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Mental Health Stigma, Discrimination and Prejudice Karen Bleicher Spring, 2009 Professor Mark Harris Social Problems 2023 To Fight Stigmas, Start with Treatment Last fall, British television broadcast a reality program called “How Mad Are You? ” The plot was simple: 10 volunteers lived together for a week in a house in the countryside and took part in a series of challenges. The amazing thing was that there were no prizes at the end of the challenges. There was a very interesting concept to the reality show.
Five of the volunteers had a history of a serious mental illness, like obsessive compulsive disorder and bipolar disorder, and the other five volunteers did not have any mental illness. The challenges that were meant to elicit latent symptoms included mucking out a cowshed, performing stand-up comedy and taking psychological tests. At the end of the week there was a panel of experts that watched hours of video tape. The panel consisted of 3 people: a psychiatrist, a psychologist, and a psychiatric nurse. The real concept of the show was to see if the panel of professionals could distinguish between who had mental illness and who didn’t.
After watching hours of videotape, the experts correctly identified only two of the five people with a history of mental illness. Also they misidentified two of the healthy people as having mental illness. The point that was made is that even trained professionals cannot reliably determine mental illness by appearances and actions alone. The true reason the experts were stumped is because the participants’ most dramatic symptoms immobilizing depression, agitated mania, and relentless hand washing and so on had been treated and were under control.
Rob Liddell, the producer, wrote “Having a mental illness doesn’t have to become your defining characteristic and it shouldn’t set you apart in society. ” The show “How Mad Are You” might be the first reality show of its kind, but it fits within a well-established category of social marketing aimed at removing stereotypes and combating negative attitudes about people with mental illness. According to Sally Satel, M. D. , a psychiatrist, the leading mental health advocacy group in England and Wales, MIND, praised the program for encouraging viewers to re-examine their preconceptions of mental illness. 1) The World Psychiatric Association sponsors antistigma campaigns in 20 countries. In the United States, the federal Substance Abuse and Mental Health Services Administration has a resource center to promote acceptance, dignity and social inclusion associated with mental health. The National Alliance on Mental Illness has a program called Stigma Busters to break down the barriers of ignorance, prejudice or unfair discrimination by promoting education, understanding, and respect for all people who have mental health challenges. That’s just some of the organizations I found that have antistigma campaigns in place.
My question is do such campaigns work. According to a 2006 article in Psychiatric services, a journal of the American Psychiatric Association, “education produces short term improvements in attitudes, but that the magnitude and duration of improvement in attitudes and behavior may be limited. ” Even though antistigma campaigns are in good faith, they lack a crucial element. No matter how sympathetic the public may be, attitudes about people with mental illness will inevitably rest upon how much or how little their symptoms set them apart.
Therefore altering public attitudes would largely depend on whether the mentally ill was receiving treatment that works to stop the symptoms. This would in turn set into motion a self reinforcing energy that the more that treatment is observed by all people, the more that it would be encouraged by all people. We see this in some of the more recent direction of treatment promotions. Psychiatric medications are now routinely advertised on television. The military is finally taking real steps to make treatment standard for combat stress. Last fall, President George W.
Bush signed a law that prohibits health insurance discrimination against patients with mental illness. (1) What is the Antistigma Campaign all about? There is a lot of stigma, discrimination, and prejudice against people with mental illness. Social stigma is severe social disapproval of personal characteristics or beliefs that are against cultural norms. Some examples of existing social stigma include mental illness, physical disabilities, and diseases. (2) Bruce Link and Jo Phelan propose that stigma exists when four specific components converge. First individuals differentiate and label human variations.
Second is prevailing cultural beliefs tie those labeled to adverse attributes. Third is when labeled individuals are placed in distinguished groups that serve to establish a sense of disconnection between US and THEM. Fourth is when labeled individuals experience status loss and discrimination that leads to unequal circumstances. In this model stigmatization is also conditional on access to social, economic, and political power that allows the identification of differences, construction of stereotypes, the separation of labeled persons into distinct groups, and the full execution of disapproval, rejection, exclusion, and discrimination.
