This first full week in October is being celebrated as Mental Illness Awareness Week (MIAW). The holiday doesn’t even exist. More about that later.
But in celebration of this mythical event, well meaning mental health advocates are busy hosting events to reduce the “stigma” of mental illness.
Stop. Stop right now. Hold it. Here’s another reality check: There is no ‘stigma’ to having a mental illness. There is ‘discrimination’, but that’s another story.
Serious mental illnesses are real biologically based disorders that are no ones fault. Serious mental illness is not, “a mark of shame or discredit”, or “a mark or token of infamy or disgrace”. There’s no stigma to being mentally ill the same way there is no stigma to being “black”, “gay”, “short”, ”tall”, “lefty”, “righty”, inny, or outy. There is discrimination. As J. Rock Johnson, a former board member of a major mental health organization once said, “the most stigmatizing thing we do is talk about stigma”
The efforts to reduce this non-existant stigma are harmful because they are designed to work by diverting attention away from those who need our help the most: the most seriously mentally ill.
The anti-stigma campaigns are premised on the belief that the key to reducing ‘stigma’ is to convince the public that “the mentally ill are just like you and me” and “with proper supports can become productive members of society”.
Those two facts are true, if you’re talking about the high functioning “worried-well”--the 25% of Americans who have a “diagnosable mental disorder”. But, hey, who doesn’t?
But what about the others? The effect of Mental Illness Awareness Week is to divert attention away from the 3%-5% of Americans who are the most seriously mentally ill--like those suffering from schizophrenia or treatment-resistant bipolar disorder, the very mentally ill people who are not “like you and me” and need our help the most.
MIAW intentionally diverts attention from those who as a result of their untreated illness are homeless psychotic, eating out of garbage cans, sleeping in cardboard homes, and living with festering wounds under layer after layer of filthy clothes. Done that lately?
The anti ‘stigma’ campaigns intentionally divert our attention from the mentally ill who are in jail or due to lack of treatment are likely to become violent. The advocates attack the media for reporting on violence, and go through mathematical contortions to “prove” “the mentally ill are just like you and me”.
Trying to gain sympathy for mental illness, by only displaying the highest functioning individuals, is like trying to end hunger by showing the well-fed.
This effort to divert attention away from the seriously ill and towards the worried-well may be well intentioned, but it is definitely harmful. It leads to the term “mental illness’ losing all its meaning. And with no meaning, federal and state agencies can dilute their efforts and spend money on any project they want.
Rather than provide services that would make people with mental illness more welcome in the community, the Substance Abuse and Mental Health Services Agency (SAMHSA) funds ‘anti-stigma’ efforts to change the people in the community. Say what?
Everything is fair game for funding if it can be even tangentially connected to mental anything. Funding goes to the “worried-well” leaving the seriously ill to fend for themselves. The government can even divert their money to funding, say, PSAs that say, “the mentally ill are just like you and me”.
Diverting attention from the severely mentally ill also diverts the public from addressing the policy initiatives that can help the seriously ill: like ending health care discrimination and government discrimination against the seriously mentally ill, saving state hospitals, and finding a cure. It leads to reports by the Surgeon General and President’s Commission on mental “health” that virtually ignore the mentally “ill”.
Dr. E. Fuller Torrey of the Treatment Advocacy Center, and the nations leading mental illness researcher and advocate has a solution. He suggests that any government mental health program that doesn’t use at least 50% of the money for the seriously mentally ill should lose it’s funding. My own solution is a federal definition of “serious mental illness” that would force federal programs purporting to serve the seriously mentally ill population to serve that population instead of serving people “just like you and me”.
How bad is it? Mental Illness Awareness Week does not even officially exist anymore. Congress first declared it in 1989 at the strong urging of the National Alliance on Mental Illness, which still celebrates it. (Who needs Congress anyway?) It was re-enacted in1990, 1991, 1992 and 1993. But since then, no one in Congress has had enough interest in the seriously mentally ill to keep it going.
However even though Mental Illness Awareness Week bit the official dust, stigma groupies will be happy to know Mental Health Awareness Month (May) is coming on strong.
So here’s an idea. This week, while everyone else is celebrating the non-existent MIAW by working to divert your attention to the “worried-well”, let’s think what we can do for those so seriously ill, so imprisoned, impoverished and punished by their psychosis, they are not at all “like you and me”--the 150,000 mentally who are homeless, the 231,000 who are incarcerated due to acting out when untreated, the 5,000 who took their lives this past year, the 70,000 in state psychiatric hospitals, and the 28% who get food from garbage cans.
They don’t deserve to be ignored. Least of all by those who say they want to help.
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10/5/2010: Authors Note:: A paragraph criticizing NIMH for not focusing resources on the most seriously ill was deleted today because it was based on old research. The current Director of NIMH, Dr. Thomas Insel has done a better job than his predecessors in focusing NIMH Research on the most serious disorders.
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