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Stigma: Society's impact on the mentally ill

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http://www.ynot1.com.au/magazines/Stigma.pdf

When invited to do a paper on this topic, the first thing one does is
seek out the old reliable dictionary for a definition of stigma. I
came up with the following: A stigma is a shameful reputation that
a particular action or way of behaving has because so many people
disapprove of it. If something is stigmatised a lot of people regard
it as shameful.
Are mentally ill people stigmatised? The answer to this it would
appear depends of what one means by mentally ill. In fact it may
depend on how recognizable they are as mentally ill, how
significantly different the mentally ill are from the rest of us and
what type of mental illness one is considering.
I have counselled people for 20 years. In the early days my clients
used to park around the corner and ask if there was a back entrance
to the office. Now most park out the front and hope people see
them coming in. Having psychotherapy has moved from being a
stigma, to being a status symbol. One now commonly sees
mentally ill people being counselled on worldwide television
shows like Oprah. With traumatic events like earthquakes, random
shootings and so forth it is now openly stated that the police,
ambulance officers and emergency service personnel involved in
such tragedies receive counselling. The stigma for this sort, or
level of mental illness is less evident. It is far more accepted now.
However, when I recently took two groups of about 7 mentally ill
people on ARAFMI holidays, there appeared to be a much
different reaction from the public in general to these individuals
than to those who come to me for counselling. As far as stigmas go, yes there is a difference, it would seem, between having a
phobia and being a person with schizophrenia. It is perceived as
different for a policeman who has been traumatized by removing
bits of bodies from under a train, to being a person who is seen as
having manic-depression. Perhaps society is moving in the right
direction by there being less of a stigma for the neuroses or normal
mental illness, but there still is a stigma for many of the psychoses.
While we may be able to conclude that a stigma exists at least for
the psychoses, the next question must be - Why does a stigma
exist? If we look at some historical factors we are given insight
into an answer for this question. The famous movie Dr Jeckl and
Mr Hyde portrays an individual with a split personality. This for
many has become associated with schizophrenia. Of course anyone
with even a small understanding of schizophrenia knows that this
mental illness has nothing to do with a split personality. Such a
personality is more along the lines of a multiple personality
disorder. However as far as society goes that basically does not
compute, and the character of Dr Jeckl and Mr Hyde is commonly
seen as a schizophrenic.
More to the point however, Mr Hyde is portrayed as both evil and
dangerous. When Martin Bryant shot 35 people at Port Arthur in
Tasmania it did not take the media long to begin asking, or at times
just stating outright that he must be mentally ill or schizophrenic.
The entire cover of Who Weekly magazine of December 1996
carried Martin Bryant's photograph with the title - AUSTRALIAN
PSYCHO. Such portrayals are not uncommon. Whenever there is
some infamous act of violence the media regularly raise this
question, or just assume straight away the person must be mentally
ill. From the media the general public get regular confirmation that
mentally ill people are violent and dangerous. Some indeed are but
they constitute a very small minority. There is much more
likelihood of a sane person being violent and dangerous.


Other historical factors that encourage a stigma could include the
comparison that has been made between witches and warlocks and
the mentally ill. The fact that in the past mentally ill people were
locked up in institutions which were disdainfully called the looney
bin or the nut house. The people in such institutions are often
portrayed as looking odd and weird. They are seen to do such
things like shouting out for no reason and other socially
unacceptable behaviour like inappropriate urination, defecation
and sexual acts. While these do occur in some forms of psychoses
they are only a very small minority. A normal person under the
influence of alcohol is much more likely to do such things.
However with the mentally ill these are what will get noticed and
remembered.
Also if society can define the mentally ill as being like that then
this reassures us others that we are normal because we do not do
things like that. It also allows an expression of prejudice or bigotry
in society. It provides a justifiable focal point for prejudice by
some. The bullies in society who have prejudicial beliefs can focus
those beliefs on the mentally ill.
Any minority group with a poor ability to articulate and repeatedly
state their needs and wants is going to be poorly resourced and
often viewed in a non-ok fashion. The psychotic by definition have
a thinking disorder of some description and thus are not going to
be good at articulating their needs. They will have very little
political power and little ability to stand up against the bully and
the prejudiced. In conclusion it would seem that there are a number
of reasons from a number of perspectives as to why a stigma exists
for the mentally ill.

