Stigma Undercuts Efforts to Treat Mental Illness

Published by Contra Costa Times

Posted on Sat, May. 01, 2004

By Donna Wigand

DID YOU KNOW that one in five people in the United States has a mental illness and that one in four families worldwide includes someone who has a mental illness? But the really sad statistic is that less than half of all Americans who have a mental illness receive treatment.

Why, in the richest country with the largest health care system on the planet, are so many untreated for mental illnesses? The answer, frequently, is the fear of being labeled "mentally ill," and the isolation, and even discrimination, that the stigma can cause.

Several misunderstandings about mental illness contribute to this problem. One is that mental illness lasts a lifetime, when in fact most such illnesses are treatable, and the people recover. Another is that most people with a mental illness are dangerous to others, when, in fact, they are more likely to be victims of crime than criminals. And a third misunderstanding is that those with a mental illness are hostile, when, in fact, hostility is often a protective shield that hides a yearning for connection and acceptance.

I know a young mental health patient who we'll call Susan, whose case mirrors those of many others and shows some of the problems mental health patients face. Susan was never a popular student. She was extremely self-conscious from a young age. She couldn't relax, laugh and have fun like most people. She gradually withdrew completely into herself.

Her family recognized her suffering and sought medical help. A psychiatrist diagnosed schizophrenia, but her family kept it a secret. Friends, teachers, neighbors and extended family members never knew the seriousness of her illness, and thus developed their own negative opinions of Susan. They thought she was strange, hostile, a drug user, a bad seed.

Despite this, Susan got through school and went away to college. However, in an unfamiliar environment, her feelings of being different and alone overwhelmed her. She broke down, had to drop out of school, and returned home to her parents.

This time, a therapist recommended medication and a Wellness Recovery Action Plan, which included therapy sessions, but also more intimate and open relationships with other people. Her family invited neighbors, extended family members and her few friends to attend treatment sessions to help her figure out what kind of support she needed and could gradually accept. This helped Susan understand and share her fears and begin to connect with others.

And it helped those around her understand her suffering and inner torment. Their fear and dislike became empathy and acceptance. Opening up helped Susan reverse others' fearful, hostile perceptions. The ways stigma and discrimination put up barriers to mental illness treatment was recently documented in the Surgeon General's report on mental health. This report describes how society's negative perceptions of those with a mental illness worsens their disease.

May is Mental Health Month and a good time to become aware of how we can all help those with a mental illness in their recovery. For those interested, the mental health community of Contra Costa County will soon host a daylong conference on how to "Take the Initiative to Combat Discrimination and Stigma." For more information about the conference, call 925-957-5169 or 925-957-5142 or visit the Contra Costa Health Services Web site at cchealth.org.

Donna Wigand is director of the Mental Health Division for Contra Costa Health Services.