This is something that I wrote for a writing class. Out of the ten weeks of classes, it was the one thing I worked on that I remotely liked (mostly because I got to choose the topic, so long as it was in a persuasive/classical argument style). It’s not that the writing is any good, but I think that any dialogue about the subject is worth putting out into the world.
Mental Illness and the Great Need to Break Down Social Stigmas
March 19, 2013
Words like retarded, mental, nuts, and psycho are just a few of the countless slurs and slang words that have worked their way into our common vernacular. The stigma against mental illness is so far ingrained in cultures and languages across the globe that we have widely grown numb to its presence. There is a clear disconnect in the way the general public perceives mental illness and what mental illness truly looks like. Naturally, there are extreme cases of mental diseases which go untreated and unsoothed. Those are the example most people see and associate as everything under the giant umbrella of mental illness, which is an incredibly inaccurate view.
The misconceptions and misunderstandings regarding mental illness builds up a wall so high and so thick that there is no way around it. On one side of the wall is the mainstream, desperate to be blind to anything “wrong” or different. It’s hard for many people to try to understand something that they are told to be uncomfortable about. On the other side, people. People who are different and who are labeled as being wrong and as a result are isolated from the help they need. The time to break down that wall is long overdue. It would take a lot of hard work to overcome the stigma towards mental illness, but overall we need to try to understand its connotations, better serve those who live with it, and, in the end, become a healthier world by being able to talk about mental illness.
During a study conducted by Diana Rose, Graham Thornicroft, Vanessa Pinfold, and Aliya Kassam, published in 2007 in the BMC Health Services Research journal, nearly 500 14-year-old students were able to list over 250 different terms to describe people with mental illness. As can be imagined, the descriptive words they came up with were not greatly positive. In fact, nearly half of the words were categorized as “popular derogatory terms.” On the top of the list: disturbed, nuts, psycho, confused, and spastic, along with other terms like violence, dumb, scary, and unpredictable. 14-year-olds from recognizably good schools came up with these words time and time again. The results of this study, though it is over five years old now, still hold true. Too many people, young and old, refuse to trust or try to understand anyone with a visible mental illness.
The most common feelings about mental illness are that the mentally ill are threatening, harmful, and can’t be trusted. That exists in people’s beliefs–consciously or not– just as much as it appears in their speech. The way we talk about mental illness is the quickest way we alienate people with any kind of mental problem. From severe schizophrenia to mild depression, anyone with thoughts, feelings, and mannerisms dictated by a mental illness is forced into feeling shame about it. It’s understandable, then, that anyone with those feelings would do anything to hide them and fear needing help, let alone seeking it.
One of the biggest injustices about this stigma is how far reaching it is. Not only does it affect every demographic (admittedly, some experience this more than others), but it envelopes every type of mental illness– and there are of course many types. Though there are different causes, results, and duration of mental challenges, all of them are valid and deserve to be taken seriously.
Many people seem to forget the range of mental illnesses. There are situation-based afflictions, caused by a traumatic event like a breakup or a divorce, being evicted, losing a job, or the death of a loved one. This could include mental illness that is the result of a past trauma or a difficult childhood. Then there are other chronic illnesses, biologically rooted, that are not necessarily the result of an outside force.
There are many options for people seeking treatment, but it takes time to find a solution that works. It can require many doctors, lots of lifestyle changes, multiple therapists, and trying different medications before a person finds something that works for them. The most important thing to remember is that no one has to do it alone. Still, there are many reasons why someone would avoid getting help.
The inability to afford help is certainly a force that keeps people from seeking treatment, especially when low-fee services are not available (most major cities have therapy options which are income-based, but those resources can be non-existent in rural areas). It’s likely, though, that there are other factors besides money preventing someone from seeking help. Despite the years worth of improvements to mental health treatments, the stigma against admitting to mental illness has gone largely unchanged.
It’s fair to say that there is greater outward support for those suffering from mental illness in high-income, affluent communities. That’s not to say that people in such communities have it easy, but while while they have the help of friends and neighbors, a lack of community support is especially seen among minorities and people living in poverty. Conditions like depression and anxiety are seen disproportionately in women, namely in poor, urban, and ethnically diverse women. A study led by Mary Doornbos is currently in the process of determining what resources these women need most. Although seeking resources is a valiant and necessary mission, it is secondary to the need to overcome the stigma towards mental illness.
