In honor of World Mental Health Day 2016, I want to address the important issue of stigma and mental illness. Recent statistics indicate that approximately 1 in 5 adults in the U.S. will experience mental illness in a given year. Suicide rates continue to climb, with suicide being the 10th leading cause of death in the U.S., equivalent to approximately 117 people who die by suicide daily. Such a critical need for intervention at all levels–assessment, treatment and prevention–underscores the barriers that still exist and why we must more fully understand mental health stigma to effect change and bring about real care for people.
Stigma affects people who have mental illness from both external and internal sources. Individuals with mental illness are frequently stigmatized by society based on many factors, including fear, difference, lack of understanding, prejudice, stereotyped beliefs and cultural practices. Many people in our country are not educated about mental illness and, as a result, hold erroneous beliefs. Some of these misconceptions stem back to our cultural history in which people with mental illness and cognitive disabilities were institutionalized, as a way to keep them out of society, under the claim that they were being protected for their own good and hence keeping society safe, when in actuality these people were further marginalized, mistreated and even dehumanized. Here in Maine, we had an institution called Pineland (originally “Maine School for the Feeble Minded”) where people were placed because they were Deaf, mentally retarded or had mental illness. During the period of institutionalization, people suffered greatly and were routinely sterilized so they could not reproduce.
While we have made some progress from this era, the underlying prejudice and stigma against individuals with mental health problems continues. For instance, a common misguided belief is that just because one person with a history of mental illness commits a crime, all people with mental illness must be violent or dangerous. The reality is that only 3-5% of violent acts can be attributed to individuals with serious mental illness and, in fact, individuals with serious mental illness are 10 times more likely to be victims of violent crimes. This kind of blanket prejudice creates huge stigma and disadvantage for people with mental illness to be fully accepted and integrated into our society. Families also misunderstand what it means if a family member has mental illness, often ostracizing that person or overcaring for them, creating either isolation or dependency. Many important organizations exist to help educate and combat stigma, including NAMI (National Alliance on Mental Illness) which advocates at national and local levels and offers support groups for people affected by mental illness in their lives.
Internal or Personal Stigma:
People with mental illness also internalize stigma and may think that something is wrong with them–that they do not have a place in society or their families because of these public perceptions. This has major ramifications on the individual, who often is reluctant to seek psychological treatment for mental illness for fear of being labeled and seen as having a problem. Stigma remains about being placed on medications, having to see a psychiatrist or therapist, or needing additional help like a case manager. Often, we see individuals with mental illness who self-medicate their symptoms by turning to drugs, alcohol, self-harming behaviors or abusive relationships. Many individuals with mental illness also fear that by simply seeking help, they will put themselves in a category with other people who are homeless, spiraling in addiction, hospitalized or incarcerated because they don’t understand that living with mental illness in a way that one can thrive, manage and embrace their symptoms, and have meaningful lives is possible. This latter concept–living a full, meaningful life with mental illness–is not really touted by society, and hence stigma against mental illness is perpetuated.
Contact – The Key to Reducing Stigma:
To reduce stigma requires education, understanding and especially contact. We must, as individuals and as a society, be in contact with people who experience mental illness. We must turn toward them, be curious, try to understand what it is like to be them, stand up and advocate for them, and allow our worlds to overlap. We can enhance participation in our communities, families, schools, places of worship, workplaces, parks, restaurants and anywhere that people come together. We can include more regular characters in TV and movies of people who have mental illness and who get treatment as a matter of course. We can reduce stigma by spreading the belief that all humans are unique and valued, and deserve a life with equal access to opportunities. The statistics lie in our favor that we will know someone or be affected ourselves by mental health issues. Will you or they have to confront stigma for seeking treatment? Let’s choose the antidote to stigma–contact with each other–and begin to create caring, kinder communities for all.