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The Stigma of Mental Illness Is Making Us Sicker

An estimated 450 million people world wide suffer from mental illnesses, and a majority of them do not receive care. One of the major barriers to care is social stigma associated with mental illness. To ensure the lasting health and overall well-being of those who suffer from mental illness, we need to overcome our biases as a society. Read More

untrue

There are many ways to express mental illness.

Sometimes aggression and violence is a part of it.

Suggesting otherwise is a lie.

I'll be happy to continue this discussion.

Its a connundrum

Its truly tragic that serious mental illnesses exist, but they do. I wish that everyone could be at least reasonably mentally healthy, happy, well-rounded, and able to function adequately.

But the fact is that when a person frequently and intensely engages in behaviors that are unpredictable and impulsive (leaving your small children alone in the car on a hot day because you ran into friends who invited you to come smoke some choice weed); when a person engages in behaviors that harm themselves and/or harm others (such as rage driving or drunk driving), in behaviors designed to con or trick others into giving him or her their love, their money, their power (serial bigamists; check out "LoveFraud Blog"); when a person engages in behaviors that are frightening, dangerous or even lethal because the person has lost touch with reality (Andrea Yates) or because they want revenge (Jodi Arias), when a person engages in behaviors that are physically aggressive and predatory (child rapists like Jerry Sandusky at Penn State etc.,) then, unfortunately, yes, that IS alarming to the general population because that person has "broken the social contract", so to speak. These behaviors destroy our ability to trust that person, perhaps ever again.

We as human beings can form friendships, form cultures and civilizations when there is mutual trust, so when a person is having cognitive breaks with reality or intense, frequent mood swings which causes them to behave erratically, or when a person is a chronic liar and con-artist whose "word" means nothing, then unfortunately relatively mentally healthy people find that alarming or otherwise negative and tend not to seek a relationship with such persons.

So, I don't see a way out of this because behaviors that harm other people (particularly behaviors that harm kids) should carry stigma.

I personally can't see incest perpetrators or child predators like Miramonte teacher Mark Berndt ever being cheerfully welcomed back to the old teaching job at the neighborhood elementary school.

Would you want an "angel of death" nurse (a type of serial killer) to be taking care of you at the hospital after your apendectomy? So, OK, she's killed a half-dozen patients, but she's done her time and she's gone through therapy, so let's give her her old job back so she won't feel stigmatized.

Would you give spree killer James Holmes a job in your store, after he does his time? Would you let him babysit your children?

Behaviors that are self-harming should be pitied, but in any case (self-harming, other-harming or both) those who engage in harming behaviors need to be in some form of supervised care, either in a psychiatric hospital or in prison, if they can't stop themselves from doing harmful things and can only function adequately when on serious psychotrophic meds. (How can you trust someone who is psychotic, or someone who is a heroin addict, or someone who has extreme mood swings, or someone who is a serial child molester to actually take his or her meds ON THEIR OWN at the right dose and at the right time, consistently?)

Its a connundrum, truly.

Annie, what you write assumes

Annie, what you write assumes that all people with mental illness are violent, or harmful to themselves or others. You probably know many people with mental illness that you are not aware of, who suffer in silence, because they know you and others will assume the worst about them. You assume that they will commit the horrible atrocities that you list in your post, and that is exactly the problem with stigmatizing mental illness. People making assumptions and generalizing about a group, based on fear false information, which you clearly have. A very small percentage of the mentally ill commit the atrocities you list, but what you have said reveals your fear of the mentally ill based on false information.

Also, not stigmatizing a population does not mean that the small percentage that does cause harm to others should be released to avoid stigmatizing them. It means recognizing that most are regular people who want to live their regular lives like everyone else, and not be subjected to social distancing. Your ignorance is exactly why educating the general public is so important.

If someone you worked with who was competent at their job and an average, decent person told you they are bipolar, what would your reaction be? Would you continue to treat them as you always have? Or would you suddenly view them and treat them differently, or treat them as you would one of the people you have described above?

Do you get why people might feel ashamed and try to hide the fact that they have a mental illness? Or that they, themselves, would be in denial, and avoid treatment and help? Because they don't want to face the stigma and social distancing you and others would subject them to.

Sorry, but I have to respectfully disagree

What I wrote is that there are *behaviors* that should be stigmatized, chiefly behaviors by adults that harm kids (and I'll extend that to kids who bully and traumatize other kids as well.)

However, these behaviors I wrote about are unfortunately usually due to mental illness.

I have known and worked with people who are bipolar and I have no problem with any of those people, because they seem normal and competent at their jobs.

