Stigmatization of Mental Illnesses - Coursework Example

Introduction The stigma associated with mental illness is so widespread that it impacts mentally ill persons in virtually all aspects of their lives. It complicates their lives in terms of housing, employment and insurance. It can prevent mentally ill persons seeking treatment. Although historically, mentally ill persons were perceived as dangerous and intrinsically demonized, attitudes have changed but remain rapt with stigma. More recently, mentally ill individuals are still perceived as dangerous but a new dimension replaces the old. They are now perceived as weak rather than evil and many see this weakness as bearing responsibility for their own conditions (Dubin and Fink 1992, 1). This paper attempts to shed some light on why mentally ill persons are stigmatized. This paper will therefore first offer a brief description of stigma and then it will evaluate the extent of the stigmatization of mental illness and then it will analyze why mental illness attracts such stigmatization. I. Stigma defined Byrne (2000) describes stigma as “a sign of disgrace or discredit which sets a person apart from others” (65). Stigma is more about the connection between attitudes, perceptions and stereotypes. In this regard, Brohan, Slade, Clement and Thornicroft (2010) formulated six dimensions of mental illness. These dimensions are, “concealability”, “course”, “disruptiveness”, “aesthetics”, “origin” and “peril” (Brohan et al 2010). Concealability refers to “how obvious or detectable a characteristic is to others” (Brohan et al 2010).Course refers to the characterizing the longevity or reversibility of the condition. Disruptiveness is used to refer to how the stigma affects “interpersonal relationships” (Brohan et al 2010). Aesthetics distinguishes between reactions that are replete with disgust and those that perceive the condition as “unattractive” (Brohan et al 2010). The dimension of origin refers to what brings about differences in attitudes toward mental illness and peril refers to the level of the differences which could conceivably induce “feelings of threat or danger in others” (Brohan et al 2010). Stigma is therefore social in nature and application. II. The Extent of the Stigmatization of Mental Illness Stigmatization of the mentally ill has negative consequences for employability and social acceptance (Lai, Hong, and Chee 2000, 111). However the problems of stigmatization is far more pervasive than employability and social acceptance. It pervades everything from treatment to family support. A study conducted by Crisp, Gelder, Goddard and Meltzer (2005) demonstrated that although negative attitudes toward mental illness is softening, stigmatization remains prevalent. The study was conducted among a population sample of 1725 random persons who participated in interviews. The surveys were conducted in two parts over a five year period to gauge changes in attitude toward mental illness. In the latest survey, the researchers discovered that although there was a reduction in negative attitudes toward mentally ill persons, negative perceptions remained high. More importantly, the researchers discovered that the most likely persons to harvest negative attitudes toward the mentally ill were persons in their late teens and those who did not have a post-secondary education (Crisp et al 2005, 106). The stigma attached to mental illness also has negative consequences for healthcare providers and the families of the mentally ill and the healthcare providers. A study conducted by Streuning, Perlick, Link, Hellman, Jerman and Sirey (2001) demonstrates that stigmatization of mentally ill persons has a corresponding devaluation of caregivers and the families of mentally ill persons (1633). The study was conducted among 461 mental health caregivers and approximately 70 percent expressed the view that mental health patients and their families are devalued. This form of stigmatization places greater stress on the mental health caregiver, and thereby compromises the ability to provide treatment in the best way possible. Moreover, the devaluation of family members also compromises the ability of caregivers to get additional and valued support (Streuning et al 2001, 1633). Although this research does not replicate all attitudes among caregivers and the general population, it provides some insight into the pervasive and debilitating nature of the stigmatization of mental illness. The fact is, stigmatization of mental illness is an obstacle to all relationships and interactions that are necessary for securing for the mentally ill a reasonable semblance of normal life. Not only does stigma impact the way that mental patients, live work and relate to others, it also impacts the way that they are supported by family members and medical health providers. The fact is stigmatization leads to self-stigma on the part