Update: Student Union Director confirms post was innocently posted on social media and has been removed, there was never an on campus presence as originally reported.
On April 17th our Exec. Director sent a call to action regarding an insensitive
Ball State University
Department of Communication Studies
STIGMA RESEARCH PAPER
By Jake Griffin
April 19, 2017
Submitted in partial fulfillment of the requirements of:
Human Relationship Development
CSPY 230, SECT 800
S T I G M A
S-T-I-G-M-A—Stigma. How can one six letter word cause so many people suffering from mental illness so much pain, shame, isolation, secrecy and discrimination? Stigma refers to the negative or misperceived feelings one exhibits towards another of a certain trait or characteristic, such as in this instance, being plagued with mental health issues ranging from Major Depressive Disorder to post traumatic stress disorder(PTSD). How can having to deal with a mental illness be just as bad as having to face the major forms of adversity that come with sharing the way you feel with others? While many share a commitment to helping improve equality pertaining to those struggling with mental health, there are obstacles and barriers in place by society and in the general publics’ perceptions that make equality a distant reality. This stigma is often a major determent towards those in need opting to receive quality care, leading to impediments of their overall wellbeing which disables them from living the most positive and fulfilling lives possible.
The movies and media sometime describe people with mental illnesss as, “homicidal maniacs” leading to a public perception of mental illness that leads many suffering not to pursue treatment out of fear of be labeled. This in turn leads to several major types of stigma known as public, label avoidance, structural stigma and self-stigma. These varying forms have led to public perceptions. According to Rogers & Pilgrim (2009), the public has mixed perceptions regarding people with mental illness. They believe that people with mental disorder are more likely to act violently, commit crimes, endanger others, and behave inappropriately or unintelligibly. Some people have a “fear of contamination by the illness and fear of unpredictable danger” initiated by mentally ill people (Rogers & Pilgrim, 2009, p. 24-26). As result, the general public tends to stereotype and discriminate people with mental illness. The stigmatized people are often excluded from their social or cultural groups which can further lead to further isolation (Rogers & Pilgrim, 2009). Additionally, the prejudice attitude and the label that people with mental illness perceive from the public lower their self-efficacy or self-esteem, and threatens their sense of self-identity. They are most likely to feel depersonalized, rejected, and disempowered (Rogers & Pilgrim, 2009). The feeling of despair, helplessness, and worthlessness are also the result. Leading not only to negative impacts for the stigmatized person struggling from a mental illness but in addition these negative connotations, also have a disadvantage in employment, particularly in the already competitive job market as well. So what exactly is stigma? Stigma shows up in different forms. The President’s New Freedom Commission on Mental Health defines stigma as “a cluster of negative attitudes and beliefs that motivate the general public to fear, reject, avoid, and discriminate against people with mental illnesses.” So, stigma begins in our minds. It happens when we believe myths and popular media portrayals of mental illness, such as, “All people with mental illness are violent,” and we start to put those with mental illness in a box. We assign labels and see them as different from us. And the moment society starts to see someone or something as “different”, it sets the stage for wrongful treatment to follow. Think of racism or sexism. Stigma is not much different, although we don’t consider it a blatant social taboo in that sense, as it sometimes should be. Like the “-ism” forms of prejudice, stigma manifests itself outwardly—by way of discrimination in both subtle and overt forms.
Most importantly to consider in regard to stigma is the harm this causes—both for the person with mental illness and for society at large.
First, stigma impacts the individual with mental illness. The CDC reports that only 20% of adults with a mental disorder saw a mental health provider in the past year, and the shame and embarrassment associated with getting help is a major barrier. We have created a society where people don’t want others to find out about their “issues”, and for this reason alone, many avoid seeking treatment. Instead, they may turn to dangerous coping methods such as binging or self-coping with explicit drugs or drinking, which raises their risk for chronic disease, addiction and premature death. According to the National Alliance on Mental Illness, those living with serious mental illness die an average of 25 years earlier than the general public—largely in treatable conditions. On a broader level, stigma harms society. Discrimination against people with mental illness leads to unequal access to housing, health care, employment, education, and community support, and this leads to unemployment, homelessness, and poverty. In addition, the perception that mass media portrays about mentally ill people as “being naively cheerful, childlike, and quirky” (Rogers & Pilgrim, 2009, p. 36) lead to social misinterpretation. Martinez (2014) stated that fear of social discrimination becomes a major barrier that does not motivate people who are experiencing mental distress to seek for psychiatric help. Fear of losing job status, fear of criticism, and fear of losing a family also prevent them from obtaining psychiatric intervention (Martinez, 2014). Evidently, people with mental illness perceived stigma in all angles which further lead to mental health deterioration.
