What is the first thing that comes to your mind when you hear the words “mentally ill?” Is it the latest school shooter? Your friend who has been hospitalized for the third time since Christmas? Your schizophrenic aunt who refuses to stay on her medication? How does it make you feel? For me, I tend to feel a sense of pity, maybe disgust, and definitely more than my fair share of judgement. The stigma associated with mental illness is so deeply ingrained in our lives and our culture that we don’t even notice ourselves passing judgement unless it is brought to our attention. Our judgement and criticism are far too easily given and, especially in regard to mental illness, personal reform is necessary.
Erratic behavior is one thing, but when it comes to mental illness, it would seem that judgment only follows more closely with diagnosis and treatment. When someone is diagnosed with a mental illness, it is mostly for treatment purposes. However, research has shown that the label can have many different effects. In the article Psychiatric Illness and Family Stigma the authors, Jo C. Phelan, Evelyn J. Bromet, and Bruce G. Link, state that “There is also evidence that psychiatric labels themselves can elicit stigmatizing responses above and beyond those attributable to symptomatic behavior.” This is to say that, while misbehavior that is associated with mental illness is damaging enough in terms of social perception, the label given to psychiatric patients can serve to further the stigma and discrimination directed at the bearer of the title. But I think something that is often forgotten is the stigmatization that faces the family of those who have a mental illness. The studies reported in Psychiatric Illness and Family Stigma showed a correlation between higher socioeconomic status and increased rates of avoidance by those in the same circles. Because of the stigma that comes along with a label like “bipolar” or “schizophrenic,” families sought to conceal the illness of their loved one. Families with loved ones who have mental illnesses fear that they will be judged, discriminated against, or avoided because of one family member’s illness. Though the trend of avoidance is far less common today than it was 20 years ago, there is still oppression as it pertains to the family.
The stigma behind these labels impacts much more than just social and familial endeavors. In the article Sane in Insane Places, it is clear that even in treatment facilities these labels (that are so easily handed out) determine the care that patients(even those without any true illness) will receive. There were two really and truly disturbing facts that I took away from that article. The first was that it is indeed very much possible for medical workers, trained to deal with mental illnesses, to misdiagnose an individual who has nothing wrong with them. The reason I found this particularly perturbing was because of the long-lasting impact of such a diagnosis. Culturally, and as was reiterated in the article, we do not believe that mental illnesses are something that heal like a broken arm. Instead of being fully recovered, it is said that patients with mental illnesses are simply “in remission” until the next attack strikes. The second distressing fact is that any behavior following the diagnosis could be construed as being related to the illness itself. In the article, perfectly sane individuals were admitted to mental hospitals on the basis of their misdiagnosed mental illness. They did not display any further behaviors to support this data, but any behavior, from writing, to walking around, or even asking questions, was treated as though it was carried out under the influence of their “illness.”
Further, the label that is intended for treatment purposes is instead used for discrimination. In this way, the label they carry is the much the same as Hester Prynne’s red A in The Scarlet Letter. Not only is it clear to others that there is something different about them, it is clear to themselves. In the words of Joelle Pasman in her article The Consequences of Labeling Mental Illnesses on the Self-concept: A Review of the Literature and Future Directions, “Labeling theory describes the negative impact of labeling on self-esteem and self-efficacy.” In this, we can observe that once given a title, one may more readily seek to fulfill the expectations that come with it, or as Pasman wrote “one realizes what others expect of him as a mentally ill person.”
If labels truly do amplify the display of behaviors that are associated with any given mental illness, it should be no surprise that those diagnosed with mental illnesses suffer discrimination. Patrick W. Corrigan, Benjamin G. Druss, and Deborah A. Perlick reviewed the topic of discrimination in their article The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. They said: “From a public standpoint, stereotypes depicting people with mental illness as being dangerous, unpredictable, responsible for their illness, or generally incompetent can lead to active discrimination, such as excluding people with these conditions from employment and social or educational opportunities.” Corrigan, Druss, and Perlick repeat that public perception is largely based on stereotypes, through which stigmas are born.
But when faced with so much judgement, individuals with mental illnesses began to stigmatize themselves. Self-stigma, as identified in Corrigan, Druss, and Perlick’s article, is essentially the acceptance of others views of one’s mental illness. In self-stigma, one believes they are not worthy of care or able to get better as the illness they have is their own fault. There are some very clear issues with t self-stigma, but the greatest areas of concern in my mind have to do with mental illnesses that have negative tendencies to begin with. If a patient with borderline personality disorder presents with depression and starts to display self-stigma, blaming themselves for their situation, the potential for negative outcomes increases significantly. Especially in cases involving severe depression, the prospect of recovery is what is needed to press on. Self-stigma removes this prospect. This is so unfortunate because self-stigma is so heavily influenced by social stigmas that have been created by a critical, intolerant society.
Negative preconceptions related to mental illnesses are so deeply ingrained in our society that we often times fail to recognize the fundamental barriers that are in place. This phenomenon, known as structural stigma, is related to lack of coverage with medical insurances, inadequate research on the topic of mental illnesses, and the use of mental illnesses for the purpose of discrimination in a court of law.
It is unfortunate that our society has placed itself in an endless loop of stigmas related to mental health. I think that if the stigma related to mental illness was non-existent, self-stigma would decline significantly, if not disappear completely. Abnormal behaviors would be recognized more quickly and instead of trying to hide mental illness, treatment could be sought immediately. In this, illnesses may be caught earlier and thus treated more effectively. The world would have increased levels of mental health and mental illness would no longer be a premise for discrimination in any facet of daily life.
To conclude, there is so much stigma surrounding mental illness. Societal stigmas place judgement on those who have mental illnesses and serve only to exacerbate the shame one may feel upon diagnosis. Self-stigma causes individuals to deem themselves unworthy of care and recovery. Finally, structural stigma provides a basis for legal discrimination against individuals with mental illnesses. Despite societal norms of discrimination towards those who have mental illnesses, I believe it is important to overcome the overwhelming stigmas and work to provide the care and treatment needed for those with mental illnesses.