of mentally ill persons who have the ability to identify their own illness and seek help (Mishra, Alreja, Sengar and Singh 2009, 39). This form of self-stigma can naturally result in a reluctance to seek help and can also encourage self-alienation. In other words, the stigmatization of the mentally ill is pervasive on many levels. Even the parents of mentally ill children are stigmatized. This is particularly so in cases where the children are adult and have life-long mental disabilities requiring perpetual care. These children are stigmatized for the stress that they put on their parents for life-long support. Parents are likewise stigmatized for producing children with these mental disabilities (Kelly and Kropf 1995, 5). The fact is, everyone who is remotely connected to the mental illness of the mental patient receives some form of stigmatization. This means that families, associates, caregivers, employers and anyone who comes into contact with the mentally ill is at risk of being stigmatized, although not to the degree and extent of the mentally ill themselves. In the final analysis, the extent of the stigmatization of the mentally ill is entirely pervasive and far-reaching with negative consequences for society as a whole. III. Why Mentally Ill Persons are Stigmatized Since stigmatization of mental illness acts as a significant barrier to treatment and prevention, researchers are constantly trying to determine what causes stigmatization with a view to responding to it effectively. Ann and Hitmelein (2004) conducted a survey of 116 college students to determine their perceptions of mental illness as a means of determining why there is stigma associated with mental illness. Research findings indicate that the respondents perceived mental illness, particularly schizophrenia as genetic and as such incurable (Mann and Hielein 2004, 195). This perception helps to explain why some persons stigmatize mental illness and why that stigmatization reaches the family of the mentally ill patient. Obviously, if persons believe the condition is genetic they will perceive that family members are likewise predisposed to the disease. Similarly, since persons may perceive that mental illness or some forms of mental illness is permanent and incurable they may not want to hire, live with or socialize with those persons. Likewise, perceptions of the permanent nature of some forms of mental illness may contribute to self-stigmatization and obviously act as a barrier to treatment. In trying to shed some light on why mental illness is so pervasively stigmatized, Lai, Hong and Chee (2004) conducted a study among three hundred mental health patients consisting of both in-patients and out-patients at a general hospital and a day care programme in Singapore. The mental health patients expressed a predominant opinion that the stigma attached to mental illness primarily emanated from the media and the entertainment industry. Other prevailing views were that there was insufficient public awareness of mental illness (Lai et al 2004, 113). Lai et al (2004) also surveyed 100 mental healthcare providers and findings were that many of the professionals felt that mental health patients develop low self-esteem as a result of stigma and this low self-esteem only contributes to the public stigma already attached to mental illness (113). The fact is, there are many layers to stigmatization of mentally ill patients and therefore the causes are inter-relating and self-perpetuating. Lai et al (2004) felt that even the “psychiatric label” rather than the illness itself fueled some degrees of stigma (114). As Lai et al suggest, a lot of the stigma is attached to ignorance. The research bears this out (see Crisp et al 2005). It would appear that the more people know of the various mental diseases the less likely they are to respond to mentally ill patients in a negative way. Similarly, perceptions are generated as a result of psychiatric labeling and this trickles down to the patient who perpetuates the stigma by developing feelings of low self-worth and projecting those into mainstream society. It would therefore appear that lack of knowledge and its chain reaction is perhaps the greatest source of mental health stigmatization. The psychiatric labeling theory is supported by Raskin, Harasym, Mercuri and Widrick (2008) who maintain that: A substantial amount of research has consistently shown that being assigned a psychiatric or other socially stigmatizing label can impact how one is perceived by others (285). In fact, research efforts have consistently revealed that labels have a significant consequences for how an individual “is perceived” (Raskins et al 2008, 286). One study demonstrates that labels contribute to how persons are “evaluated” (Raskins et al 2008, 286). Complicating matters, when people are labeled they either go into self-exile or they are deliberately shunned by