There is some sentiment among advocates for persons with serious mental illnesses like schizophrenia and bipolar disorder that movements like Mental Health Awareness Month and fighting stigma is a waste of resources because it doesn’t help get treatment and resources to the most severely mentally ill. I disagree. I think awareness and stigma fighting are an important component in getting those people the services they desperately need. I have four reasons why.
Reason One: Doctors Don’t Diagnose Because of Stigma
The medical community doesn’t treat psychological illnesses as important and physical illnesses. Medical schools treat the subject of mental illness as a lower priority than the rest of their medical training. An NIMH study shows psychiatrists actually avoid persons displaying mental illness in public MORE than the general population does. How many of us have had a child psychiatrist tell us they won’t diagnose our child with schizophrenia or bipolar disorder because they don’t want to put that on our child’s permanent record? If our doctors won’t interact with the mentally ill because of a stigma, how can we expect anyone else to?
Reason Two: Politicians Don’t Pass Laws Because of Stigma
Sometimes a politician’s stigma is obvious. We’ve all heard Donald Trump call all of his opponents insane at one time or another. Ted Cruz has said that he has had, “…a lot of experience with mental health,” issues during his time in Congress. We have had former Governor Mike Huckabee say the Supreme Court is, “off their medication for schizophrenia,” when they issued a judgement he didn’t agree with.
When politicians frame mental illness as character flaws, they don’t put value on bills that are meant to help the mentally ill. The Mental Health Parity Act was signed into law in 1996, the revision, the Wellstone Mental Health Parity and Addiction Act was signed in 2008, but there are no laws or procedures in place to enforce the law.
HR 2646, the Helping Families in Mental Health Crisis Act, has been stalled in committee for a year.
Reason Three: the Judicial System Doesn’t Care About Treatment Because of Stigma
If you haven’t read Pete Earley’s Book, Crazy: A Father’s Search Through America’s Mental Health Madness, you should. One of the stories that sticks out to me is the story about a woman with schizophrenia arrested for a petty crime, but found mentally unfit to stand trial. The jail sent her to the state hospital who got her just well enough to be tried, but then she languished back in the jail awaiting her trial date long enough to destabilize again and had to be sent back to the hospital. This cycle went on for years – longer than she would have ever spent incarcerated if she had been convicted.
Sometimes it’s the judge himself, not the system. Read up on the case of Morgan Geyser, arrested at age 12 and diagnosed with childhood onset schizophrenia. In my opinion, Judge Bohren is interested in vengeance, not justice, which is why he denied her treatment.
Reason Four: The Public Doesn’t Support Laws and Spending Because of Stigma
CDC research shows that public health spending on mental illness suffers when the community views mental illness as a weakness instead of a medical condition. They support increased police because they see the mentally ill as violent and dangerous, but, for example, when Chicago closed half of the mental health clinics in the city, there was no public outcry outside of the patient population.
If the public doesn’t see mental illness as a medical condition, they won’t see treatment as a way to make their community safer.
I’m really interested in your opinion. What is your opinion of the value of anti-stigma campaigns? Tell me in the comments, please!
Resources for further reading on stigma:
https://www.psychologytoday.com/blog/why-we-worry/201308/mental-health-stigma
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632277/