How do the mentally ill lose from such a stigma? The obvious first
point is that they lose -- or suffer is perhaps a more accurate word -
- from a loss of self esteem. If one is told often enough by many
people that they are not good, not contributing, weird, dangerous and abnormal then one will start to believe it.
Even the individual
with the strongest sense of self will finally believe what others say
about him if it is said often enough. The mentally ill individual
usually does not have a strong positive self image or belief that
they are a good, contributing member of society. So when they are
portrayed time and again with the stigma it does not take them long
to start believing what is said.

Indeed it is not just what is said but also what is done, or not done.
It would be safe to say that the majority in society are kind and
considerate and want the best for others. Most of us would not
want mentally ill people to feel marginalized, to feel inferior and to
feel bad about themselves. Unfortunately when the stigma is
stated, whether that be in private statements by individuals, public
portrayals in the media, or by the looks and avoidance behaviour of
the general public, these tend to get noticed and remembered. The
minority of the general public who for whatever reason need to
deprecate the mentally ill tend to get heard and the majority who
want the best for the mentally ill tend to remain silent. So the
stigma is perpetuated as much by silence as by prejudicial
comments.
This silent majority may seem like a nice, good group of people
and members of this group may even gain solace for themselves in
that belief. They may even attempt to reassure themselves that they
are not biased or bigoted against the mentally ill. That may even be
true but there remains one other fact which they cannot deny. The
majority of the silent majority play the bystander role, or they
would not be silent! Their thoughts and actions go along the lines
of, I myself do not think mentally ill people are strange and a drain
on society, but I do not do anything about it. They stand on the side
and do nothing. If the silent majority stopped being silent, the
stigma against the mentally ill would quickly vanish. But they do
not, they remain as bystanders, and bystanders support prejudice
and ridicule by inaction. It seems safe to conclude that if they really wanted to do something about the stigma then they would
not be a silent bystander.
So society does have a stigma about the mentally ill. That seems
beyond question. It is however a double edged sword. This unfair
discrimination is indeed unfair. But what does the mentally ill
individual, and those around them, do with that knowledge? It can
be used to motivate action to fight the stigma both at a political
level and at an individual to individual level.
On the other side it can lead to the mentally ill individual taking on
the victim position. Poor me or Ain't life awful are easy positions
to fall into for the mentally ill. It is a safe position, as one can
easily use it to justify their inaction, or their giving up on life. They
can believe - What is the point of doing anything if society thinks I
am no good.
It is an unfortunate reality of life that in the human species it is the
politically strong that get treated best and get the most resources.
Throughout the history of mankind I do not know of any politically
weak group in any society who has fared well in the long term. The
mentally ill certainly have not. As a result of their illness they have
always been political infants. Throughout history societies have
essentially dealt with the mentally ill by putting them away
somewhere. Keeping them out of sight. Long term favourable and
fair treatment has been rare for this group over history.
To hope that this aspect of human nature is going to be different in
our lifetimes or even the next few generations is false hope. We
can even think that it should be different, and that it is not fair.
Indeed it is not fair and it should be different, but that is how it is
and how it is going to remain at least in the near future. The
mentally ill and those around them need to actively avoid the
victim standpoint. To feel maligned or hard done by as a result of
the stigma will do no good, in fact it will harm. The stigma is there, it must be recognized for what it is, it needs to
be confronted at a societal or political level, but as importantly it is
each individual mentally ill person who must fight for their own
self image and demand respect from others. This is what will
really, finally, bring the long term demise of the stigma against
mentally ill people.

Tony White - Psychologist

A few comments myself it seems when someone does something like murder or even worse a serial killer people are quick to label him a "nutcase" or some "crazy person" the reality is most murderers, true sociopaths or serial killers are sane people. People are ignorant and they don't think sane people are capable of doing atrocious or horrendous things like that, this perpetuates stigma that mentally ill people are dangerous and violent...

People are also ignorant to external factors which may make a person temporarily insane or have psychosis, many traumas, or an illness(virus), possibly even underlying genetics. Those with autoimmune disease are more prone to psychosis even those who are geniuses or near are more as well.

Mentally ill people are much more likely to be victims rather then perpetrators. Bullies like to pick on weaker target or those who are less likely to defend themselves if someone is mentally their probably less likely to be assertive therefore being more humble. By being cruel and attacking a person with a fragile psyche, and then using self justification or others means to rationalize one's behavior is quite disturbing.
 
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