Do any of these attitudes seem familiar?
- Nearly 6 out of 10 people describe a person with a mental illness as “someone who has to be kept in a psychiatric or mental hospital”
- One third of people think that those with mental health problems should not have the same rights to a job as everyone else
- Only 31 percent of people think that mental hospitals are an outdated means of treating the mentally ill
- 1 in 8 people would not want to live next door to a person with a mental illness
- 5 out of 10 people believe that the mentally ill are violent and a threat to society
These findings are from a poll released by the U.K.’s Department of Health in May, 2008. There is ample evidence to show that the same stigma attached to mental illness in the U.K. is just as operative in the United States.
Other research has found that nearly 9 of 10 people with mental health problems have been affected by scapegoating, stigma and discrimination. Two thirds of the mentally ill say they have stopped doing things because of the stigma they face.
Mental health stigma
Mental health stigma refers to society’s regarding mental illness as a mark of disgrace. The stigma is associated with the particular circumstances and quality of an individual. It leads to a stereotyped set of negative attitudes, inaccurate beliefs, and fears about mental illness. These influence how mental health issues are understood by our government and the general public.
There is no intrinsic reason why mental illness should be thought to be any more of a negative or frightening thing than physical illness, but it is. This is a long-standing issue, though it hasn’t always been that way.
It’s only since about the seventeenth century that mentally ill people have been segregated from society. This process was accelerated in the nineteenth century as insane asylums were built to house the mentally ill. Only in the past twenty years has the movement to reintegrate the mentally ill with society begun to take hold.
But the fear and the urge to marginalize the mentally ill still remains, a holdover from the earlier part of the twentieth century when asylums were the norm.
Scapegoating of the mentally ill
It is easier to grasp how mental illness becomes stigmatized while physical illness does not by understanding scapegoating. It is one of the important ways that stigmas gets applied to mental illness.
The term scapegoating referred originally to an ancient ritual used to cleanse a community of sin and judgement. In the scapegoating ritual, the sins of a community were transferred from community members onto an animal (a goat or other animal suitable for sacrifice). The animal was then destroyed or driven away from the community.
To make sense of this ritual, it must be understood that the process of transferring sin was a psychological one, and not a physical one. Psychologically, what was actually being transferred was a set of negative judgments. These judgments were being transferred from one creature to another — from the self-concepts of the guilty, sinful community members to the goat. The psychological act of transferring personal sin away from the self and onto something else created a real relief in the minds of the community members.
While literal sacrifice of scapegoated animals is rare today, the psychological practice of scapegoating has remained alive and well. It has shaped our cultural attitudes towards mental illness. The mentally ill are pushed to the margins of society, denied equal status as “normal” citizens, and held in fear and contempt, or at best pity.
The failure of the community to understand and properly deal with mental illness is put on the backs of the sacrificial goats — the mentally ill. They are driven away out of sight and mind to relieve the community of the uncomfortable fact that mental illness will affect one in six in their lifetimes, as well as the responsibility to deal compassionately and justly with the problem.
The modern stigma attached to mental illness has two major components,
neither of which has any basis in reality:
- The belief that the mentally ill are violent and a threat to society: The mentally ill are crazed killers who hear voices telling them to kill other people and then do so.
- The belief that mentally ill individuals are weak, and that they are moral failures: Mental illness is evidence of a failure of strength. Mentally ill people could have prevented their illnesses or could pull out of them if only they were not such weaklings.
Society acts on these mistaken and unsupported beliefs in profound ways:
- There is inadequate national funding for research or treatment of mental illness. Drug companies provide much of the funding for research, for which they are heavily criticized. Repeated attempts to increase funding have been denied, and just this year, funding was actually cut back.
- Private sector mental health institutions can barely meet expenses. They frequently lose money because they cannot get health coverage or funding to pay for necessary services. Many have had to close their doors.
- State-run mental health outpatient services are chronically underfunded. This results in miserable conditions and inadequate treatment of patients. Many either have long waiting lists or turn away people seeking treatment.
- Health insurers often offer much less coverage for mental health problems than they do for physical health problems. They fight grassroots efforts to mandate equal treatment of recognized disorders. Copays for treatment and medications are often higher for mental illnesses than for physical illnesses. People regularly have to jump through hoops to get mental health coverage at all.
- Employees with a history of mental illness must be careful about disclosing their treatment history for fear of discrimination. It is common for employees to not seek treatment to avoid the possibility of it appearing on their work record.
- The Media pays close attention to mentally ill persons who commit violent crimes, but not to mentally ill persons who get better and lead productive lives. They frequently reinforce the stereotypes of the violent killer mental patient.
- The mentally ill face many kinds of discrimination: rejection by family and friends, work problems, difficulty finding housing, and being subjected to physical violence and harassment.
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This is the first of a two part series. Tomorrow: Coping with stigma and scapegoating.
Resources used in this article:
Psych Central. (2008, May 9). Mental Illness Stigma Alive and Well in U.K. Retrieved July 1, 2008 from Psych Central Web site: http://psychcentral.com/news/2008/05/09/mental-illness-stigma-alive-and-well-in-uk/2260.html
Dombeck, Mark. (2000, May). Scapegoating and Mental Illness Stigma. Retrieved June 27, 2008 from MentalHelp.net Web site: http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=686&cn=144
Mayo Clinic. (2007, December 8). Mental health: Overcoming the stigma of mental illness. Retrieved June 27, 2008 from Mayo Clinic Web site: http://www.mayoclinic.com/health/mental-health/MH00076
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