How do the attitudes of community members contribute to stigmatization in people with mental illness? Schulz (2007) states that people with mental illness not only experience this stigma or social discrimination from families, relatives, colleagues, and employers, but they also experience stigmatization from being exposed to someone with a mental illness firsthand. For example, Rogers & Pilgrim (2009) point out that “mental health care workers tend to be paternalistic towards psychotic patients by distrusting and rejecting of those with a diagnosis of personality disorder” (p. 38). Patients diagnosed with mental illness are more likely to receive a lesser quality of psychiatric care by mental health care providers. A study reveals that patients felt stigmatized when mental health professionals do not have interest in their patients’ concerns, do not explain the side-effects of antipsychotic medication such as extrapyramidal symptoms, weight gain; and in fact, they provide generalized treatment to all patients rather than patient-centred treatment (Schulz, 2007). Patients further report that mental health professionals are often provided “a negative prognosis such as ‘You’ve got schizophrenia, you will be ill for the rest of your life’ or ‘your illness means that you will end up committing suicide” (Schulz, 2007, p. 145). These comments not only provide a clear explanation to patients about the treatment, but these comments also further stigmatize patients with mental illness. It is obvious that patients with mental illness perceived stigma before, during, and after seeking for psychiatric treatment.
How can we all help reduce stigmatization in people with mental illness? There are many programs that the stakeholders and advocates have employed on a nationwide and global level to to fight and curve the stigma in mental health. Active Minds, is a national student mental health awareness and advocacy group based in Washington, DC formed in 2003. Their mission is to increase students’ awareness of mental health issues, provide information and resources regarding mental health and mental illness, and to encourage to seek help as soon as it is needed. By promoting awareness and education, Active Minds aims to reduce stigma that surrounds mental illness and create an open environment for discussion of mental health issues. The goals of these programs are aimed to change the publics attitude toward the people with mental illness and respect them as equal citizens. According to Horsfall (2010), the expected outcomes are to eliminate discrimination and prejudice, increase public awareness, provide knowledge regarding mental health, reduce barriers to psychiatric treatment, and improve stigma management. In order to address the issue of discrimination in employment, the CDC alongside stakeholders such as Mental Health America provide educational programs and outreach teams in an effort to curtail the stigmatizing thoughts and beliefs in society about mental illness. Studies suggest that advocates must also educate themselves to avoid stigmatization in mental health field. By providing an in-service training session or QPR(Suicidal ideation version of CPR) regarding stigma to mental health care professionals, undergraduates, postgraduates and by focusing on encouraging hope, promoting recovery process, and providing a human centered approach, society gains perspective on stigmatization and their attitudes are better equipped to combat the ideologies that may contribute to stigmatization. In addition, Corrigan in 2001 found that the emotion of compassion provided by mental health care providers “are typically conceived of as directed outside the self, can redirect toward the self to promote care-taking actions such as treatment seeking.” Simply providing insight and resources for those who are experiencing mental illness use to learn more about the illness and treatment, attend a self-help group support, and meet and discuss about mental illness with community advocates are the strategies that help increase treatment seeking behaviors/ In addition, advocates should respect, listen, acknowledge consumers concerns, provide emotional support, and work with their strengths in order to reduce stigma. There are a plethora of ways for advocates and community members to help sufferers live more positive and fulfilling lives.
In relation, people who are living with mental illness experience stigma from all aspects of life even from consumers or those with illnesses themselves who understand most about the nature of mental illness. Fortunately, there are many programs and campaigns that are designed to combat stigma in mental health nationally and internationally. It is evident that reducing stigma in mental health requires everyone’s effort, especially advocates who frequently interact with people in all walks of life. Mental illness can be present in anyone; regardless of socioeconomics status, age, or race—so it is not shameful to seek for help. In fact, it is beneficial to seek for treatment because one’s mental health can be well-nurtured and cared for. Together, these forms of “stigma” further form barriers to treatment for those with need. In order too effectively begin to heal the symptoms of mental illness, we must challenge the notion that seeking aid for behavioral health problems is not a sign of weakness or flawed character. We must raise public awareness of the realities of the behavioral health disorders afflicting those at risk. As Americans and as communities, we must take steps to provide adequate and continuous care for in all aspects of cognitive and social development. Community beliefs surrounding mental health, and especially suicide, is eradicated, out of touch and desensitized. Schools are discouraged from discussing suicide out of fear of memorializing suicides—out of fear of “suicide contagion.” However, chain suicides are rare and only account for 1 to 5 percent of suicides annually. In addition, 90 percent of people who commit suicide have a predetermined mental disorder, so there is no way to “catch suicide.” This means censoring suicide memorials and desensitizing mental illness in schools or in other mediums such as Netflix benefits no one. This misinformation rooted in miseducation causes negative effects into adulthood. Just take a look at how politicians speak about mental illness:“We should work to reduce tragic acts of violence by addressing violence at its source, including untreated mental illness,” Marco Rubio said to a crowd of reporters shortly after the Sandy Hook shooting. Rubio has been notorious for using mental illness as a scapegoat for gun violence. When we only talk about mental health when something goes wrong, society is inevitably are going to associate these disorders with tragedy.