However I would have a great deal of difficulty IF someone I worked with told me that they'd incested their own child, or if they were into child pornography, or they admitted they'd triggered into a rage and beaten up their spouse or their child and put them in the hospital, or shared that they'd killed someone while driving drunk, or any such horrific things. I don't think I could work with someone who'd done such things.

Harming behaviors that hurt other people and especially hurt kids should carry stigma.

Show me a pedophile/child rapist, a violent batterer, a serial bigamist, a con artist, a negligent or abusive parent, or a drunk driver who *isn't* mentally ill.

We can both agree, it seems, with the statement that not everyone who is mentally ill does real harm to other people, BUT the equally true corollary is: everyone who DOES do real harm to other people is mentally ill.

My .02 worth

We are talking about addressing stigma and this is turned into a behavior discussion. As long as people act and appear 'normal' then you are alright with them? News flash: there is NO normal. The behaviors are what causes people to freak out. Is that all you see of an individual? People need treatment to avoid having behaviors that are harmful. Treatment will not occur because stigma keeps people hiding, embarrassed and silent. Stigma will continue as long as people see the behaviors first. There are situations everyday, some are those not wanting to accept responsibility for their actions.

"I don't think I could work with someone who'd done such things." I can understand your thinking, that shows a lack of compassion and a putting large groups of people into irrational, violent behaviors. A person may lose control, may throw objects or break items. Another will withdraw and be unable to leave their home. They may never hurt others. I honestly am scared because your views are of the majority. Stigma exists about disabilites, about marriage, about health issues, about things new, unknown. Educate and learn about it. I am hoping things will improve in my lifetime. I am tired of this always being seen in the wrong way. I'm tired of being ashamed.

Mmental issue is the cause. The behaviors are the occurance. You are seeing the end results. Please don't label all of us as violent, abusive, we are all NOT bad as you may think. There are many good, sweet, hurting individuals that never get help because they are scared of being lumped into behavior groups like is done in your post.

"There are many good, sweet,

"There are many good, sweet, hurting individuals that never get help because they are scared of being lumped into behavior groups like is done in your post." Exactly!

You are correct

You are correct in that I cannot assess what someone else is actually thinking or feeling, because I am not psychic. I can only assess another person, assess what kind of character he or she has, and whether they are potentially dangerous to me or my family by what they physically say and do, or have done or said.

You are incorrect in saying that I have put everyone who is mentally ill into one category, though.

I am trying to make it clear that I make judgements about whether I want someone as a friend, or as an employee, or employer, or neighbor, and whether I can trust them, based on what they have said and what they have done.

I'll repeat what I stated earlier:

Not everyone who is mentally ill does harmful things to other people or to their own self.

But everyone who DOES do harmful things to other people and/or to their own self, is mentally ill in some way.

So, I will stand by my original comment and say that if it comes to my attention that say, for example, my neighbor has done time for having molested children, then I am NOT going to let my neighbor babysit my child.

People who are attracted to children as sexual objects are mentally ill; sadly. Its called "pedophilia", and its a serious mental disorder. The worst part of this disorder is the harm it does to others; being incested by your own father or brother or sexually molested or raped by a trusted adult, or by a stranger, or by an older child/teen when you are a small child does incredibly devastating, long-term harm to the child.

I don't think either you or the other poster or the author of the article would knowingly place your own child in the care of a convicted-and-released child rapist or incest perpetrator; at least I sincerely hope you would not do such a thing.

I don't think you would knowingly leave your small child alone in the care of someone who has a history of suicide attempts, or a history of cutting herself when she's upset.

I don't think you'd knowingly leave your toddler with someone who has frequent explosive rage episodes due to a hair-trigger temper, or someone who slides in and out of reality due to a psychotic disorder.

So I think you are hypocrites to demand that other people should do this.

The individuals (only a few, I admit) I've met and worked with who had (at one time) alcohol addiction disorder, have had to summon up the personal courage to admit that they had this mental disorder and the humility to seek help for it. These alcoholics had to face very real stigma, but instead of whining that stigma is unfair (so unfair that they would not seek treatment because of it) they did the right thing and admitted they had a problem and sought help. I admire these individuals for their courage in seeking the outside help they needed to get better. They deserve admiration and respect for their courage, and I gave them my admiration and respect.

However, I was able to do that, give them my admiration and respect for admitting their alcoholism and seeking help, because they hadn't done anything to harm a child; in the cases I know personally, their addiction disorder only affected their own self.

And after time passed in which these individuals demonstrated healthy, responsible, sober behavior, they earned my trust as well.

