Each time I walk a new class of college students through the history of mental illness and stigma, the shock and revulsion are palpable. We review, horrified together, the successive chapters of our civilization’s attempts to rid itself of mental illness through exorcism, torture, surgical intervention, and neglect. We revisit the cyclical periods of mass quarantine, institutionalization, and criminalization that make up our collective history. It’s shocking. It’s shameful. And it creates an almost irresistible impulse to look around and point to the evidence of how far we’ve come.
The Stigma Of Mental Illness Is Alive And Well
It’s an understandable impulse, but I urge my students to resist it. Because as far as we’ve come as a civilization, our approach to mental illness is still decidedly uncivilized; our treatment of many of our fellow humans still heartbreakingly inhumane. What was once overt hostility and blatant stigma has now receded to the shadows of our collective narrative. But the mental illness stigma is still there.
These days, we can find it woven into the jokes we tell or passively dismiss as harmless. Or in the language we use without even thinking about it. Those of us in the mental health field often see it in the chuckle of a stranger who, shortly after inquiring, “What do you do?” follows the response with a mock-nervous, “Ooh, don’t analyze me! I swear I’m not nuts!” (Nuts? Who knows? Predictable? Most definitely.) The mental illness stigma is real and it is well-documented. Even after all this time. This is a serious problem for all of us.
Here Are 3 Reasons Why Mental Illness Stigma Hurts Us:
1) Stigma silences and dehumanizes those who are living with mental illness.
Despite noteworthy instances of courageous individuals sharing their stories in public forums (like this blog), the reality is that many people living with mental illnesses simply don’t feel safe disclosing their experiences.
Some isolate themselves, opting out of activities and opportunities that might otherwise provide valuable information, care, and social support. Many reflexively turn the stigma inward, resulting in heightened risk of psychological and physical harm.
The pervasiveness of stigma further dehumanizes in the public’s mind (and thus subjects to greater risk of violence) those living with mental illness.
Moreover, the intersectional nature of mental illness stigma cannot be discounted: It is more pronounced among communities of color, members of the LGBTQ community, veterans and active-duty individuals, higher weight-status individuals, and those living in homelessness.
2) Stigma discourages help-seeking behavior in all of us.
Not only does stigma dissuade those with diagnosed mental illness from disclosing or seeking appropriate care, it also perpetuates a widespread reluctance to seek help for any of a wide range of concerns.
Stigma has been identified as a key factor influencing general attitudes toward help-seeking, which strongly predict actual help-seeking. And this attitudinal reluctance to ask for help has cemented itself as a cultural norm, affecting all groups indiscriminately, and certain groups (e.g., college students, men) in particular.
One of the most insidious ripples in the mental illness stigma chain of reaction, our attitudes toward asking for help are transmitted both directly and inadvertently through our communication with others— to our siblings, our friends, our co-workers, and our children.
3) Stigma undermines our conception of “wellness.”
If you drop into any discussion of mental health, chances are the focus will revolve primarily around the issue of diagnosed mental illness.
But, equating mental health solely with the absence of mental illness is problematic for at least a couple of reasons. What about the 1 in 5 adults (and estimated 1 in 5 youth ages 13 to 18) living with some form of mental illness? Does their diagnosis preclude them from experiencing wellness? Does it mean they can’t draw rich and nuanced conclusions about health, humanity, and wholeness through the lens of their mental illnesses?
And what does this mean for the rest of the population? Does their lack of a diagnosis ascribe to them a static mark of “healthy” and preclude them from engaging in health-promoting activities and ongoing education and self-care?
Mental illness stigma dilutes and cheapens the entire construct of mental health by shutting down meaningful reflection, critique, and discussion that might otherwise usher us forward into a new period of understanding.
As it stands today, most of us would be hard-pressed to answer the question, What does “mental health” (and indeed what does “health/wellness”) mean to you? If mental health is the hallmark of optimal human functioning, the aim of every treatment intervention, and the fault line that bisects our treatment of one population from our treatment of another, should we not at least be able to describe it?
Harnessing the humanity we all share
One clear inoculation against the dehumanizing effects of stigma is to draw upon the strengths that make us uniquely human. A few ideas:
- Engage in meaningful reflection. What does mental health mean to you? What are its essential components, and how can you work to promote each of these in your own life? In the lives of those around you?
- Initiate, and participate in, open conversation about the construct of mental health. Stigma begets silence, so take steps to disrupt the process by sharing your own experiences and questions. If you are living with a mental illness, this action may take the form of ongoing dialogues within safe and supportive communities. Use your own judgment about when, how, and with whom to have these discussions. If you wish to be an ally to those living with mental illness…
- Educate yourself. Seek out opportunities to advocate. Share this post, and other resources like it, within your circles of influence. Then check out Part II of this post and take the Mental Health Promoter’s Pledge.
We’ve come this far. Where to next?The humanity we all share is more important than the mental illnesses we may not. - Elyn Saks Click To Tweet
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