Mental illness and the enlightened stigma

Mental illness can be an awkward topic to address. Everyone has notions of what someone with a mental illness is like, from depression to schizophrenia. The fact is that too often having a mental illness carries a negative stigma that is difficult to overcome.

Regardless of advocacy and public education in recent years about the neurobiological basis of mental illness, the stigma associated with it has not decreased. According to the General Social Survey, a study done by the National Institute of Mental Health, 67 percent of the public in 2006 attributed major depression to neurobiological causes, compared with 54 percent in 1996. Of those surveyed in 2006, 79 percent supported professional treatment for mental illness, as compared to 61 percent in 1996. Despite increased understanding of the causes of mental illness and the need for treatment, the stigma was not alleviated. In fact, community rejection of people with mental illness was shown in 2006 as having increased.

A common misconception about mental illness is that it is caused by some type of personal weakness. For example, one might write off a person with severe depression as someone who is feeble or simply has a bad attitude. So it would make sense that if (according to the General Social Survey) people accept that mental illness is caused by biological factors, this stigma would be alleviated. Then why does it remain?

Think about how other illnesses are portrayed in the media and in society. Personally, I think about positive examples such as people overcoming cancer, or the Wake Forest University baseball coach who recently donated his kidney to one of his players. Now think about the way people with mental illnesses are portrayed. We are often exposed to serial killers and criminals: people who are dangerous, aggressive and unstable. We are surrounded by stereotypes: soccer moms who live their lives like zombies because they are taking too much Prozac. We use negative vocabulary like “crazy” and “lunatic” to talk about mental illness. Stigma can be observable and direct, such as someone making an open negative remark about mental illness. But it can also be extremely subtle, such as someone assuming a person is dangerous or violent because of a mental illness.

It is the subtle stigmas that may be the hardest to eradicate. Those suffering from a mental illness are deeply affected by negative stigma both on a public and personal level. According to the Mayo Clinic, stigma can cause low self-esteem and prevent people from seeking the help they need. It can also cause rejection by family and friends, problems with discrimination at work or school, difficulty finding adequate housing and more. Negative stigmas too often result in social avoidance of people with mental illness. The General Social Survey found that more than a half of those surveyed were unwilling to spend an evening socializing, work next to, or have a family member marry a person with mental illness.

Negative stigmas also impact the families and friends of those who have a mental illness. Even when families understand the causes, they may be reluctant to discuss their family member with others for fear of adverse reactions due to negative stigmas. For many, even their close friends may not understand, resulting in feelings of isolation and being withdrawn. Families may also feel ashamed of their loved one. In early psychoanalytical traditions, it was believed that problems in adulthood were a result of childhood experiences. Although this is sometimes found to be false, many families still blame themselves for their loved one’s condition.

A different survey found that beliefs surrounding mental illness fall into three categories. The first school of thought is that people with severe mental illness should be feared, and therefore excluded from most communities. The second category believes that people with mental illness are irresponsible, and so their decisions should be made by others. The third group believes that those suffering from mental illness are childlike and need to be cared for.

But why are we equating people with their illnesses? We use the term “mentally ill person” but we never say “cancerous person.” In the case of mental illness, we put the disease before the human being, and that is completely unfair. In a time of so many medical advancements and so much access to information and resources, society is still holding people with mental illnesses back because we are choosing to look past what we know and give into what we think we know.

The fact is that just like other diseases, people can and do overcome mental illness. By working to eradicate negative stigmas, this can become a more common reality.