This stigma is understood to be “a combination of inaccurate or distorted beliefs, negative attitudes and discriminatory behaviour [...] separation of ‘us’ and ‘them’, followed by discrimination and status loss” (Knifton, 2012). When admitting to a mental illness results in such severe social banishment, it’s no wonder why anyone who can hide their illness will do so for as long as possible. Sometimes that stigma is understood so deeply that people will live in poor mental health and never even allow themselves to realize it. They are not allowed to be so “weak” as to have a mental illness. It’s simply not an option.
This denial, particularly among minority groups, is articulated by comedian Anthony Griffith. Griffith performed for The Moth (an organization that presents live storytelling across the U.S.) in 2008 at the U.S. Comedy Arts festival. His story detailed two sides of his life. On one side, he was enjoying new success in his career as a stand-up comedian, appearing on The Tonight Show three times and receiving a total of 16 applause breaks. Alongside that joy, however, he was living with unimaginable sorrow. At that time, his two-year-old daughter was battling cancer and slowly dying before his eyes.
It would be an understatement to say that it was a difficult and depressing time in Anthony Griffith’s life. In his performance, he describes his feelings of hopelessness– how lost he felt. As could be expected, the trauma of this experience left him deeply depressed. If anyone needed to see a therapist, it was him, but he couldn’t get help. He acknowledged that getting help wasn’t an option for him because he’s black:
You’re not prepared for this. There’s no book, there’s no home ed class to teach you how to deal with this. And you can’t go to a therapist because in the black world a therapist is taboo. It’s reserved for rich white people. So you’re trying to figure it out. What did I do? Maybe it’s something I did. Maybe it’s something my wife did. Maybe my doctor diagnosed it erroneously. Something. But at night I still have to be a comic, I have to work on The Tonight Show because that’s what I do. I’m a clown. I’m a clown whose medical bills are raising, who’s one step from being evicted, who’s one step from getting his car repo’d, and I have to come out and make you laugh because no one wants to hear the clown in pain because that’s not funny.
Griffith’s struggles are an all-too-familiar example of someone denying themselves the help they desperately need because of the social structure they are bound to. Whether Griffith had been born with depression, newly experiencing depression as his daughter was dying, or still dealing with the grief years later, it would be unacceptable for him to seek help because of his race. That help is reserved for rich white people.
If we are ever going to help people get the mental health resources they need, we have to let them seek that help. Feeling shame, worrying about what other people will think, and accepting that there just isn’t help available or that help is off limits prevents people from getting better. The result: festering mental illness that grows heavier and heavier until it’s too much to carry around anymore. If we want to prevent the tragedies that come out of mental illness, we can’t allow mental illnesses to go untreated. Treatment needs to be prompt, personalized, and on-going. The only hope of that reality by is first breaking down the stigma against mental illness and allowing people to accept help.
Countless misconceptions about what causes mental illness are part of the problem. Sometimes everything can look right and there can still be something that’s wrong. Many people have a hard time recognizing that. In some cases, someone could have had a stable childhood, have a great job, be in a healthy relationship, have good overall health, and still experience depression or anxiety. Those negative thoughts and feeling are not less valid because someone seems to have a great life. Everyone deserves help, no matter what may be causing an illness or who the person is.
While there are ways to find help, there is still a lot that communities can do to improve the mental health of their neighbors, their friends, their families, and even themselves. Currently, there are programs which work to improve awareness, such as Mental Illness Awareness Week (the first full week of October) and World Suicide Prevention Day (September 10th). This is a good start, but we can always do more. There ought to be more effective and regular activities about mental health, not just one unit in a mandatory health class or on assembly out of the year during Mental Illness Awareness Week. Ongoing programs which show kids– and adults– what a typical therapy session would be like, group discussions, and presentations by people who struggle with mental illness themselves could be a greater help than what’s offered now.
Possibly the most important goal is to create a dialogue about mental health. Talking about the issue and giving people accurate information is the only way to break down the social stigmas against the mentally ill. There are already some great models for this, and technology has been a large help in spreading information. Blogs and websites are natural places to find personal stories about people’s experiences with mood disorders and mental illnesses. One person’s story is the purest way to spread awareness; there’s no room for rumor or prejudice, just the truth about how one person lives their life alongside a mental illness.