When you do bad things to other people, you are accepting that there will be stigma and serious consequences attached.

Then what should be

Then what should be stigmatized is the behavior, not the mental illness. As for your statement that everyone who does to real harm to other people is mentally ill - where did you find that information? I'd love to find some actual data on that. Do you have any?

Exactly

That is exactly the point I was trying to make: behaviors that actually do real harm other people should be stigmatized, such as: its NOT OK to think of and treat children as sexual objects. That behavior is wrong and bad because it harms children.

Doing harm to others (and/or to the self) is simply one of THE *defining characteristics of mental illness.*

I personally can't give you any examples of mentally healthy indivuals who have seriously or repeatedly harmed others (or harmed themselves.)

Mentally healthy, well-adjusted, relatively normal people don't think of children as sexual objects (pedophilia)

or break into their neighbor's homes to steal from them, and perhaps murder them (antisocial pd)

or kidnap women to keep as sex slaves (sexual paraphilia plus antisocial pd/psychopathy, probably)

or poison their neighbors' pets (antisocial pd)

or trigger into rage and beat up their spouse (intermittent explosive disorder, borderline pd, bipolar pd, PTSD, substance abuse)

or bankrupt their trusting stockholders (narcissitic pd, antisocial pd)

or marry a series of people with the sole intent of gaining access to their money (antisocial/sociopathic pd, narcissistic pd)

or drive drunk (substance abuse/substance dependent disorder)

or sell illegal drugs (antisocial pd)

or obsessively stalk other people (possibly obsessive-compulsive pd, antisocial pd, or narcissistic pd),

or go on a killing spree (sometimes its family members or neighbors who are targeted, sometimes its complete strangers, and sometimes its employers or coworkers) and then commit suicide (possibly a combination of a psychotic disorder plus a mood disorder plus a personality disorder.)

Relatively mentally healthy people don't kill themselves (or try to; borderline pd has the higest completed suicide rate if I remember correctly.)

or decide to first kill their children in order to "save their souls" and then kill their own self in a suicide/filicide attempt (postpartum psychosis or some other psychotic disorder, or a mood disorder, or perhaps PTSD.)

All of those horrific behaviors are due to some mental illness or another, or possibly due to "temporary psychosis" (like from an LSD trip or a bad prescription drug reaction or combining alcohol with prescription meds.)

People don't do things like that unless their brains are seriously messed up in really severe ways, aka mentally ill. Such tragically disturbed individuals who do such harmful things need intensive theraputic help so that their negative behaviors can't do further harm to others or to themselves, or both.

Its just sad, any way you look at it.

Mental Health Stigma

Although the article on stigma is focused on the U.S. I feel it is mirrored in the UK. I am a counsellor, advocate and have been a carer for nearly thirty years and find that there is far too much room for improvement. The professionals cancel appointments on a regular basis or keep clients waiting for significant periods in waiting rooms then accuse clients of refusing to engage. From my experiences emotional dysregulation is part of most if not all mental well-being issues so can result in anxiety levels rising exponentially in waiting rooms etc so if a client is not comfortable/feeling safe the survival instinct takes over. What’s the easiest way to feel safe? Don’t go where you don’t feel safe. This is all supported in Tuckman’s group dynamics theories and Maslow’s Hierarchy of Needs, basics such as this is ignored. I support the assertion that if the therapeutic relationship is correct the therapy will be more likely to work.
Even theories are not understood properly, not so long ago I listened to a psychologist giving a talk on Dialectic Behaviour Therapy that couldn’t have been more inaccurate. It is not CBT with a few add on’s but a fully integrative framework. Person Centred Therapy must lead in substance and not in cosmetic appearance.

Stigma Within the Mental Health Professions

I have experienced mental health stigma among practitioners in the field of mental health more than anywhere else. In fact, I have never felt so bad about myself as when I have been in a psychiatric facility. They tend not to believe a word I say and even blame me for their own medical errors. Being presumed a liar is very invalidating and hurtful and certainly does not serve as a good basis for therapy. I think the end of stigma needs to start with those that treat the broad range of disorders among us. These illnesses are subjectively painful and are not choices we make to be "difficult" or "attention-seeking" as I have heard patients including myself being described. I have often thought that, as horrible as my mental illness symptoms are, the mistreatment and judgment I have gone through based on stigma are as painful if not more so. The healers sometimes only do harm, leaving the patient with no safe place to turn to.

