Mental Illness Stigma and How to Eliminate It

The June issue of Schizophrenia Bulletin contains an action plan by Dr. E. Fuller Torrey on how to reduce the stigma of mental illness. As I've previously written, I do not believe there is "stigma" to having mental illness; in other words, mental illness is not a "mark of shame." I think when people talk about "stigma" they really mean discrimination and prejudice. Dr. Torrey believes otherwise:

Stigma against mentally ill persons is a major problem and has increased in incidence. Multiple studies have suggested that the perception of violent behavior by seriously mentally ill individuals is an important cause of stigma. It is also known that treating seriously mentally ill people decreases violent behavior. Therefore, the most effective way to decrease stigma is to make sure that patients receive adequate treatment.

He goes on:

Everybody wants to fight stigma, and for good reason -- it is probably the heaviest burden borne by mentally ill persons. It affects opportunities for housing, employment, and socialization and becomes for many a scarlet letter.

Despite efforts to combat stigma, there has been a reluctance by the mental health community to objectively assess its causes. It is as if putting up enough posters saying ''mentally ill persons make good neighbors'' will make stigma go away.

He argues that in order to eliminate the stigma of mental illness, advocates and professionals have to connect six dots:

1. Stigma against individuals with mental illnesses has increased over the past half-century
2. Violent acts committed by mentally ill persons have increased over the past half-century
3. The perception of violent behavior by mentally ill persons is an important cause of stigma
4. Most episodes of violence committed by mentally ill persons are associated with a failure to treat them
5. Treating people with serious mental illnesses significantly decreases episodes of violence
6. Reducing violent behavior among individuals with mental illnesses will reduce stigma

He discusses each of these dots in detail and cites peer-reviewed research supporting each one. His article goes on to cite ways to reduce violence by people with mental illness, including reforming civil commitment procedures and standards, using conditional discharge and implementing assisted outpatient treatment.

Dr. Torrey's prescription jibes entirely with the Surgeon General's report on mental health. While that report was wrong about violence and mental illness, it was right about stigma:

Why is stigma so strong despite better public understanding of mental illness? The answer appears to be fear of violence: people with mental illness, especially those with psychosis, are perceived to be more violent than in the past.

Unfortunately many advocates for improved mental health believe that it is wrong to discuss violence and even try to deny that violence exists. They may have worked in a counseling center but probably never a prison, jail or police department.

To learn more, read "There's No Stigma to Mental Illness."

 

 

 

Follow DJ Jaffe on Twitter: www.twitter.com/MentalIllPolicy

Comments

[DJ Jaffe]

10:13 AM on 07/19/2011

This just in: Rather than complain about "stigma" (sic) a Canadian lawyer sued for "discrimination" and won $100K. That's what I'm talking about! DJ
http://www.ctvbc.ctv.ca/servlet/an/local/CTVNews/20110718/bc_lawyer_human_rights_complaint_110718/20110718/?hub=BritishColumbiaHome

[Pippen]

01:20 PM on 06/28/2011

Here's a glimpse for you.

I was diagnosed with PTSD about 4 years ago. I don't any medication, never did. It's not a nonfunctional version like it was when I first was diagnosed and I don't sit in a rubber room and shake from flash backs of Iraq bombs. I for all purposes appear entirely "normal".

I work in a very deeply traditional corporate environment.

One day while talking with a colleague of 3 years I suggested I was diagnosed with ptsd and I thought the woman was going to flee across the passageway while I was talking. She couldn't get away from me fast enough. Since then I get odd looks and brief smiles from her friends and coworkers. She never stops to talk now she just offers the courtesy wave and modest smile and continues pace.

If somebody like me can observe this minor amount of stigma can you imagine what they do when they encounter someone who clearly has a "non-normal" body language from a mental challenge ?

Appalling human behavior is the disease not the mentally challenged.

[DJ Jaffe]

10:02 PM on 07/06/2011

Thanks for writing.
What you witnessed/experienced was discrimination. It was most likely due to ignorance. You do not have is a "mark of shame" which is what sigma is.

[HelloInThere]

11:54 AM on 06/27/2011

We live next door to a group home for people with mental illnesses, I frequently have people ask me if I am scared to be living next to them. We also rent out the other half of the house we own and have had people love the house but turn it down due to the home next door. It seems to come from a lack of understanding and a lack of exposure (or only exposure from sensationalized media stories). This seems to be especially true with more extreme forms of mental illness, where possibly public understanding has not increased as much.

[HaroldAMaio]

10:42 AM on 06/23/2011

In all claims of "stigma" there is a profit. Find the profiter, end the claim.

The profit in the calim of the "stigma" of rape ended here, the silence that permitted the rapist to continue. The profiter is now arrested.

Harold A. Maio
[e-mail]

[DJ Jaffe]

09:50 AM on 06/25/2011

Interesting. The claims of 'stigma' are largely those of NAMI and consumertocracy. And you are right, the gov't loves giving grants to 'fight stigma' rather than 'cure serious mental illness'. And these groups are more than happy to take it. Hmmm?

[robin360]

12:58 PM on 06/28/2011

I'm not sure what your beef is with NAMI. They do a great job of advocacy for family members and those with mental illness. They are no different than advocacy groups for the physically challenged, religious groups, human rights organizations, etc. You want a cure for mental illness, have a telethon, meanwhile, NAMI will continue to help those suffering right now. As for stigma, oh, it most definitely exists and often is a mark of shame that sometimes comes from families themselves, but more often from society. You hear it in the mainstream media all the time: "He's psycho", "she's off her meds", "that one is moody, must be bi-polar", "I'm dating a borderline". These are not compliments, doc. That is stigma. Lastly, your snarky comment about "working in a counseling center" bugs me. You think it's like working in a bank or library? Look, most people with mental illness are not violent. Those in jails, prisons AND outpatient clinics are so sick that they can not stay off the radar of law enforcement and other first responders. I'm not living in a bubble, I have worked inpatient and have been assaulted once, as most of us doing the day to day work have been. Usually, it's the doctors that hide in the nurses station when that sort of thing goes on. If you don't see stigma, it's not because it's not there.