The Stigma

In this episode, Wendy looks at the stigma surrounding mental illness.



International Helpline Info

 For those living outside the United States, I finally found some helpful information. The International Association for Suicide Prevention has a directory of crisis centers and helplines for over 50 countries! 

Just got to the internet and type in:

       findahelpline.com/i/iasp

 And it will bring you to a drop-down menu where you can input your country and region, and it will give you the information for your location. Granted, it doesn’t cover everywhere, but it’s a start!

** Remember if you, or a loved one, is in emotional crisis... Help is just a phone call away. Simply dial 9-8-8 for the Suicide and Crisis Hotline, or text "HOME" to 741741 to chat with someone via text 24/7 across the United States. **

Please contact us at bipolarforlife@myyahoo.com with any questions, suggestions, or comments.

Transcript

Bipolar for Life
Ep 6/S2-The Stigma

Good evening and welcome to “Bipolar for Life.” I’m your host, Wendy Foard, and I’ve managed to live with bipolar disorder for 44 years now. It hasn’t always been pretty, but I’ve survived several suicide attempts, four psychiatric hospitalizations, and one disastrous trip to rehab. Yet, I’m still here!

 Let me say up front that I am NOT a medical doctor. I am simply a seasoned manic-depressive trying to help others survive this deadly mental illness through shared information and experiences.  

As we discuss issues, please remember that I am speaking from my own experience; your bipolar experiences may be entirely different. Yet, I suspect highly that we have more in common than not. 

  Tonight, I thought we’d break away from therapies and talk about something that is still pervasive in our society today… the mental health stigma. 

 Those of us with a serious mental illness are doubly challenged… On the one hand, we struggle with the symptoms and disabilities that result from our disease. That’s bad enough! On the other, we are challenged by stereotypes and prejudice that result from misconceptions about mental illness. As a result of both, those of us with mental illness are robbed of the opportunities that define a quality life: like good jobs, safe housing, satisfactory healthcare, and integration into the society. 

 People with mental disorders have been stigmatized for millennia across many cultures and societies, dramatically affecting the afflicted person’s social life and self-esteem. More than any other type of illnesses, mental disorders are subject to negative judgements and stigmatization. 

 Stigmatization of the mentally ill has a long tradition, and the word “stigmatization” itself has negative connotations. In ancient Greece, a “stigma” was a brand to mark slaves or criminals. 
 
 For millennia, society did not treat people suffering from depression, autism, schizophrenia, and other mental illnesses much better than slaves or criminals; they were imprisoned, tortured, or killed.

 During the Middle Ages, mental illness was regarded as a punishment from God; sufferers were thought to be possessed by the devil and were burned at the stake, or thrown into penitentiaries and mad houses where they were chained to the walls or their beds.

 During the Enlightenment (1685-1815) the mentally ill were finally freed from their chains, and institutions were established to help sufferers of mental illness. 

However, stigmatization and discrimination reached an unspeakable peak during the Nazi reign in Germany, when hundreds of thousands of mentally ill people were sterilized and murdered.

 The stigmatization of mental illness is still an important societal problem. The general population is largely ignorant about this problem, and fear of the mentally ill remains prevalent. Although we no longer imprison, burn, or kill the mentally ill as in the Middle Ages or Nazi Germany, our social standards and attitudes are nonetheless unworthy of a modern era. Structural discrimination of the mentally ill is still pervasive, whether in legislation or in rehabilitation efforts. 

 Stigma is when someone views you in a negative way because you have a distinguishing characteristic or a personal trait that is thought to be, or actually is, a disadvantage—a negative stereotype. Unfortunately, negative attitudes and beliefs towards people who have a mental health condition are far too common. 

 More than half of people with mental illness don’t receive help for their disorders. Often, people avoid or delay seeking treatment due to concerns about being treated differently, or fears of losing their jobs and livelihoods. That’s because stigma, prejudice, and discrimination against people with mental illness are still very much a problem. 

 Stigma, prejudice and discrimination against people with mental illness can be subtle or obvious—but no matter the magnitude, they can lead to harm. People with mental illness are marginalized and discriminated against in various ways, but understanding what that looks like, and how to address and eradicate it, can help. 

 Stigma often comes from a lack of understanding or fear. Inaccurate or misleading media representations of mental illness contribute to both of these factors.