Also in this model the term stigma is applied when labeling, stereotyping, disconnection, status loss, and discrimination all exist within a power situation that facilitates stigma to occur. The first component is identifying which human differences are most important, and therefore worthy of labeling is a social process. There are two primary factors to make this process a social one. The first is the fact that significant oversimplification is needed to create groups. Secondly, the differences that are socially judged to be relevant differ vastly according to time and place.
The second component centers on the linking of labeled differences with stereotypes. In my research I have found that there is a lot of research and studies about the process of applying certain stereotypes to differentiated groups of individuals as it helps to understand the psychological nature of the thought process taking place as this link occurs. The third component is the linking of negative attributes to differentiated groups of individuals facilitates a sense of separation between the proverbial US and THEM.
This sense that the individuals of the labeled group are fundamentally different causes stereotyping to take place with little hesitation. The US and THEM component of the stigmatization process implies that the labeled group is slightly less human in nature and at the extreme not human at all. At the extreme is when the most horrific events occur. The fourth component of stigmatization includes the status loss and discrimination that is experienced. This loss occurs inherently as individuals are labeled, set apart, and linked to undesirable characteristics.
Phillip Bleicher said “most people that I tell that I am schizophrenic, have a tendenancy to shy away from me, because they do not understand it and are afraid of me, and because of what they hear in the news and see on TV about how people like me act. ” The members of the labeled groups are subsequently disadvantaged in the most common group of life chances including income, education, housing status, health, and medical treatment. Also emphasized is the necessity of social, economic, and political power to stigmatize. The power can be clear in some situations and masked in other situations. (3)
Consequences of Stigmatization The needs for diagnosis and remediation of behavioral and emotional problems are enormous. Rather than acknowledge that we are just embarking on understanding, we continue to label patients “schizophrenic,” “manic-depressive,” and “insane,” as if in those words we had captured the essence of understanding. The facts of the matter are that we have known for a long time that diagnoses are often not useful or reliable, but we have continued to use them. Numerous studies have documented the deleterious effects of stigma on the lives and treatment outcomes of individuals with mental illness.
It has been reported that the effects of stigma to be more debilitating than the illness itself. Little attention has been paid to the system by which this stigma is maintained despite scientific understanding of these illnesses as brain disorders. One notable exception is the work of the Chicago Consortium for Stigma Research, which has been examining the nature and impact of stigma on the experience of mental illness for several years in order to develop interventions to improve awareness of the nature and experience of serious mental illness.
On the Stigma of Mental Illness book is a compilation of the consortium’s research on stigma and mental illness that details the processes that create and perpetuate stigma and offers recommendations for its mitigation. The book presents first-person accounts of stigma and reviews autobiographical accounts of self-stigma, public stigma, and stigma from mental health professionals. The book also offers suggestions for combating stigma with chapters such as “Strategies for Assessing and Diminishing Self-Stigma,” “Dealing with Stigma through
Personal Disclosure,” and “Changing Stigma through the Media. ” With books like this one and the recent studies on stigma, discrimination, and prejudice will enlighten people on what people with mental illness goes through. (4) A symbolic interactionists studies how people use language, symbols, interaction, communication, meanings, and definitions to analyze the problem of stigmatization in mental health. How we define health and illness has an impact on how we see the world and on our behavior.
If we define depression as a disease, we perceive a person who is depressed as sick, but if we define this person’s behavior as laziness, we perceive the person as lazy. (5) In conclusion, I hope the mental health system starts implementing antistigma campaigns and the school system provides extra education on what mental challenges are and how to deal with them. I think the mental health system will eventually adopt new language, policies, and be able to better help the clients that seek help for themselves. References 1. Satel, S (2009, April 21).
To Fight Stigmas, Start with Treatment. The New York Times. http://www. nytimes. com 2. Erving Goffman, Stigma: Notes on the Management of Spoiled Identity Prentice-Hall, 1963 ISBN 0-671-62244-7 3. Bruce G. Link and Jo C. Phelan, “Conceptualizing Stigma”, Annual Review of Sociology, 2001 p. 363 4. Corrigan, P (2004, November 30), On the Stigma of Mental Illness: Practical Strategies for Research and Social Change. American Psychological Assn. 5. Henslin, J (2008) Social Problems: A Down-To-Earth Approach Eighth Edition Southern Illinois University, Edwardsville Il