Mental Health stigma

The Voices in my Head

Stigma: a mark of disgrace or infamy; a stain or reproach, as on one's reputation

Stigma referred to a mark on Greek slaves used to separate them from free men

In common usage today the word signifies a disgrace or defect

types of stigma

• External Stigmatization
• Internal Stigmatization
• Both lead to negative consequences 

history of stigma

Ancient history

• No way to explain odd behavior
• Supernatural forces were to blame 
• Punishment from the gods (Greece)

early TREATMENTS

• Exorcism
• Seance
• Trephination

plato

• Organismic point of view
• Conflicts between emotion and reason
• With time the mentally ill were separated 
• This begins a history of isolation

Middle ages

• Christian Era
• Church came to practice medicine
• Demonology and superstitions
• Belief in magic and witchcraft increased

stigma today

Stigma still exists despite

• Advancement of treatment
• Deeper understanding of mental illness
• Knowledge about the brain 
• Efforts of many organizations and individuals

Where does it come from?

• A combination of factors
• Beliefs and stereotypes
• Lack of knowledge and understanding
• Movies, TV shows
• News

The role of the media

• People get information from the media
• Media promotes negative and false views
• Violence and criminality
• Social outcast and drain on society

Nearly two-thirds of all news stories involving those with psychiatric diagnosis could be classified as “crime news” (Rose, 1998)

Yet when news on the whole was examined, only 10% of the stories were “crime news,” with 90% of the stories revolving around issues unrelated to crime or violence.

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 Wilson et al. (1999) concluded that 67% of the mentally ill characters depicted were seen to be unproductive and failures.

tv example

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The impact of stigma

Who is affected?

• The mentally ill
• Their families
• Treatment providres
• Society 

What are the effects?

• Internalization of public attitudes
• Failure to seek treatment
• Diminished self esteem
• Increased isolation
• This affects every apsect of their lives

Effects on society

• Cost 
• Serious mental illness costs $317.6 billion
• Direct and indirect cost
• Over half is from loss of earnings

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Endorsed and Anticipated Stigma Inventory (EASI)

Beliefs about mental illness

• People with mental problems cannot be counted on
• People with mental health problems often use their health problems as an excuse
• Most people with mental health problems are just faking their symptoms
• I don’t feel comfortable around people with mental health problems
• Most people with mental health problems are violent or dangerous

Beliefs about treatment

• Medications for mental health problems are ineffective
• Mental health treatment just makes things worse
• Mental health providers don’t really care about their patients
• Mental health treatment generally does not work
• Therapy/counseling does not really help

Beliefs about treatment seeking

• Seeing a mental health provider would make me feel weak.
• I would feel uncomfortable talking about my problems with a mental health provider
• I would think less of myself if I were to seek mental health treatment
• I wouldn’t want to share personal information with a mental health provider
• If I had a mental health problem, I would prefer to deal with it myself

If I had a mental health problem and friends and family knew about it, they would . . .

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• . . . think less of me
• . . . feel uncomfortable around me
• . . . think that I could not be trusted
• . . . avoid talking to me
• . . . Be afraid that I might be violent or dangerous.

If I had a mental health problem and people at work knew about it...

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• My coworkers would think I am not capable 
• My career/job options would be limited
• A Supervisor might treat me unfairly
• People at work would think I was faking
• A Supervisor might give me less desirable work

In an ideal world

Social justice vision

• No prejudice
• No discrimination
• Empowerment 
• Tools for success
• Effective and available treatment

economic justice vision

• Ability to work
• Housing
• Health insurance
• Retirement
• Savings and security 

Consequences

Consequences for population

• Continued stigmatization 
• Poverty
• Unsuccessful treatment 
• Isolation
• Physical illness

Consequences for population

• Physical abuse 
• Homelessness
• Prison
• Early death

CONSEQUENCES for society

• Direct and indirect costs
• Cost of treatment 
• Cost to the economy
• Cost to the future generation 
• Continuing cycles of abuse and poverty

Taking action

community action

• NAMI
• Community Mental Health Center
• Case Managers

Community action

• Mental Health Day at the Capitol
• Workshops
• Advocate/Advocate/Advocate

the case for community support

POLICY AND LANDMARK CASES

• Olmstead v. L.C. & E.W.
• Atlanta Legal Aid
• Supreme Court on April 21, 1999
• (Residential CAre in OKlahoma)

social workers

• Advocate
• Community Involvement
• Networking

stop stigma now

Fighting stigma

Use respectful language

• Person before illness
• Don's say "crazy", "lunatic", "psycho"
• Correct people when they do

Become an advocate

• Create awareness
• Write lawmakers and newspapers
• Challenge stereotypes
• Tell others the truth about mental illness

Teach others

• Mental illnesses are just illnesses 
• Tell them about your experiences

Stay in the trenches!

The interaction between case manager and self-stigma was significant. Some case managers were able to mitigate the negative effects of self-stigma on quality of life.

Change a life

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