This study explores the use of a metacognitive tool in the preparation of secondary English teachers. This multi-faceted qualitative study presents the findings from a phenomenological research approach that focuses on how literacy quadrants depict pre-service teachers' (PSTs') understandings of, or beliefs about, mental illness and the teaching of literature. Literacy quadrants were interpreted using a visual discourse analysis method, and themes such as isolation, negative emotions, and deficit narrative were identified. Through the use of literacy quadrants with pre-service teachers, teacher educators can tap into PSTs' experiences with, and navigation of, mental illness biases and stereotypes. Incorporating visual protocols in instructional plans can aid teacher educators in creating opportunities for meaning-making, critical reflection, and challenges to stigma associated with mental illness.