 A review of studies on mental health stigma shows that while the public may accept the medical or genetic nature of mental health disorders and the need for treatment, many people still have a negative view of those with mental illness. Some mental health professionals might also have negative beliefs about the people they care for—this is also considered stigma.

Researchers identify three different types of stigma:

1)          Public stigma involves the negative or discriminatory attitudes that others may have about mental illness.

 2)          Self-stigma refers to the negative attitudes, including internalized shame, that people with mental illness may have about their own condition.

 3)          Structural stigma is more systematic, involving policies of government and private organizations that intentionally, or unintentionally, limit opportunities for people with mental illnesses. Examples include lower funding for mental health research or fewer mental health services compared to other health care. 

 Stigma not only directly affects individuals with mental illness but also the loved ones who support them, often including their family members.

Stigma around mental illness is especially an issue in some diverse racial and ethnic communities, and can be a major barrier to those people from those cultures accessing mental health services. For example, in some Asian cultures, seeking professional help for a mental illness may be counter to the cultural values of strong family, emotional restraint and avoiding shame. 

The stigma of mental illness is universal. A 2016 report on stigma concluded, “There is no country, society, or culture, where people with mental illness have the same societal value as people without mental illness.”

 Some harmful effects of stigma include:

·     Reluctance to seek help or treatment, and a reduced likelihood of staying with treatment

·     Social isolation

·     Lack of understanding by family, friends, coworkers, and others

·     Fewer opportunities for work, school, or social activities and trouble finding housing

·     Bullying, physical violence, and harassment

·     Health insurance that doesn’t adequately cover mental illness treatment, and stigma

·     Leads a person to believe they will never succeed or improve their situation

 Media representations of people with mental illness can influence perceptions and stigma, and on the whole, they have been violent, negative, or inaccurate representations at best.

 A study in 2020 looked at a recent example, the popular film Joker (2019) which portrays the lead character as a person with mental illness who becomes extremely violent. The study found that viewing the film was “associated with higher levels of prejudice towards those with mental illness.” In addition, the authors suggest, “Joker may exacerbate self-stigma for those with mental illness.” 

Media can play a part in strengthening stigma by:

·     Showing inaccurate stereotypes of people with mental illness

·     Connecting mental illness to criminal behavior and violence, and

·     Wrongly using mental health diagnoses to explain behaviors

 For example, if the media links mental illness with violence, this helps create the myth that all people with a mental illness are dangerous. In fact, research shows people with mental illness are more likely to be victims than perpetrators of violence.

 Family members and friends, who often provide essential help and support for people with mental illness, can also experience stigma and discrimination. They may internalize stigma and blame themselves, or they may fear that people will blame them for their loved one’s illness or reject the family socially. This stigma can lead to reduced emotional support, social isolation, and reluctance to seek care for their relative.

 There are different ways you can experience discrimination, including:

·     Direct discrimination: if you are treated worse than others because of your mental health problem

 ·     Indirect discrimination: if a person or organization has arrangements in place that put you at an unfair disadvantage

 ·     Discrimination arising from your disability: if you’re treated badly because of something that happens because of your mental health problem, for example, if you’re given a warning at work for taking time off for medical appointments

 ·     Harassment: if you’re intimidated, offended or humiliated

 ·     Victimization: if you’re treated badly because you made a complaint

  According to the Centers for Disease Control and Prevention (CDC), mental illness is among the most common health conditions in the United States. More than 50% of American adults will need mental health treatment at some point during their lifetime. 

In addition, 1 in 25 are currently living with a serious mental illness, such as an eating disorder, bipolar disorder, post-traumatic stress disorder (PTSD), or major depression.

 Given how common it is for people to experience a decline in mental health, the level of stigma that exists in society is surprising and often contradictory. 

For example, one survey concluded that the majority of people in the U.S. believe in supporting those living with mental illness, so they can live normal lives with others who could help them recover.

 The respondents stated they do not support the idea of keeping those with a mental health condition out of society. The survey also suggests that generally, people do not believe that those living with a mental illness are excessively dangerous or prone to violence.

 However, two-thirds of the survey respondents believed there was still a great deal of stigma attached to mental illness, while almost half said they would not welcome a mental health facility into their neighborhood.  

 A 2022 national poll from the American Psychiatric Association (APA) found that mental health stigma is still a major challenge in the workplace. About half (48%) of workers say they can discuss mental health openly and honestly with their supervisor, which is down from 56% in 2021, and 62% in 2020.

