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Stigma and Mental Illness

Stigma and Mental Illness
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Note from the author:Ai?? Could the media’s intense focus on the mental health problems suffered by the Germanwings jetliner crash result in even fewer of those needing mental health services to seek help? That’s the concern of mental health experts who have weighed in following thisAi?? heart-wrenching event. What’s important to remember is that while depression is very common, the vast majority of sufferers, stress mental health experts, do not commit suicide or pose a risk to others.

By Kathleen Heins

Just imagine the uproar if we referred to someone on dialysis as a kidney crasher. Wouldnai??i??t that be insensitive, inhumane and simply horrible? Yet when it comes to mental illness, many seem to think itai??i??s okay to give those afflicted with a biological brain disorder all types of hurtful and stigma-inducing labels such as ai???psychoai???, ai???whackoai???, ai???lunaticai???, ai???nutsai??? or ai???crazyai??? (you can probably think of more). The negative labelling of those with a mental illness is worldwide and has taken place throughout history. Stigma is defined as a mark of disgrace associated with a particular circumstance, quality or person. Why is it considered a disgrace to have a mental illness but acceptable and understandable to have heart disease? Stigma hurts, and when it comes to mental illness, it keeps people from seeking help. One in five Americans, in fact, live with a mental disorder and two-thirds do not seek help.

Fifty-somethings Still Victims of Stigma

It would seem that those 50 and over would be more inclined to seek help because theyai??i??re beyond the point of worrying about what others think but itai??i??s not always the case. ai???I believe that many of the 50 something population hesitates to seek help primarily because there is still weighty stigma associated with needing ai???mentalai??i?? health care,ai??? says Sally Fiehrer, past executive director of the National Alliance on Mental Illness (NAMI) affiliate in Butler County, Ohio, and a mental health advocate.

The same demographic doesnai??i??t hesitate, however, to seek help for physical concerns. ai???Research confirming that mental health conditions are seated in the complex neurotransmitter system of the brain has not been widely projected as scientific fact,ai??? adds Fiehrer. ai???Because the brain is the most complex of human organs, much still remains unknown about its function and the causes of illnesses like schizophrenia, bi-polar disorder, obsessive-compulsive disorder, severe depression and a host of debilitating anxiety disorders,ai??? she adds.

Minorities, poor, among those least likely to seek help

Some groups suffer more than others. Ai??ai???Middle and upper income level people are more likely to seek mental health services than lower income people, and certain ethnic groups are more or less resistant than other groups;Ai?? so there is a lot of diversity,ai??? says Kenneth Doka, Ph.D., professor of gerontology at the Graduate School of The College of New Rochelle. While more educated and affluent populations are more receptive to seeking help in the 50 plus age group (having grown up, says Dr. Doka, in an era of guidance counselors and self-help groups), lower income groups, or certain ethnic groups, may lack an understanding of whatai??i??s being offered and be more resistant to getting treatment. Ai??Instead of thinking of help as being, well helpful, many believe that seeking mental health services will label them unfavorably in the eyes of family and friends.

According to the NAMI, the reasons for not seeking treatment for mental health issues include lack of knowledge, fear of rejection, and concerns about discrimination when it comes to finding work, getting an education, seeking housing or getting healthcare. Bullying, violence and harassment, reports the Mayo Clinic, are also concerns.

Affordability, availability of services and privacy concerns are among other concerns. Effectiveness of treatment is also an issue. ai???Even when there are very effective treatments available that have few negative effects (like cognitive behavioral therapy for anxiety disorders), these fears can be major barriers to treatment,ai??? says David Hellerstein, M.D., professor of psychiatry at Columbia University Medical Center. Ai??Not seeking treatment can result in other problems. ai???Many people who donai??i??t seek treatment for years, even decades, may try self-treatments that can make their problems worse, for example, drinking alcohol or using marijuana to deal with anxiety or depression,ai??? he adds.

How we can help fight stigma

It is helpful when celebrities such as Catherine Zeta-Jones, Carrie Fisher and Demi Lovato come forward to discuss their own experiences with mental illness. Glenn Close, who has family members living with mental illness, has also become an advocate and started the organization Bring Change 2 Mind ( to help fight stigma. So, how can we help?

  • Watch your words. A person is not ai???schizophrenicai???. Ai??He or she is ai???a person with schizophreniaai???. We also need to remove derogatory words and terms from our language. Ai??When others use them, we need to explain why itai??i??s harmful.
  • Volunteer for your local NAMI ( and Mental Health America, MHA, (
  • Speak up. When you witness discrimination consider it an opportunity to educate others.Ai?? Challenge the media, and others in positions of power, when they portray those with mental illness in a negative light. Write letters, call and send e-mails. Let policy makers know how they can help.
  • Dr. Hellerstein says that communities also need to get involved. ai???Society can help by providing adequate funding for services ai??i?? mental health services are often under-funded, even though many studies show that treatment is cost effective in that it prevents disability, overuse of other medical services, and often prevents problematic outcomes like homelessness, suicide and
  • Educate yourself. Did you know, for example, that some types of mental illness donai??i??t emerge until the ages of 18 to 25? Itai??i??s a powerful bit of information. ai???There is now evidence that early intervention to identify, diagnose and treat symptoms result in a much improved outcome,ai??? says Fiehrer. ai???Even for older adults, identifying illness and receiving treatment as soon as the symptoms appear,ai??? she adds, ai???have great
  • Know the facts. The vast majority of those suffering with a mental illness are far more likely to be a victim of a crime than a perpetrator of one. This is especially true when treatment is in place.

How you can personally deal with stigma?

  • If you are being treated for a mental illness, donai??i??t stigmatize yourself (known as self-stigma). According to The Carter Center, when people with mental illness engage in self stigma they are less likely to seek help or stick with treatment.
  • Get help. Donai??i??t let anyone keep you from seeking treatment. By finding out whatai??i??s wrong, the odds are in your favor that you will be able to get treatment that will enable you to live a more desirable and fulfilling life.
  • Reach out to friends, family and others. By reaching out to those you trust, including religious leaders, you may be able to get the support and understanding that you need.
    • You are not your illness. Instead of saying ai???Iai??i??m bipolarai??? or ai???Iai??i??m schizophrenicai??? start separating yourself from your illness by saying ai???I am being treated for schizophreniaai??? or ai???I have bipolar diseaseai??? instead.
    • Learn all you can about your diagnosis and what you can do to feel your best.
    • The Depression and Bipolar Support Alliance ( recommends that you focus on your strengths instead of your limitations.
    • Be proactive when it comes to feeling better. If you donai??i??t feel your treatment is working talk to your health care provider about it. It can take many attempts to find the right prescription or provider.
  • Join a support group. Your local NAMI affiliate offers free support groups for those living with a mental illness. They also offer free classes, known as Family-to-Family, to educate and support family members who have a loved one with a mental illness.

There is help and it works

There remains a great deal of fear and misunderstanding about mental disorders, says Dr. Hellerstein, even in the context of major advances of psychiatric neuroscience and treatment. ai???People are often fearful of the unseen, and have an easier time understanding other medical illnesses like cancer or heart disease because they are so ai??? Although it can be frightening to come to terms with a problem with the brain, many of those suffering from mental health conditions are able to, with treatment, return to a life of purpose and fulfillment.

Bottom line: There is help and it works.

If you, or someone you know, needs immediate help please call the Crisis Hotline at








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