April 18, 2014
“We must stop criminalizing mental illness. It’s a national tragedy and scandal that the L.A. County Jail is the biggest psychiatric facility in the United States.”
— Elyn Saks
Saks knows of which she speaks.
She is Associate Dean and Orrin B. Evans professor of law, psychology, and psychiatry and the behavioral sciences at the University of Southern California Gould Law School, an expert in mental health law and a MacArthur Foundation Fellowship winner. Saks lives with schizophrenia and has written about her experience with the illness in her award-winning best-selling autobiography, The Center Cannot Hold: My Journey Through Madness. She is also a cancer survivor.
Saks said, in a New York Times interview in 2011, “there’s a tremendous need to implode the myths of mental illness, to put a face on it, to show people that a diagnosis does not have to lead to a painful and oblique life.”
But, there are those who argue, as difficult as that can be to comprehend in the current dialogue, that stigmatization has its place in accepting and treating mental illness.
Especially when one considers that it’s most accepted among clinicians and the mental health community that one in four of us have suffered from or continue to suffer from a form of mental illness — be it depression, or more serious, debilitating types of mental health challenges.
But, while most of us think it vile and unthinkable to stigmatize those with mental health issues, Towson University professor Richard E. Vatz wrote in the Baltimore Sun, that there are those who believe there are indeed cases for stigmatization. In making the argument, he cites one scholarly work as it refers to those in addiction treatment.
“Psychiatrist Sally Satel wrote less than a decade ago, in a piece titled ‘In Praise of Stigma’ in the work Addiction Treatment: Science and Policy for the Twenty-first Century” (The Johns Hopkins University Press, 2007) that the issue is ‘whether addicts’ behavior can be influenced by its consequences (i.e., is voluntary). The answer is that it can.’ She believes that addictive behavior should be stigmatized, but not the seeking of help or the treatment process.”
Vatz concluded there will be cases where stigmatization is useful:
“The answer as to whether mental illness should be stigmatized is probably: “yes, in some cases; no in others.” Wherein mental problems are caused neurologically, brain disease should be viewed as all other diseases, but wherein problems are caused by individual choice, as in drug usage, people should be stigmatized to discourage their behavior.”
Of course, that’s a narrow take on the circumstances of stigmatization as it applies to mental illness.
In an October, 2004, paper presented in the journal American Psychologist, Patrick Corrigan of the University of Chicago found the very stigmatization of mental illness impedes those who are suffering from any form of mental disease impedes the treatment.
In essence, Corrigan concluded, quite plainly, that many who are mentally ill just avoid treatment or mental health services because of stigma: “namely to avoid the label of mental illness and the harm it brings… Stigma yields two kinds of harm that may impede treatment participation: It diminishes self-esteem and robs people of social opportunities.”
In fact, the previous presidential administration made strides in the area of addressing the problem as far back as 2003, Corrigan wrote.
“Advocacy and government groups have strongly endorsed resolving the stigma of mental illness as a way to improve service use. The report of President Bush’s New Freedom Commission highlighted anti-stigma programs as a primary goal to improve the mental health system. A better understanding of the problem of stigma is needed to inform the development of these anti-stigma programs… Psychologists who are able to embrace this research agenda will help advocates to better tackle the stigma problem and will significantly advance treatment use in turn.”
(“How Stigma Interferes with Mental Health Care.” October 2004, The American Psychologist. The American Psychological Association.)
It’s easier said than done, it seems. While there have been extensive discussions, and scholarly dissertations on the effects of stigmatization and marginalization of those suffering from mental illness, no one seems to have a societal cure for the underlying answer to the problem.
At the 2013 TEDxMet conference (TED.com), writer Andrew Solomon presented a moving talk on his own personal battle with depression and underscores the simple truth about the stigma of mental illness — talking about it can bring about understanding and acceptance, leading to help and treatment.
“People still think that it’s shameful if they have a mental illness,” Solomon told the TEDxMet conference. “They think it shows personal weakness. They think it shows a failing. If it’s their children who have mental illness, they think it reflects their failure as parents.”
It’s not always easy to coax someone with highly personal – and let’s face it, often painful – experiences with mental issues to speak about them openly. But, those who’ve spoken cogently on the subject, as Solomon did at the 2013 TEDxMet conference, believe the dialogue has to begin somewhere for it to be effective.
“The most moving letter I ever received in a way was one that was only a sentence long, and it came from someone who didn’t sign his name. He just wrote me a postcard and said, ‘I was going to kill myself, but I read your book and changed my mind.’ And really, I thought, okay, if nobody else ever reads anything I’ve written, I’ve done some good in the world. It’s very important just to keep writing about these things, because I think there’s a trickle-down effect, and that the vocabulary that goes into serious books actually makes its way into the common experience — at least a little bit of it does — and makes it easier to talk about all of these things.”
In Canada, this month, six-time Olympic medalist in cycling and speed skating Clara Hughes, is pedaling a bicycle across the broad expanse of the country to do just that – open the dialogue.
“Clara’s Big Ride” is rolling across Canada to promote her message of “working together to create a stigma-free Canada.”
Hughes herself battled depression before becoming an Olympic-caliber athlete and said she has been fortunate in her life to have support where others do not.
“I actually had the help, I had the support — I didn’t lose my job, I didn’t lose my spot in my sport on my national team,” she said in an address this week to a mental health fundraising dinner in Halifax, Nova Scotia.
“Everybody around me rallied to bring me back, to make me stronger (and) to have me win again for my country. I don’t think that’s the case for the woman that works at the hospital, or the teacher at the school or the mother who’s at home alone with postpartum depression,” said Hughes. “I know it’s not the case, because people tell me their stories.”
Personal stories. Dialogue. Discussion.
It may not be the stuff that moves governments to act, but it is the only universally accepted means by which to correct the demonization, the stigmatization of those with mental health challenges.
Seems simple, doesn’t it? Such a simple thing as talking about it, but as the experts point out, it all starts at home, in our own neighborhoods, in our own places of work and in our own families.
Hey, it’s a start.
Chris Malette is a retired newspaper journalist with 35 years of experience as a reporter and city editor. Over his career, Malette covered municipal and federal politics, military, health and court beats. He has reported from Somalia, Bosnia, Haiti and covered relief efforts in Honduras in the wake of Hurricane Mitch in 1998. He now works for SPN News as an editorial columnist.