Muppets, military men and mental health

IN TODAY’S fast-paced and often stressful world, mental health issues are increasingly prevalent. Despite this, they often remain undiscussed and overlooked due to stigma, discomfort, or simply not knowing what to say.

Recently, one of Sesame Street’s much-loved characters, Elmo, asked on X (formerly Twitter) a seemingly innocent question: “Elmo is just checking in! How is everybody doing?”

This casual question, posed on a Monday morning, elicited an unexpected torrent of responses. One X user disclosed: “Elmo I’m suffering from existential dread over here”; another said: “Every morning, I cannot wait to go back to sleep. Every Monday, I cannot wait for Friday to come. Every single day and every single week for life.”

Even celebrities, such as actress Rachel Zegler, joined in the responses, saying she was “resisting the urge to tell Elmo that I am kinda sad”.

Sensing before the ‘dam’ breaks

Perhaps the question should not have been asked at the end of a long first month like January – and on a Monday morning at that. Or perhaps it was just the proverbial final straw that broke the camel’s back – exposing the illusion that everything is “fine” externally (when it was not), resulting in a cathartic avalanche of the emotional and mental health pressures that have built up.

In many cultures, discussing mental health is still considered taboo, which can lead to feelings of isolation for those struggling. By reaching out and asking about a friend’s mental health, one signals that it’s okay to talk about these issues. The act of reaching out and asking a person whom one cares for, creates a safe space for them to share their thoughts and feelings, which can be an invaluable source of comfort and solace.

In today’s environment, where perfection in life is portrayed as the norm, having emotional or mental health challenges can often be seen as a sign of weakness or an inability to “hold it all together”. This is particularly so if one is in a position of seniority or leadership.

The act of checking in regularly can help one spot changes or signs of struggle that those we associate with may not feel comfortable bringing up themselves. Mental health issues can often manifest in subtle changes in behaviour, mood, or demeanour. So, regular check-ins like Elmo’s simple question can help one detect these signs early and provide support.

Often, when someone is dealing with mental health issues, they might feel alone and misunderstood. By asking about their well-being, one can reaffirm that the individual is not alone in their struggle and that these feelings are valid. This sense of understanding and shared burden can provide immense relief and comfort.

Being candid and open to discussing mental health also helps normalise these conversations, breaking down the stigma that is often associated with mental health issues.

The more we openly discuss mental health, the more we foster an environment where seeking help is encouraged and accepted – particularly powerful if those in leadership or senior ranks in organisations set this tone from the top.

Psychological safety

The recent spotlight on how US Defence Secretary Lloyd Austin handled his prostate cancer diagnosis and subsequent surgery treatment (initially undisclosed) offers some valuable insights into the issue of psychological safety in revealing and talking about one’s health challenges – in this case a physical one.

In late December 2023, Austin, 70, had surgery to treat prostate cancer, a physical illness not uncommon to men of his age. He was re-admitted to hospital on New Year’s Day with severe abdominal, leg, and hip pain because of complications related to the procedure.

An evaluation revealed a urinary tract infection, and he was subsequently transferred to the intensive care unit for further treatment. He remained in hospital for more than two weeks.

However, senior defence officials and the White House did not learn that Austin was seriously ill until three days after his re-admission.

Austin has since said he is “deeply sorry” for failing to notify the chain of command when he was first admitted to hospital in December. He admitted that he “did not handle this right,” and said: “I should have told the president about my cancer diagnosis”.

As defence secretary, Austin’s role is just below the president in the chain of command for the US military and is regarded as one of the most important members of the Cabinet.

While he has apologised and taken responsibility for his actions, one wonders what prompted Austin’s lack of candour and transparency. Quite apart from the national security issues attached to his role, was it simply a desire to “suffer” and “ride through” this physical health challenge in private, for fear that any revelation would impact his position or how others may see him through a lens of stigma?

Given that his physical illness is highly treatable, often with good prognosis, there appears to have been a reluctance to be open about it, whatever the real motivation and reason may be. This mindset appears to be corroborated by the audio of an emergency call made on the day of Austin’s readmission – released by officials as the result of a freedom-of-information request.

In the heavily redacted four-minute call, a caller is asking that an ambulance “not show up with lights and sirens” to transport Austin to Walter Reed National Military Medical Centre in Maryland.

“We’re trying to remain a little subtle,” said the caller, who has been identified by US media as a member of Austin’s staff.

The above observations are not intended to be critical of Austin’s actions or to judge him. Rather, they are merely meant to highlight and demonstrate the struggles that an individual goes through in deciding how much needs to be revealed when seeking help to treat a physical illness.

Clearly, the struggles associated with a mental health challenge would be exponentially greater.

Good conversations

So how can (or should) one approach conversations on mental health?

First, it’s crucial to approach the topic with empathy and without judgment. Using open-ended questions such as “How are you feeling?” or “Is there anything you want to talk about?” helps invite individuals to share.

This may seem simplistic, but in a modern culture where there is an underlying expectation for prescriptive instantaneous solutions and outcomes, one must be reminded that this is not necessarily the optimal approach to supporting those grappling with mental health issues.

It is important to remember that the goal is not to provide solutions, but to listen and validate the feelings of the one who feels safe to unburden their struggles. It’s essential to respect the individual’s comfort level and pace, without pushing for more information than they are willing to share.

If a friend shares that they’re struggling, validate their feelings, remind them that it’s okay to ask for help, and encourage them to seek professional support if they haven’t already done so. It’s important to remember that you’re not a replacement for professional help, but your support can make a significant difference.

In this regard, the recent announcement by the Singapore government that the country’s mental health support will be delivered through the community health system – where there will be greater visibility and inclusivity of those with mental health challenges, and the support that is provided to them – is both a bold and enlightened step in the right direction.

Muppet wisdom

It is interesting to note that Elmo, the furry red-haired muppet, was not fazed by everyone dumping their troubles on him.

His response to the outpouring to his question was reassurance and validation of the responses he received: “Wow! Elmo is glad he asked! Elmo learned that it is important to ask a friend how they are doing. Elmo will check in again soon, friends! Elmo loves you.”

Elmo was not alone in responding; other Sesame Street characters also spoke up to support their friend.

The Cookie Monster wrote: “Me here to talk it out whenever you want. Me will also supply cookies.”

Ernie’s best friend Bert added: “I’m here if you ever need a shoulder to lean on. I’ll make us both a warm cup of tea.”

More significantly, Elmo’s efforts were praised by US President Joe Biden himself, who said he agreed with the puppet.

Writing on X, the president said: “I know how hard it is some days to sweep the clouds away and get to sunnier days. We have to be there for each other, offer our help to a neighbour in need, and above all else, ask for help when we need it.

“Even though it’s hard, you’re never alone.”

These words likely reflect the essence of what President Biden would have said to Austin – when the latter finally called to share openly about his health struggles.

That conversation is a valuable presidential lesson on how we should support family and friends in their health recovery journey – physical or mental.

The writer is the group general counsel and chief sustainability officer of Jardine Cycle & Carriage, a member of the Jardine Matheson Group. He is also CEO of mental health charity Jardine Mindset and serves on the boards of the Singapore International Chamber of Commerce, Cyber Youth Singapore and the Global Guiding Council of One Mind At Work. He is a member of the board advisory panel of mental health platform Talk Your Heart Out and an adviser to the sustainability panel of the association of listed entities on the Singapore Exchange, SGListcos.