The madness of using mental health for fashion

Written by Sarah Surget, 21.

Illustration by Sumena Owen


“It’s about love. It’s about life. It’s about us. It’s about you. It’s about now. It’s about health. It’s about mental health.” – Vogue Portugal


It’s also about glamourising asylums and traumatic methods of treatments. It’s about reinforcing stereotypes. It’s about being complicit to the stigmatisation of mental health.

On Friday 3rd July, Vogue Portugal released “The Madness Issue”, where the cover picture depicts a young girl in a bath, naked and curled up on herself, surrounded by two nurses who pour water on her head. In other words, a psychiatric hospital was used as a fashion statement.



Simona Kirchnerova, the featured model, has since received hate messages since the release of the cover. She argues that she has no control over the aesthetics, and having herself lived with depression, she doesn’t find the cover to be offensive. The problem lies when the urge for fame is stronger than morals. Countless people would have been involved in the editorial process of the issue, from graphic designers to make-up artist to the printers themselves. Not having a say in the choice of cover is different to not speaking up about the issue at hand, making them compliant, blinded by the claim to fame that working for such an influential magazine could offer.


Challenging the institutional misunderstanding of psychiatric hospitals from within could have led to a change in the cover

Undeniably, if Simona Kirchenerova had refused the take part in the photoshoot, Vogue Portugal would have easily found another model. But what happens if they refused. And the next model. And the next model. And what happens if the printer refuses to accept this degrading depiction of mental health. And the make-up artist. And the graphic designer. Challenging the institutional misunderstanding of psychiatric hospitals from within could have led to a change in the cover, to one that could have actually help break stereotypes around mental health. After all, Vogue’s mission statement, described by Vogue Australia, is “Together we make a strong declaration about the issues that mean the most to our readers: sustainability, inclusivity, diversity, innovation and creativity.”


After seeing the public uproar, Vogue Portugal issued a statement:

It is important to acknowledge that they did manage to shine a light on the important issue of today. This being of course the common lack of education around mental health.


Yet, they justify the cover by explaining that deep research had been conducted on the topic prior to the release. This was probably the case and the photographer and colleagues presumably do have a very good understanding of what asylums use to look like. However, the topical societal concern is not our access to knowledge around the inhumane treatment of asylums and old practices in psychiatric hospitals. A challenge we face today, that would have been accessible for a campaign by Vogue, is the stigma and stereotype that present themselves as barriers to getting help.


Knowing someone with mental health issues does not mean that you have a global understanding of how to approach the topic

Branislav Simoncik, the photographer and the brains behind the picture, issued a statement. In his words “Art must do no harm, encourage hatred or discrimination, and must not be used as an instrument of dehumanization”, “It was never meant to encourage the stigmatisation of the patients, fetishize or glorify past practices.” He justifies his actions as taken inspiration from historical events and authentic accounts of mental health hospitals. “I apologise to whom I have offended, even though I consider this a basic misunderstanding. If this photograph and the discussion around it have contributed to an increase interest in mental health problems, and if the polemics helps at least one person, it was worth it.” This statement is quite controversial and counterproductive, showing once again the lack of understanding.


The photograph depicts the picture of a patient living with a mental illness, dehumanised as she is naked in front of the nurses. Her eyes seem lost in the void as she tries to cover up her frail body. The patient is seen as weak, which despite what Simoncik claims, most probably won’t empower anyone to speak up and get support. Furthermore, knowing someone with mental health issues, whether they have been hospitalised or not, does not mean that you have a global understanding of how to approach the topic, as Simoncik claims. Having a level of exposure does not entitle oneself to not educate themselves on the barriers to getting support, the causes, the triggers, the recovery process and so on.


This is not the first time that mental health has been used as a fashion statement. On the Gucci runway, in September 2019, Alessandro Michelle dresses 20 models in white clothing with straps and buckles, that are oddly similar to uniforms worn in a psychiatric ward. Ayesha Tan-Jones, Gucci Model, wrote “Mental Health is not fashion” on their hands. In their words “I could have stayed silent, walked off the job, and let another model take my place. But I was raised with a voice and armed with hands whose duty is to heal”.



This is a prime example of how a model, despite not having a say in the artistic creativity of their brand, can still condemn the exploitation of mental health in the fashion industry.


The Corpus of Historical American English analysed 115,000 textual sources from 1810 to 2009 to determine the association of terms use to describe mental health with the words they are characterised with.



On this graph, we can notice different trends associated with the word madness. From villains to adverse marijuana usage, the recurring theme between all of these words is the negative connotation associated with the word Madness. Interestingly, the lexicon of mental health does not seem to appear in the top ten words that characterise Madness. This is reassuring considering that the terminology mad is not used anymore in hospitals due to the pejorative nature of the word.



For comparison’s sake, this is the lexicon for the word insane, which is unfortunately frequently used to describe mental health. Interestingly, even in 2009, the word “insane” is commonly linked to “asylum”, which testifies of the stereotypes that patients face when they get institutionalised. The increase in correlation between criminality and insane also demonstrates a pejorative side to mental illnesses, demonstrating the common misconception that someone living with a mental illness is more prone to criminality. The words we employ are extremely important in this process of reducing stereotypes within our communities.


In a time where you can be anything you want to be, don’t be complicit. As Vogue Portugal say, “#themadnessissue It’s about time”. Time to stop conceding to fashion trends that exploit disturbing historical moments. Time to speak up to try and break those stereotypes. Time to educate ourselves on mental health difficulties.


Editorial edit: Following the claims that Vogue Portugal were capitalising on mental health, they pulled the cover and published an apology. In their words, "On reflection, we realise that the subject of mental health needs a more thoughtful approach. We sincerely apologise for this." Seeing the stance of the model and the photographer aforementioned, this still raises a problematic issue of whether the cover was pulled due to the polemic or because they realised the implications it could have. 


Let’s change the world, one word at a time.


Avoid: Normal Behaviour

Use: Usual behaviour / typical behaviour

Explanation: There isn’t a definition as to what a ‘normal’ symptom are for mental health. ‘Usual’ and ‘typical’ are less critical and are less likely to alienate an individual who doesn’t fit the textbook definition of a mental illness.


Avoid: Afflicted by mental illness / suffers from mental illness / is a victim of mental illness

Use: Living with a mental illness

Explanation: A mental health diagnosis isn’t necessarily a negative thing. Yet the words ‘afflicted’, ‘suffers’ and ‘victim’ refers to a negative state of mind which reinforces the stereotype around weakness.


Avoid: Mental ill person/ person who is mentally ill

Use: Person with a mental illness/ person living with a mental health issue

Explanation: This uses a ‘people first’ language, where we acknowledge that people are people before they are illnesses.


Avoid: Schizophrenic / psychotic

Use: Person living with schizophrenia / person experiencing psychosis

Explanation: This also uses the ‘people first’ language. You wouldn’t say “cancer-ic” or “heart diseased”. This is a clear example as to how disparities persist between labels of medical conditions in health and mental health.


Avoid: Committed suicide

Use: Died by suicide / lost by suicide

Explanation: The word ‘committed’ is only used for crime and implies blame. Suicide was decriminalised in 1961 yet we haven’t changed the way we talk about it.


Additional links:

https://www.mentalhelp.net/aware/mental-word-association/

https://www.healthpartners.com/blog/mental-illnesses-terms-to-use-terms-to-avoid/


This contribution was written by Sarah Surget, 21. Visit her profile here to find out more about the voice behind the words.



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