others. This only perpetuates stigma because distance and lack of exposure to those stigmatized only increase the stigma attached to those labeled (Raskins et al 2008, 286). This is because myth is perpetuated and takes the place of personal observations. Raskins et al (2008) explain that: Even though both mental illness and homelessness are stigmatized identities, labeling research makes clear that the amount and kind of exposure to stigmatized individuals impacts one’s evaluations of them. This suggests that, in the absence of any direct exposure, people may have a ‘default’ means of judging stigmatized individuals, one in which negative information outweighs positive information or serves as a baseline against which anything positive is considered (286). Obviously, stigmatization of the mentally ill is a complex and evolving phenomenon. It begins with labeling which creates an impression and a response. The response which is self and societal isolation only serves to exemplify and perpetuate the stigma. Conclusion The research reviewed in this paper demonstrates that perceptions of mentally ill individuals are such that there is a prevailing degree of stigma attached to the mentally ill and those with whom they are related or those from who they look to for medical or social support. The primary cause of the stigma attached to mentally ill persons appears to be a result of psychiatry labeling which is in turn fueled by ignorance. This in and of itself creates a complex web of demoralization, premature and uninformed evaluations and relationships. Stigmatization results in self-alienation and forced alienation which by itself creates new forms of stigmatization and complicates existing stigmatization. Researchers have committed a great deal of time and resources to understanding why there is so much stigma attached to mentally ill persons. The undeniable fact is that the level and degree of stigmatization is a significant barrier to effective treatment. This is because, patients and caregivers alike are stigmatized and this impacts the patient’s desire to obtain treatment and it impacts the quality and quantity of mental health provision. The research demonstrates however, that older and more educated persons tend to be least likely to stigmatize mentally ill persons. This means that ignorance and immaturity is perhaps the most significant causes of stigmatization. It therefore follows that in order to overcome stigmatization or to at least minimize it, education and public awareness appears to be the key. In other words governments should commit more resources to heightening public awareness of mental illness with a view to reversing the current prevalence of stigmatization. Teachers and parents may need to put more attention to changing the perceptions of the young and immature. Certainly, stigmatization is always going to be a problem for many different groups of people. However it can be minimized one group at a time. Works Cited Brohan, E.; Slade, M.; Clement, S. and Thornicroft, G. (2010) “Experiences of Mental Illness Stigma, Prejudice and Discrimination: A Review of Measures”. BMC Health Services Research, Vol. 10:80. http://www.biomedcentral.com/1472-6963/10/80 (doi:10.1186/1472-6963-10-80 Retrieved 11 October 2010). Byrne, P. (2000) “Stigma of Mental Illness and Ways of Diminishing It”. Advances in Psychiatric Treatment, Vol. 6: 65-72. Crisp, A.; Gelder, M.; Goddard, E. and Meltzer, H. (June 2005) “Stigmatization of People with Mental Illnesses: A Follow-up Study within the Changing Minds Campaign of the Royal College of Psychiatrists.” World Psychiatry, Vol. 4(2): 106-113. Kropf, N. and Kelly, T. (1995) “Stigmatized and Perpetual Parents: Older Parents Caring for Adult Children with Life-long Disabilities. Journal of Gerontological Social Work, Vol. 24(1/.2) 3-16. Lai, Y.; Hong, C. and Chee, C. (2000) “Stigma and Mental Illness. Singapore Medical Journal, Vol. 42(3): 111-114. Mann, C. and Hitmelein, M. (Feb. 2004) “Factors Associated with Stigmatization of Persons with Mental Illness”. Psychiatric Services, Vol. 55(2): 185-187. Mishra, D.; Alreja, S.; Sengar, K. and Singh, A. (2009) “Insight and Its Relationship with Stigma in Psychiatric Patients.” Industrial Psychiatry Journal, Vol. 18(1): 39-42. Raskins, J.; Harasym, M. Mercuri, M. and Widrick, R. (2008) “Construing Stigmatized Identities: A Golden Section Study.” Psychology and Psychotherapy: Theory, Research and Practice, Vol. 81: 285-296. Rubin, W. and Fink, P. (1992) “Effects of Stigma on Psychiatric Treatment” cited in Fink, P. and Tasman, A. (eds) Stigma and Mental Illness. American Psychiatric Publication. Struening, E.; Perlick, D.; Link, B.; Hellman, F.; Herman, D. and Sirey, J. (Dec. 2001) “Stigma as a Barrier to Recovery: The Extent to Which Caregivers Believe Most People Devalue Consumers and Their Families.” Psychiatric Services, Vol. 52: 1633-1638. Read More