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.