What Mental Health Awareness Month Gets Wrong

Every May, the graphics start appearing.

Soft colors. Gentle fonts. “It’s okay to not be okay.” Reminders to check on your strong friend. Statistics about one in five Americans living with a mental health condition. All of it well-intentioned. Most of it true. And almost none of it reaching the people who need it most.

I’m not here to dismiss the awareness. The stigma around mental health is real, and any conversation that chips away at it has value. But after five years of living inside the cancer and patient advocacy world, and considerably longer sitting with my own mental health, I’ve come to believe that the way we talk about this month is missing something important.

It’s too clean. Too resolved. Too much before-and-after, and not enough during.

The Mental Health Nobody Photographs

Here’s what a mental health awareness post rarely looks like:

You’ve been in remission for two years. You’re doing meaningful work. People call you inspiring. You speak at conferences. You wrote a book. From the outside, you have more than survived — you’ve built something.

And then on a Tuesday afternoon, you get a message that someone from your community didn’t make it. Someone you’d spoken with, encouraged, watched fight. You read the message. You set your phone down. You go make a cup of coffee, because you don’t know what else to do with it.

That’s survivorship. That’s advocacy. That’s also a mental health experience that doesn’t fit neatly into awareness month messaging.

I’ve written about the grief that comes with this work before, specifically the toll that loss takes on advocates who are doing the emotional labor of walking alongside people through some of the hardest moments of their lives. → Read: The Hidden Cost of Patient Advocacy: Grief, Burnout, and Survivorship

What I didn’t fully understand when I started was how cumulative it gets. Each loss lands differently. And the longer you do this work, the more relationships you’ve built, which means the more loss you experience. That isn’t a reason to stop. But it is a reason to be honest about what the work actually costs.

When the Hard Part Doesn’t End When Treatment Does

One of the things I’ll be talking about in my Bloom TV appearance later this month is the survivorship gap. The strange, disorienting space that opens up after active treatment ends.

While you’re in treatment, there’s a structure. Appointments. Protocols. A team. People checking in. The medical system, for all its gaps, gives you a roadmap.

And then treatment ends, and everyone celebrates, and you’re supposed to feel relief — and sometimes you do. But often, underneath the relief, there’s something else. Anxiety about recurrence. Grief for the person you were before diagnosis. A kind of identity vertigo. Who am I now? What do I do with all of this?

Most mental health awareness messaging doesn’t reach that person. It speaks to the person who hasn’t yet acknowledged they’re struggling. But what about the person who did the work, got through it, built a life on the other side — and still has hard days? That person exists too. I am that person sometimes.

The survivorship mental health conversation deserves its own language. It isn’t the same as the pre-diagnosis conversation. It lives in a different part of the body.

What It Takes to Actually Get Better (And It’s Probably Not What the Posts Say)

I want to be specific here, because vague self-care advice is part of the problem.

Therapy helped me. I don’t say that casually, I say it as someone who resisted it, who thought I could process everything through reflection and writing and forward motion. I was wrong. Having a skilled, qualified person help me understand my own patterns, my grief, my relationship to control and vulnerability — that changed things. It didn’t fix everything. Nothing fixes everything. But it gave me tools I didn’t have before.

A decade of mindfulness and meditation practice helped me. Not the app-based, five-minute version (though there’s nothing wrong with that as a starting point). The kind that becomes a genuine daily practice, that teaches you to sit with discomfort rather than immediately trying to solve or escape it.

Community helped me — specifically, the right community. This is where Man Up to Cancer changed my life in ways I’m still processing. Finding a room full of men who were living with cancer and not pretending otherwise. Men who cried and said “I love you” and showed up for each other. Not despite their strength — as an expression of it.

→ Read: More Than an Event: Reflections from Gathering of Wolves 2025

And losing people, really sitting with it rather than rushing past it, helped me understand something that took years to learn: I don’t have to be angry at cancer for bringing Chuck and Lee into my life in order to be angry that it took them. The grief and the gratitude can live together. The wound, over time, becomes the wisdom. And the wisdom becomes the work.

The Men in the Room (Or Not in the Room)

I’d be leaving something important out if I didn’t name this directly.

Mental Health Awareness Month, in its current form, largely doesn’t reach men. Not because men don’t need it, the data is staggering on that front, but because the way it’s packaged doesn’t connect with how most men have been taught to think about themselves.

As many as 70% of young men avoid mental health services entirely. The research on traditional masculinity and health behavior is consistent: the “be strong, handle it yourself, don’t show vulnerability” script is deeply internalized, and it keeps men from getting help long before it keeps them from advocacy.

I felt that pull myself. When I was first diagnosed, my instinct was to research alone, process quietly, present the composed version to everyone around me. What broke through wasn’t a social media graphic. It was other men, specifically men who had gone before me, who modeled what it looked like to be open and strong, honest and resilient.

If you’re a man reading this, and mental health month has always felt like it was speaking to someone else: it’s speaking to you. The way you access it might look different. Community before clinical, sometimes. Story before statistics. But you deserve support as much as anyone.

What I Actually Want From This Month

I want the conversation to go deeper.

I want it to reach the cancer survivor two years out who is quietly struggling and doesn’t think they’re allowed to say so anymore. I want it to reach the advocate who is burning out from carrying other people’s pain without ever being asked how they’re doing. I want it to reach the man who won’t call a therapist but might show up to a retreat if another man he respected invited him.

I want the messaging to make room for the during — not just the before and after.

And I want it to be honest about what helps. Not just “reach out if you need help” — but here’s what reaching out looked like for me, and here’s what changed.

If you’ve been doing this work — advocacy, caregiving, survivorship — and you’re tired in a way that sleep doesn’t fix: that’s a real thing. It has a name. And it doesn’t mean you’ve failed at any of this. It means you’ve been paying attention.

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If you want to go deeper on building sustainable advocacy practices — including how to handle burnout, loss, and the emotional weight of the work — my book From Patient to Advocate: Turning Survivorship Into Impact has a full section dedicated to exactly this. It’s the guide I wish I’d had.

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Tim McDonald is a stage IV colorectal cancer survivor, liver transplant recipient, and patient advocate. He is the Florida Chapter Leader for Man Up to Cancer, a Research Advocate with Fight Colorectal Cancer, and the host of the Advocacy at Work podcast.