial couple, with her mother being white and Jewish and her father being black. With both of them being lawyers, they have enough money to get Mira the care she needs and also to transfer her from her public school to a private one. Yet it is made clear early on that Mira’s house is “the one holdover on the street from an age before people in the neighborhood started building faux mansions that went up to the edge of their property lines” (19).
 
While Mira’s depression seems more biologically originated, Sebby’s has been triggered by the trauma of a hate crime. Sebby was severely beaten for being gay. Sebby is a white foster kid living with an Evangelical Christian woman and struggling with drug addiction. Mira and Sebby befriend Jeremy, who has been the subject of bullying for having two dads. Jeremy and Sebby raise the question as to whether mental illness, when presented in novels whose characters have trouble fitting in, should be presented as a result of circumstances and the struggle to fit in socially or whether that mental illness should be presented as genetic and inherited as well. This issue raises some interesting questions: is a story of mental illness caused by trauma necessarily a different story than a story of mental illness that is not? Is a character who is depressed because they’ve been bullied for being gay or transgender significantly different from a story of a straight kid who wakes up one morning not wanting to get out of bed for no apparent reason? According to Michael Cart (2016), gay teens are two to five times more likely to attempt suicide than straight ones. Is the depression a result of a lack of social acceptance or did a chemical predisposition to depression cause the suicidal teen to react to bullying in that particular way? What came first: the chicken or the egg? Does it matter?
 
In John Green and David Levithan’s Will Grayson, Will Grayson, depression is the first issue that the character struggles with and is treated for, and he figures out that he is gay afterward; the novel seems to be much more about struggling with low mood than struggling to accept sexuality. Often, we expect the reverse to happen: the character struggles with sexuality and therefore becomes depressed. 
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Similar questions about nature versus nurture are raised when autism co-occurs with mental illness. Do the brain differences of autism predispose those on the spectrum to have the anxiety and depression that are so often co-morbid with autism (Autism Speaks, 2018), or are anxiety and depression simply the result of the social setbacks that result from a communication/developmental disorder? In Maybe in Paris, the case is complicated by the fact that the mental illness is schizophrenia. One organization suggests that overlapping symptoms often cause misdiagnosis of mental illness when people simply have autism alone (Kaim, 2018). Maybe in Paris was also the only novel I found in which the mentally ill character was also diagnosed with autism, probably because I was looking for YA novels classified by “mental illness” as a subject term; I suspect if one searched for YA novels under the subject term “autism,” some of these books would feature autistic characters with depression and anxiety since these mental illnesses often occur in individuals with autism. Again, the question arises: Do brain structure and chemistry differences cause the depression and anxiety of autistic people, or are depression and anxiety caused by the trauma of bullying or some other manifestation of the lack of acceptance? Does it matter? Can a teen with genetic mental illness relate to and learn from a character who has trauma-induced mental illness?  
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Overall, then, there are plenty of fruitful discussions for us and our students to have when we consider YA novels of mental illness in light of ethnic, religious, and/or gender/sexuality diversity. I’m not surprised by that at all. 
References
 
 Kaim, Nomi. (2018). “Autism spectrum and mental illness: Misdiagnosis or co-occurring condition? Asperger/Autism Network. Retrieved from https://www.aane.org/misdiagnosis-co-occurring-condition/

American Psychological Association. (15 Sept. 2015). “New APA report analyzes demographics of the US psychology workforce.” Retrieved from http://www.apa.org/pubs/newsletters/access/2015/09-15/psychology-workforce.aspx

Autism Speaks. (2018). “Autism's associated medical and mental-health conditions.” Retrieved from https://www.autismspeaks.org/what-autism/learn-more-autism/associated-health-conditions
​

Cart, Michael. (2016). Young adult literature: From romance to realism. 3rd ed. American Library Association.
Lin, Luona, Karen Stamm, and Peggy Christidis. (2018). “2007-16: demographics of the U.S. psychology workforce.” American Psychological Association Center for Workforce Studies. Retrieved from http://www.apa.org/workforce/publications/16-demographics/index.aspx
​

National Alliance on Mental Illness (NAMI). (2018). “Minority mental health awareness month.” Retrieved from https://www.nami.org/Get-Involved/Awareness-Events/Minority-Mental-Health-Awareness-Month
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3 Comments
top5writingservicesreviews.com link
8/1/2018 07:47:05 pm

Before anything else, I want to thank Ms. Diane Scrofano for writing this article. It's true that most of the authors we have nowadays have been coming up with a fresher concept for their masterpieces. This is a good thing because they are starting to explore and desiring to come up with a new concept that they will offer to their readers. But when it comes to mental illness, they need to make an outmost research about it. They must be extra sensitive and should be able to deliver a good message to everyone.

Reply
Diane Scrofano
5/22/2019 10:02:33 am

I've just been made aware of another YA novel of mental illness that focuses on a whole cast of Latinx characters: When Reason Breaks, by Cindy L. Rodriguez. Check it out!

Reply
m 30 blue pill link
11/1/2019 11:29:22 pm

Hi there! This post couldn’t be written any better!
Reading through this article reminds me of my previous roommate!
He always kept talking about this. I’ll send this
article to him. Pretty sure he will have a
very good read. Thank you for sharing!

Reply



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    Dr. Gretchen Rumohr
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    Gretchen Rumohr is a professor of English and department chair at Aquinas College, where she teaches writing and language arts methods.   She is also a Co-Director of the UNLV Summit on the Research and Teaching of Young Adult Literature. She lives with her four girls and a five-pound Yorkshire Terrier in west Michigan.

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    Dr. Bickmore is a Professor of English Education at UNLV. He is a scholar of Young Adult Literature and past editor of The ALAN Review and a past president of ALAN. He is a available for speaking engagements at schools, conferences, book festivals, and parent organizations. More information can be found on the Contact page and the About page.

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