Plain Talk about Stigma
Anna Kosturek, M.D.,
Board Certified Psychiatrist

It’s easy to label someone else and overlook what’s really inside. When mental illnesses are used as negative labels it leads to branding and shame, or what is called "stigma." Everyone knows why it is wrong to discriminate against people because of their race, religion, culture, or appearance. They are less aware of how people with mental illnesses are discriminated against. Although such discrimination may not always be obvious, it exists, and it hurts.

Stigma discourages people from getting help. At any given time, one in four adults and one in five children experience a mental health problem. Early and appropriate services can be the best way to prevent an illness from getting worse. Many people don’t seek such services because they don’t want to be labeled as "mentally ill" or "crazy."

Stigma keeps people from getting good jobs and advancing in the workplace. Some employers are reluctant to hire people who have mental illnesses. Thanks to the Americans with Disabilities Act (ADA), such discrimination is illegal, but, nonetheless, it still happens. Unfortunately, many employer-sponsored health insurance plans discriminate by providing lower coverage for "mental" vs "physical" illnesses.

Stigma leads to fear and mistrust. Even though the vast majority of people who have mental illnesses are no more violent than anyone else, they are, nonetheless, portrayed as dangerous. Many observers fix a large share of the blame on the communications media. Often they stress a history of mental illness when they find it in the backgrounds of people who commit crimes of violence. Such biased portrayals lead people to fear those who have mental illnesses.

Today, research has unraveled many of the mysteries about the origins of mental illness. It has been revealed that many mental illnesses are actually caused by biochemical imbalances, as is the case with many physical illnesses.

The mentally ill should not be blamed for their condition any more than diabetics should be blamed for having diabetes. Uncovering many of the biochemical imbalances has led to treatment restoring the needed chemical balances, just as insulin controls the balances for diabetes. As long as a diabetic person takes the proper dosage of insulin, that person can live a normal life. It is much the same with mental illness. As long as the individual with a mental disorder follows prescribed treatments, that person, too, can lead as normal a life as possible.

As care has been upgraded, so, too, have the settings in which treatment is given. For many decades, the usual responses to the mentally ill were to hide them away at home or to relegate them to asylums. Generally, in these enlightened days, we do not physically remove from our midst those we do not wish to have around; and we no longer send them to a far-away asylum. Instead, we isolate them socially, a much more artful though equally debilitating form of ostracism.

Although we as a society have come far in the way we respond to those with mental illness, there is still a great distance to go. The following are some suggestions to end the stigma of mental illness: learn more about mental illness, insist on the media being more accountable, treat people with mental illness with dignity and respect (remember people who have mental illness may include your own friends and family), and finally, avoid using negative labels in referring to someone with a mental illness.

For more information on this topic visit:
www.nimh.nih.gov
www.nami.org/illness

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