Half (52%) also say they feel comfortable using mental health services with their current employer, compared to 64% in 2021 and 67% in 2020. In a more positive trend, fewer adults are worried about retaliation if they take time off or seek care for their mental health. 

 While stigma and discrimination are still prevalent in the workplace, employers are increasingly addressing stigma against mental illness. The APA Foundation’s Center for Workplace Mental Health emphasizes the importance of both robust health care and specific efforts to break the silence that surrounds the topic of mental health.

 Substantial research shows that knowing or having contact with someone with mental illness is one of the best ways to reduce stigma. Individuals speaking out and sharing their stories can have a positive impact. When we know someone with mental illness, it becomes less scary, and more real and relatable.

Here are some ways you can deal with stigma:

·     Get treatment. You may be reluctant to admit that you need treatment. Don’t let the fear of being labeled with a mental illness prevent you from seeking help. Treatment can provide relief by identifying what is wrong and reducing symptoms that interfere with your work and personal life.

·     Don’t let stigma create self-doubt and shame. Stigma doesn’t just come from others. You may mistakenly believe that your condition is a sign of personal weakness, or that you should be able to control it without help. Seeking counseling, educating yourself about your condition, and connecting with others who have mental illness can help you gain self-esteem and overcome self-judgement.

·     Don’t isolate yourself. If you have a mental illness, you may be reluctant to tell anyone about it. Your family, friends, clergy, or members of your community can offer support if they know about your mental illness. 

·     Don’t equate yourself with your illness. You are NOT an illness. So instead of saying “I’m bipolar,” say “I have bipolar disorder.” Instead of calling yourself “a schizophrenic,” say “I have schizophrenia.” You are NOT your illness!

·     Join a support group. Some local and national groups, such as the National Alliance on Mental Illness (NAMI), offer local and internet resources that help reduce stigma by educating people who have mental illness, their families and the general public. Some state and federal agencies and programs, such as those that focus on vocational rehabilitation and the Department of Veterans Affairs (VA), offer support for people with mental illnesses.

·     Get help at school. If you or your child has a mental illness that affects learning, find out what plans and programs might help. Discrimination against students because of mental illness is against the law, and educators at primary, secondary and college levels are required to accommodate students as best they can. Talk to teachers, professors, and administrators about the best approach and resources. 

·     Speak out against stigma. Consider expressing your opinions at events, in letters to the editor, or on the internet. It can help instill courage in others facing similar challenges and educate the public about mental illness.

The judgments of others almost always stem from a lack of understanding rather than information based on facts. Learning to accept your condition and recognizing what you need to treat it, seeking support, and helping educate others can make a big difference. 

Everyone can help reduce mental health stigma by taking action and getting educated. People living with mental illness should be respected and accepted. We deserve the same rights and opportunities as everyone else. 

Some tips to help you reduce stigma include:

·     Call out myths when negative stereotypes come up in conversation or the media—You can speak up and educate people so that it’s no longer accepted

·     Think about the words you use when describing yourself or others. Avoid insensitive and hurtful words, or words that define a person by their condition

·     Speak up if you see examples of discrimination or bullying. Discrimination against someone with mental illness is against the law in the United States under the Americans with Disabilities Act (ADA)

·     Check your own attitudes towards people with mental illness. Are you part of the problem?

Dealing with the effects of being treated differently can increase feelings of isolation and make mental illness worse. Many people say dealing with stigma and discrimination is harder than dealing with the mental illness itself!

If you or a loved one find yourself in need of immediate mental health support, just call the Suicide and Crisis Lifeline, dial 9-8-8 and be connected with someone who cares. They have resources that can help you find the treatment you need. They even speak Spanish!  

If you prefer, you can text someone rather than speak directly to them. Just text
H-O-M-E to 741741 to begin the conversation. 

For those of you who live outside the United States, there is help available to you as well. Each country has a Suicide Prevention Line, and those numbers are available on the internet. Please, DON’T hesitate to call—Your loved ones will thank you later for your bravery and courage!

 Stigma and discrimination are things we can control and eradicate with information and hope. Do what you can to help end the stigma of mental health!

 Thank you for being with me this evening, and be safe in all your travels. Until we meet again on “Bipolar for Life,” Good Night.