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As often as Kanye West talks about the state of his mental health, one would think that we’d be having a national conversation on mental health–kind of like the way we had a wave of conversations about domestic violence in the wake of the Chris Brown-Rihanna incident. Yet, in the four years since Kanye began talking openly about the depression related to the death of his mother and the dissolution of his romantic relationship with longtime paramour Alexis Phifer, the conversations have continued to be one-sided.

A search for “Kanye West and Depression” brings up surprisingly few articles and discussions. There’s a sterile AP article describing his initial comments, Cord Jefferson advising Kanye to go to a therapist on The Root, an MTV news article on his path to recovery, and Tom Breihan in the Village Voice distilling 808′s and Heartbreak down to “emo bellyaching” and a “album-length tantrum at his ex.” While Bassey Ikpi later argued to have some compassion for Kanye, it was one small plea in a sea of indifference and condemnation.

After four years of being open about pain and vulnerability, I’m starting to wonder if society will ever really hear him.