Stigma In Mental Illness

By: Dr. David Mulhall

There is a high level of stigma associated with mental health problems. Stigma comes from a Greek word meaning “a mark of shame or discredit”. It is an attempt to label a group of people who are less worthy of respect than others. People with mental health problems are often stigmatized due to a lack of knowledge, misinformation and fear. Stigma against people with a mental illness often involves negative labels or inaccurate and offensive representation in the media portraying them as violent, comical or incompetent.

The most common misconceptions about mental health problems are:

1) Fear. Fear of violence and unpredictability. Fear of what mental illness represents and the way it attacks the faculties (emotions, thoughts and behaviors) and the part of us (the brain and mind) that define our very humanity.

2) Blame. It is the view that people with mental illness have brought the problems upon themselves.

3) Poor prognosis. The view that there is little hope for recovery from mental illness.

4) Disruption of social interaction. The view that people with mental illness are not easy to talk to and have poor social skills.

Some people affected by mental illness say the effective stigma can be as distressing as the symptoms. Stigma can be a barrier to individuals in getting the help that they need due to fear of being discriminated against. Recent surveys showed that half the population would not want anyone to know if they developed a mental health problem; likewise, half the respondents in the survey thought that media portrayal of people with mental health problems was more negative than positive. This has negative affects in many ways. People with serious mental illness have the highest rate of unemployment and underemployment of all people with disabilities at a rate of around 85%. When people with mental illness find work, their work tends to be sporadic, poorly paid and lacking employee benefits. They all too often find themselves in the three “F” occupations (food, filing and filth). Also, mental illness is the second leading cause of work-place discrimination complaints. Surveys have found that from one-third to one-half of people with mental illness report being turned down for a job for which they are qualified after their illness was disclosed or of being dismissed from their job and were forced to resign as the result of a mental illness. Contrary to common myths, Schizophrenia is not a split personality, nor does the behavior of people with the diagnosis swing dramatically between “normal” and “dangerous”. People with Schizophrenia are rarely dangerous but are experiencing things that can be extremely unpleasant or frightening to them. Recovery rates for mental health problems are between 70 and 80%.

There have been a number of campaigns overseas to address stigma; i.e. in England, Changing Minds; and in Australia, SANE. Much of the emphasis of these programs is to let the general public know that the myths are not true and that terms like “demented/loony/madman/nutter/schizo” are offensive. The positive messages are that people who have mental illness have the same needs as everyone else; that they can and do recover and lead productive lives; that they make valuable contributions to the society and that discrimination against people who have mental illness keeps them from seeking help. These campaigns have many features in common. They include information leaflets for the public and media about mental illness and are often backed up by monitoring programs that encourage people to report examples of stigmatizing language in the media, supplemented with letter templates for people to write to the perpetrating organization. There are also guides for employers that detail the benefits of hiring people who have mental illness, providing suggestions for recruiting and training people who have mental illness, outlining action plans for educating employees about mental health illness and creating a “healthy environment”.

In Nova Scotia (in 2005), a similar survey was done on the media’s portrayal of mental illness. 2% of all stories showed some inappropriate content with either outdated, negative or inappropriate language. Often, subjects like “suicide” would be sensationalized with reference to celebrities, photograph or description of scene, description of methods, interviews with the bereaved family and with little information on how someone could get help or any contact numbers of appropriate organizations, etc.

Programs that look to change attitudes are hard to evaluate and change comes slowly; however, there is evidence that it is possible to improve attitudes towards illnesses such as Schizophrenia and behavior such as suicide with consistent changes in how the media portrays these issues.

The Department of Health and the Mental Health Program sees this area as an important part of the Mental Health Program playing a role in both mental health promotion and prevention.

For further information, please see the Department of Health website under “Our Peace of Mind” document.