Eradicating the stigmas associated with mental health needs to be addressed head on. The fact is that we need to work to address and explain these issues preemptively. Tip toeing around so called “sensitive subjects” makes them taboo, when we should be working to normalize these very prevalent and detrimental issues impacting society.
Benner, G. J., Beaudoin, K. M., Chen, P., Davis, C., & Ralston, N. C. (2010). The impact of intensive positive behavioral supports on the behavioral functioning of students with emotional disturbance: How much does fidelity matter? Journal of Behavior Assessment and Intervention in Children, 1(1), 85-100. doi:10.1037/h0100361
Brener, N. D., Martindale, J., & Weist, M. D. (2001). Mental Health and Social Services: Results from the School Health Policies and Programs Study 2000. Journal of School Health, 71(7), 305-312. doi:10.1111/j.1746-1561.2001.tb03507.x
Cappella, E., Frazier, S. L., Atkins, M. S., Schoenwald, S. K., & Glisson, C. (2008). Enhancing Schools’ Capacity to Support Children in Poverty: An Ecological Model of School-Based Mental Health Services. Administration and Policy in Mental Health and Mental Health Services Research, 35(5), 395-409. doi:10.1007/s10488-008-0182-y
Chappell, N. L., & Penning, M. (2009). Understanding health, health care, and health policy in Canada: sociological perspectives. Don Mills, Ont.: Oxford University Press.
CDC. (n.d.). Attitudes Toward Mental Illness – 35 States, District of Columbia, and Puerto Rico, 2007. PsycEXTRA Dataset. doi:10.1037/e552452010-003
Corrigan, P.W., & Lundin, R.K. (2001). Don’t call me nuts! Coping with the stigma of mental
illness. (pp. 456). Tinley Park, IL: Recovery Press.
Corrigan, P.W. (Ed.) (2005). On the stigma of mental illness: Implications for research and social change. (pp. 343). Washington DC: American Psychological Association Press.
Corrigan, P.W., Roe, D., & Tsang, H., W. (2011). Challenging the Stigma of Mental Illness: Lessons for Therapists and Advocates. (pp.213). West-Sussex, UK: Wiley-Blackwell.
Eckert, T. L., Miller, D. N., Riley-Tillman, T. C., & Dupaul, G. J. (2006). Adolescent suicide prevention: Gender differences in students’ perceptions of the acceptability and intrusiveness of school-based screening programs. Journal of School Psychology, 44(4), 271-285. doi:10.1016/j.jsp.2006.05.001
Gallagher, R. P., (2010). National Survey of Counseling Center Directors (Rep.). Alexandria, VA: The International Association of Counseling Services.
Gallagher, R. P., (2015). National Survey of Counseling Center Directors (Rep.). Alexandria, VA: The International Association of Counseling Services.
Haas, A. P., Koestner, B., Rosenberg, J., Moore, D., Garlow, S. J., Sedway, J., Nicholas, L., Hendin, H., Mann, J., and Nemeroff, C. B., “An Interactive Web-Based Method of Outreach to College Students at Risk for Suicide,” Journal of American College Health, Vol. 57, No. 1, 2008, pp. 15–22.
Horsfall, J., Cleary, M., & Hunt, G. E. (2010). Stigma in Mental Health: Clients and Professionals. Issues in Mental Health Nursing, 31(7), 450-455.
Kann, L., Telljohann, S. K., & Wooley, S. F. (2007). Health Education: Results From the School Health Policies and Programs Study 2006. Journal of School Health,77(8), 408-434. doi:10.1111/j.1746-1561.2007.00228.x
Kataoka, S., Stein, B. D., Nadeem, E., & Wong, M. (2007). Who Gets Care? Mental Health Service Use Following a School-Based Suicide Prevention Program. Journal of the American Academy of Child & Adolescent Psychiatry,46(10), 1341-1348. doi:10.1097/chi.0b013e31813761fd
Nabors, L. A., & Reynolds, M. W. (2000). Program Evaluation Activities: Outcomes Related to Treatment for Adolescents Receiving School-Based Mental Health Services. Children’s Services, 3(3), 175-189. doi:10.1207/s15326918cs0303_4
Otto F. Wahl, Ph.D.; Mental Health Consumers’ Experience of Stigma. Schizophrenia Bulletin 1999; 25 (3): 467-478. doi: 10.1093/oxfordjournals.schbul.a033394
Perry, C. L., Klepp, K., Halper, A., Hawkins, K. G., & Murray, D. M. (1986). A Process Evaluation Study of Peer Leaders in Health Education. Journal of School Health, 56(2), 62-67. doi:10.1111/j.1746-1561.1986.tb01176.x
School-Based Health Care: Practice Interventions, Outcomes, and Impacts From the Field. (2012). School-Based Health Care: Advancing Educational Success and Public Health. doi:10.2105/9780875530062pt01
Schulz, R., & Sherwood, P. R. (2008). Physical and Mental Health Effects of Family Caregiving. The American Journal of Nursing, 108(9 Suppl), 23–27. http://doi.org/10.1097/01.NAJ.0000336406.45248.4c