One of the best forms of advocacy for mental health has come out of podcasting. There are many reasons for that: it taps into the centuries-old tradition of storytelling, it’s one of the only media forms without rules or regulations, and podcasts are fairly easy to produce and access. Handfuls of podcasts have taken on a mental health focus, one of the more successful programs being The Mental Illness Happy Hour hosted by Paul Gilmartin. The intro to the show summarizes its content and its mission: “An hour of honesty about all of the battles in our heads. From medically diagnosed conditions and past traumas to everyday compulsive negative thinking. This show is not meant to be a substitute for professional mental counseling, this is not a doctor’s office, it’s more of a waiting room that hopefully doesn’t suck.” That’s exactly what’s needed. Easily accessible information about mental illness that anyone can access without risk. The show welcomes comedians and actors, listeners of the show, professional therapists, and just about anyone else who has a story to tell.
When we talk about mental illnesses, everyone benefits. The person living with the illness, the past traumas,and the negative thoughts is able to talk and receive advice. When a problem is out on the air or even written onto paper the words lose a little bit of their power and the problem seems easier to tackle. The listener gets to offer support, hear about someone else’s experiences, and just maybe they are experiencing the same thing and until now they thought they were alone. Being able to talk about mental illness is the first and only step towards tearing down the misconceptions and getting help to those who need it– and everyone needs help from time to time.
This isn’t a call for every single person to have health care with mental illness services. That’s an entirely different argument with many more connotations and consequences. What this is, instead, is a declaration that we need to break down the stigma towards mental illness. Across the world, people need to be educated, need to understand the numerous causes, forms, and results of various illnesses, and we need to be talking about this. We can’t keep choosing to be ignorant and push the problem aside. Whether or not help is available is irrelevant when people are afraid to accept that help. Before we push for affordable therapy and psychiatry, we have to teach people that it’s OK to seek those resources, no matter what their circumstances are. Everyone needs help from time to time, and mental illnesses can come and go and take on many forms. We are all healthier if we feel comfortable talking about our problems and asking for help, but that can’t happen if we keep trying to do it alone.
Doornbos, M. (2013). Desired mental health resources for urban, ethnically diverse, impoverished women struggling with anxiety and depression. Qualitative Health Research, 23, 78-92. doi: 10.1177/1049732312465018.
This article details a study that is currently in progress (I included it to show what is currently being done for people with mental illnesses, specifically poor women). It’s widely known that women, particularly those of minority groups living in poor, urban areas, are more likely to experience depression, anxiety, and many other mental illnesses. The purpose of this study is to survey these women and find out what resources would be the most help for them.
Griffith, A. (2008). The best of times, the worst of times. Retrieved from http://www.youtube.com/watch?v=qdBJ1X33rXM.
Anthony’s appearance on The Moth was recorded and made available both as a Youtube video and in podcast form. His story chronicles the period of his life when he appeared on The Tonight Show as a stand-up comedian, and at the same time his two-year-old daughter was dying from cancer. The effect the event had on his mental health as obvious even as he spoke of it after the fact, though social pressures kept him from seeking mental health counseling.
Knifton, L. (2012). Understanding and addressing the stigma of mental illness with ethnic minority communities. Health Sociology Review, 21, 287-298.
In this article, Knifton works to define the social stigma towards mental illness, and explains its prevalence in minorities. He explains that mental illness is more likely to exist in the groups that have the most prejudices and the least resources to get mental help.
Rose, D., Thornicroft, G., Pinfold, V., & Kassam, A. (2007). 250 labels used to stigmatise people with mental illness. BMC Health Services Research, 7, 97. doi: 10.1186/1472-6963-7-97.
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1925070/
This study, uploaded on the Web by the US National Library of Medicine National Institutes of Health, surveyed 472 14-year-old students from four schools in England about their perceptions of mental illness. 400 of those students brainstormed adjectives and descriptive phrases which they associate with mental illness. The study concluded that young people are under-educated about mental illness, and misconceptions need to be cleared before any of them who may be suffering mentally are likely to seek help for themselves.