It is September, and we dress in yellow. For several weeks, we speak about mental health, share quotations on social media, advocate for suicide prevention, and repeat the need to bring stigma to an end. Then October arrives, and we return to normal.
Although “Yellow September” serves as an important call to awareness about mental health, we must remember that mental illness is not a seasonal campaign: people do not fall ill only in September, nor can prevention and care be confined to a single month.
The true test begins when we find ourselves before someone who is sad, anxious, or exhausted—someone who repeats the same story time and again and simply cannot pretend that everything is all right. At that moment, all too often, the language changes. Suddenly, that person becomes “toxic,” “negative,” or “dramatic.” Although we insist that speaking openly is important, we begin to distance ourselves when someone speaks too often or for too long. We say that no one should suffer alone, yet we grow weary of listening to those who have suffered for too many years. And then comes that particularly cruel assertion: “Those who do not wish to recover cannot be healed.”
According to data from the World Health Organization (WHO), 727,000 people died by suicide in 2021—a sobering reminder that stigma and silence continue to impede the search for help. In the Azores, this reality is especially troubling. Data presented in 2025 indicate a rate of 14.7 suicides per 100,000 inhabitants, compared with 8.9 for Portugal as a whole. These figures reveal a reality too grave to be dismissed as a distant statistic.
Speaking about mental health cannot mean speaking only about illness. We must also confront the conditions capable of destroying it: loneliness, poverty, low wages, insecure employment, workplace harassment, toxic professional environments, excessive workloads, and the burden borne by those caring for elderly relatives.
The WHO and the International Labour Organization estimate that depression and anxiety are associated with the loss of approximately 12 billion working days each year. They also warn of psychosocial risks such as excessive workloads, harmful behavior, and environments that inflict suffering.
Therefore, when we discuss productivity and medical leave, prudence demands that we ask: How much low productivity is caused by people who are ill, and how much is produced by the conditions under which they are compelled to work? What happened to them? How many wounds were inflicted before someone reached the point of being unable to work and found themselves standing at the edge of the abyss?
Today, we are witnessing growing suspicion directed toward both those who are ill and the specialists who treat them. They have become the weakest link in a Region that struggles to attract qualified professionals and continues to face an alarming suicide rate. Yet I can assure you that the only thing a person suffering from mental illness pretends is that they are well. Such a person is not fleeing from work; they are, quite literally, struggling to recover so that they may return to work—and to life.
Mental illness recognizes no distinctions of age, profession, or public office. It is therefore essential to ask what kind of working environment people inhabit; whether their wages allow them to live with dignity; whether those caring for family members receive adequate support; and whether those who become psychologically ill are granted treatment, understanding, and the time necessary to heal.
I owe my life to the Regional Health Service and to the medical specialists who refused to abandon me when I had already begun to abandon myself. To them, I remain profoundly grateful.
But I leave this warning: September may be the month in which we speak most loudly about mental health, yet prevention must begin much earlier. Above all, it must continue long after September has ended.
September begins in January. And the question I leave for reflection is this: What do we allow to happen during the other eleven months?
Alexandra Manes is from Flores Island but lives on Terceira Island in the Azores. She is a regular contributor to several Azorean newspapers, a political and cultural activist, and has served in the Azorean Parliament.
NOVIDADES will feature occasional opinion pieces from leading thinkers and writers in the Azores, providing the diaspora and those interested in the current state of the Azores with a sense of the significant perspectives on some of the archipelago’s issues.
Translated to English as a community outreach program from the Portuguese Beyond Borders Institute (PBBI) and the Modern and Classical Languages and Literatures Department (MCLL).