THE STIGMA OF MENTAL ILLNESS

Consequences of Mental Illness Stigma

The consequences of these kinds of inaccurate images, and the beliefs they encourage, include many circumstances that make recovery from mental illness much more difficult, such as the following:

• Citizens who fear those with mental illness and/or believe them to be lacking in character avoid contact with them, treat them with lack of respect, and resist treatment or housing facilities in their neighborhoods. Those who may be particularly in need of social support, understanding, and assistance, then find themselves instead isolated and rejected.

• Employers, believing that job applicants with psychiatric treatment histories are likely to be both unreliable employees and a potential threat to other workers, are reluctant to hire such applicants, thereby denying these individuals the financial means to a better life and an important source of self-esteem.

• Sufferers of mental illnesses may be understandably reluctant to seek needed help because of the attitudes they know they will encounter. Less than half of those with mental illnesses seek professional help, and fear of public response is one of the major reasons for this.

Underestimation of capabilities produces situations in which people with mental illnesses are not consulted in treatment planning, in which their sensitivities (e.g., about the language used to refer to them) may be ignored, and in which their complaints — including those of abuse — may be discounted.

Stigma contributes to societal neglect and poor treatment as well. Societies have seldom given the same attention or allocated similar resources to the treatment of mental illnesses as to the treatment of other disorders. Beliefs that those with psychiatric disorders are somehow less worthy or less able to recover no doubt play a role in this.

Still another consequence of negative public beliefs about mental illness is what has been termed “internal stigma.” As people with mental illnesses encounter negative attitudes — whether in the speech and behavior of others or in the media images of mental illness that characteristically ridicule or vilify them — they begin to doubt and devalue themselves. When so many others seem to agree that they are dangerous, incompetent, and unworthy of respect, consumers come to believe it themselves. The consequences include persistent low self-esteem, lowered expectations and motivations, and exacerbation of symptoms like depression and anxiety.

Mental Illness Stigma and Elderly Persons

The stigma of mental illness and its consequences may be particularly pronounced for older citizens. Research suggests that current attitudes toward mental illness, however much they still need improvement, are somewhat more enlightened than they were 40 or 50 years ago. Thus, older citizens will have grown up at a time when attitudes about mental illness were even less informed than they are now, when having mental health problems and seeking psychiatric treatment were even less acceptable. Older individuals, then, may be even less likely to seek the treatment they need and harder on themselves when they encounter psychiatric difficulties.

In addition, social rejection because of mental illness may have an even greater impact among people for whom the deaths of elderly friends and family already contribute to increasing social isolation. They may have even fewer people to turn to for support, understanding, and acceptance, factors that we know to be important in recovery and coping.

The combination of age and mental disorder, moreover, may make it even easier for others to discount and devalue these individuals. Older individuals with mental illnesses may be perceived as having their judgment doubly impaired (by mental illness and presumed senile deterioration), their physical symptoms misjudged as products of mood disorder or confusion, and conditions like depression accepted as a “normal” circumstance of aging rather than an intrusive illness that can be treated and relieved.

What To Do In Your Community

1. Examine your own attitudes and behaviors toward people with mental illnesses. Even mental health caregivers sometimes have incorrect or out-of-date ideas about mental illness and treat those suffering with with psychiatric disorders with lack of understanding or respect.

2. Listen and talk to people with mental illnesses about their experiences so that you can have a better understanding of both mental illness and the stigma that accompanies it. Have them tell you about the kinds of stigma and discrimination they have encountered and the impact such experiences have had on their lives and recovery.

3. Take action to educate the public about mental illness and about stigma. The more informed people are about the true facts of mental illness, the less likely they are to adhere to misconceptions. Educational efforts may include posters, brochures, talks, proclamations, press releases, and dissemination of World Mental Health Day Planning Kit materials. Arranging to have spokespersons with mental illnesses give presentations to the public is a particularly effective way to counter stereotypes.

4. Speak out. If you are a mental health consumer, let others know about your illness. You can be a living example that challenges the stereotypes of dangerousness, irrationality, and incompetence. If you are a non-consumer, you can politely but firmly let your friends, neighbors, co-workers, and others know when their statements or behavior reflect inaccurate or offensive stereotypes about mental illness and help them understand the harm that those stereotypes can have.

5. Challenge stigmatizing media portrayals of mental illness. Write or call people in the media when you see a stigmatizing presentation and let them know that you are among a large number of citizens who find such depictions both offensive and harmful.

6. Work with your local media to present correct information about mental illness. Let them know when they are doing a good job and invite them to help you in bringing more accurate information about mental illnesses to the public.

“The Stigma of Mental Illness” was prepared in consultation with Otto F. Wahl, Ph.D. Dr. Wahl is the author of a forthcoming book, Telling is Risky Business: The Experience of Mental Illness Stigma (Rutgers University Press) in which mental health consumers describe their experiences of stigma, and of Media Madness: Public Images of Mental Illness (Rutgers University Press, 1995) which examines the nature and impact of mass media depictions of mental illness.