Very true, and I was just

Very true, and I was just thinking about this today. I've so often felt like a movie screen that someone, often a professional, is projecting whatever images they want to see on me, that have nothing actually to do with me. Some professionals are helpful, and sometimes it takes some looking around to find them, but you're right... there are many who don't listen and make assumptions.

maybe peer support groups would help

Perhaps those with borderline pd would encounter less stigmatization and feel more encouraged to seek therapy if it was a form of group therapy?

Sort of along the same lines as AA, where fellow alcoholics support each other through their efforts to become sober, help each other "work the program", and each new member receives a "sponsor" or mentor to help him or her through the steps to recovery. Perhaps for borderline pd group therapy, there would still be a trained psychotherapist as a sort of moderator, but one who specializes in DBT.

Peer-support therapy groups might be just the ticket for bpd; its comforting to realize that you as an individual are not the ONLY one who has this problem, that other people are struggling with the same issues that you are, and they totally "get it."

I've done the 12-step program for overeating (OEA), and I found no stigmatization and much warm support and camaraderie there, and I have a couple of friends who have done AA; it seemed to be a good program for us.

Stigma: I know stigma. Believe me, there is not only stigmatization of obese people by doctors, you get treated with contempt by the general public when you're fat. Open, sneering contempt. When you're obese, you are wearing your disorder on the outside. Even an alcoholic can get sober for a while and hide her alcoholism if she needs to, but you can't hide 75 extra pounds.

Group therapy; just a thought.

The stigma associated with

The stigma associated with mental illness is very real. I was diagnosed in 2007, and since then, I have felt like an outcast. Even the professional community views you "differently". I was seeking counselling for my diagnosis only to be told that she was not qualified. Trying to hold a job or even finding a job is almost impossible. I disclosed to a manager my diagnosis regarding my behaviour sometimes, and he used it against me and harassed me about it that I eventually quit. When I moved to a new city I found that I had to find a new doctor, and then a new psychiatrist. The doctor will be at least a 3 month wait, and the psychiatrist at least a year. What am I suppose to do without medication until then? How am I suppose to function? I will soon be homeless as my unemployment is running out. This adds further to my illness. I have a criminal record because of my mental illness and addiction. I feel my parents are to blame because my brain has been altered by trauma. When people are not given help when they are asking, then what do you expect people to do when their mental illness goes untreated? How are we to exist in this world? I know that I didn't ask for this, but I feel that people do treat you very differently because of your illness.

I agree and I hear you. The

I agree and I hear you. The stigma is very real. I don't know where you live, but in my area, we have a community mental health clinic. It's for poor. You didn't say if you are suicidal or have suicidal thoughts, but that will likely be what helps you get treatment sooner rather than later. Sometimes that is what people have to tell them in order to get treatment, and it sounds like you really need to get treatment soon. If you don't know of a community mental health clinic in your area, call the doctor's office and psychiatrist's office. Same thing... suicidal thoughts are more likely to be treated as an emergency and may get you in sooner. If not, ask them if they know where you can go for help while waiting for an appt. with the dr/psychiatrist.

As for disclosing mental illness to employers, don't do it! Discrimination and being treated differently after the diagnosis was known happened to me, it happened to you, and it's happened to other people that I know from a mental health support group. Actually, I don't know of one person who disclosed to their employer, and then had a good ending. I'll be blunt... if the subject of mental illness comes up on an application, lie. Yes, I said it... lie on your job application, when it comes to mental illness. And for the most part, I advocate honesty, but not for this. You need a job, and there is still too much stigma attached to mental illness. As long as you can function on the job, none of the rest is your boss's or co-worker's business.

I hope this helps in some small way. Sending you hugs and good wishes!

NAMI and support for the mentally ill

If you are living in the USA, then here is a link to the NAMI website (National Alliance on Mental Health) and their page that discusses mental health care services that are now available under the ACA or Affordable Care Act. Maybe there will be some resources or information there that you haven't tried yet:

http://www.nami.org/Template.cfm?Section=Health_Care_Reform

NAMI also offers peer-support group programs, both in-person and on the Internet. Hopefully there is a live meet-up group in your area.

http://www.nami.org/template.cfm?section=find_support

I agree with the premise that one's medical history (including mental health history) are private, and that you should not be obligated to share this information when applying for a job. You have the right to personal privacy.

Also, here is the link to a website for those in job or career transition, and how to handle it when you are asked to disclose any criminal offenses or convictions. The site advises you to "Know Your Rights".

http://www.thegladiator.info/articles/mulqueen-ch.phtml

I hope that helps.

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Michael Friedman, Ph.D. is a clinical psychologist specializing in how social relationships influence mental and physical health.
    
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