2 Simple Actions to Help Curb Mental Illness Stigma

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Mental health and substance abuse advocacy is a growing movement. Each May, the Substance Abuse and Mental Health Services Administration (SAMSHA) declares a week as National Prevention Week. It’s defined as “A week dedicated to bringing an annual health observance dedicated to increasing public awareness of, and action around, mental and/or substance use disorders.” The focus is on preventing suicide, substance abuse, and undue suffering from untreated conditions.

Unfortunately, despite such campaigns and mental health being more “out of the shadows” in recent years, stigma and misunderstanding are alive and well, and contribute to lack of care and, ultimately, undue suffering.

According to the National Institute of Mental Health (NIMH), about 51.5 million Americans have a diagnosable mental illness (2021), yet fewer than half seek care. Contributing factors include lack of providers and people not understanding that their condition is treatable. However, the stigma of mental illness is quite possibly the most significant contributor. According to trauma psychotherapist Lisa Ferentz (2021), “Our culture still perpetuates the belief that people suffering from mental illnesses are not intelligent, extremely violent, or incapable of making decisions that profoundly impact their lives."

In 2015, the University of Memphis published four disturbing facts about mental illness perception:

• 4 in 5 think it's harder to say they have a mental illness than other illnesses.
• 1 in 2 are frightened by people with mental illness.
• "Psycho," "nuts," and "crazy" are the most common description of those with mental illness.
• Mental illness ranked as the most stigmatized type of illness.

Ironically, even some treatment facilities contribute to the problem. Despite the push to destigmatize and encourage people to seek treatment, many facilities adopt names devoid of the words “psychological,” “mental,” or “behavioral.” While the intention is to make sure it is a place people feel comfortable entering without stigma, it is a double-edged sword; modeling associated with mental health care is unfavorable.

In 2019, The Austen Riggs Center, a private psychiatric care facility in Stockbridge, MA, published a newsletter devoted to stigma. The most remarkable statement was as follows:

In both entertainment and news media, individuals with mental illness are often inaccurately and disproportionately depicted as dangerous and unpredictable. This has negative repercussions for both those struggling with mental illness and for the public’s understanding of mental illness. The fact is that people mental illness are far more likely to be victims of violence than perpetrators of violence.

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The most remarkable recent example of the above is the 2016 movie Split. Someone with Dissociative Identity Disorder (DID), historically called Multiple Personality Disorder, an extreme form of PTSD, was depicted as a sociopath. In reality, people with DID have symptoms that would be rather subtle for people outside their close network to notice, never mind significant violence.

In 20 years of working in this field, I can count on one hand the number of violent incidents among the many hundreds of people I’ve evaluated and treated. It is the major exception, but unfortunately, it makes a better story for Hollywood, and the news media isn’t likely to discuss people with mental illness doing well. Major problems get air time, and unfortunately, the news media is a frequent source of health information for the public.

While billboards and commercials may seem like they’re getting the job done, let’s consider the fact there remains plenty of activity in the psychology journals regarding mental health and the problems of stigma. There are two simple, effective steps you can practice and encourage to help defray stigma:

1. Though symptoms may be prominent and challenging, realize people's strengths with psychological diagnoses instead of collecting deficits. Are they working, in school, or taking care of a family despite it? I often ask people, “What’s been helpful in managing all this?” and am heartened to hear of creative solutions. It is highly effective in psychotherapy to focus on cultivating mentally ill individuals’ strengths. The late, great psychiatrist Milton Erickson pioneered the approach. It is an easy concept to work into your probation supervision with families.

2. Refrain from using mental health diagnoses to describe people’s behaviors casually. For one, chances are you wouldn’t say to someone who is getting moody because they are hungry, “You’re so diabetic,” so why is it OK to use psychological diagnoses this way? Furthermore, throwing around a diagnosis as an adjective is often in a pejorative light and sets the precedent that mental illnesses are trivial or to be made fun of. Think of how often you’ve heard someone called “OCD” while getting eyes rolled at them because they’re simply being organized or “schizo” because they act erratically. If this describes any readers, I respectfully invite you to read Life in Rewind and The Quiet Room to understand what life with these respective conditions is really like.