Stigma is ignorance. Stigma is fear. Stigma is guilt. Stigma is discrimination.
Why is something so obviously wrong still so prevalent?
The roots of stigma in our society are stubborn, reaching back to the beginnings of human history. Anyone whose behaviour was different was considered dangerous, and so those with mental diseases often became outcasts. With virtually no scientific data to enlighten people ignorance of mental illness predominated for millennia.
Medieval Christianity, for example, moralized about mental illness as an issue of good and evil. A person suffering from profound depression, for example, was assumed to be possessed by the devil and therefore in need of exorcism.
Fast forward to the twenty-first century. Though religious traditions endure through millennia, in our day, it’s the police blotter that so often links mental illness to evil of violence and other threatening behaviours.
Reporters write stories from police reports often without real insights in to mental illness. Thus we see the resultant newspaper accounts with headlines such as “Schizo Son Smothers his Mom in Queens” (New York Post, 10/29/02)
The news media will always report on the sensational cases far out of proportion to the actual occurences.
The Andrea Yates story, serial murderers, random subway pushers, and the like get lots of ink compared with the millions of mental illness recovery stories that are not considered newsworthy.
Then we’re exposed to TV shows and movies that entertain us by often linking mental illness to malevolence. Baby Jane, Norman Bates, and Hannibal Lecter are cultural icons.
Cop shows on TV strive for realism, and yet they too can create distortions when their writers are inevitably influenced by newspaper stories generated by the police blotter.
What is the result of our society’s steady diet of mass media fed by such cultural and religious beliefs, most of which associate mental illness with profound negativity?
In one word, stigma.
Source: From Reintegration today, Winter 2002, The Center for Reintegration
Startling Statistics About Mental Illness
* According to the World Health Organization (WHO), 1 in every 4 people, or 25% per cent of individuals, develops one or more mental disorders at some stage in life. Today, 450 million people globally suffer from mental disorders in both developed and developing countries. Of these, 154 million suffer from depression, 25 million from schizophrenia, 91 million from alcohol use disorder and 15 million drug use disorder.
* Mental illnesses are more common than cancer, diabetes, or heart disease.
* Mental disorders can now be diagnosed reliably and accurately as the most common physical disorders; some can be prevented, all can be successfully managed and treated.
* Treatment works. Yet, as many as two-thirds of all people with a diagnosable mental disorder do not seek treatment, whether for fear of being stigmatized, fear that the treatment may be worse than the illness itself, or lack of awareness, access and affordability of care.
* Mental illnesses do not discriminate – they can affect anyone, men, women and children regardless of gender, race, ethnicity, and socio-economic status.
* Mental health problems represent 5 out of 10 leading causes of disability worldwide; amounting to nearly one-third of the disability in the world. Leading contributors include depression, bipolar disorder, schizophrenia, substance abuse, and dementia.
* Mental illnesses rank first among illnesses that cause disability in the United States, Canada, and Western Europe.
* It is predicted that by 2020, depression will be the leading cause of disability worldwide, not cancer, heart disease, diabetes, or AIDS (WHO)
* Many people suffer from more than one mental disorder at a given time, and also with co-morbid chronic diseases such as diabetes, HIV/AIDS, cancer, heart disease, etc.
* Mental illness is a serious public health challenge that is under-recognized as a public burden. The toll of mental illness is tragic:
Human Cost: Suicide claims a life every 30 seconds.
* According to the World Health Organization almost 3,000 people commit suicide every day in the world.
* For every person that succeeds in taking their own life there are at least 20 more who try.
* The global suicide rate is up 60% over the last 50 years with an even more marked increase in the developed world.
* Suicide is among the top three causes of death among people between 15 and 34 years old, but most suicide victims are found among the elderly, those aged 60 and above.
* Suicide worldwide causes more deaths every year than homicide or war. Suicide is a huge but largely preventable public health problem, causing almost half of all violent deaths and resulting in almost one million fatalities every year. Estimates suggest fatalities could rise to 1.5 million by 2020.
* In 90% of suicides, mental illness is the attributing cause.
Economic Cost: Mental disorders cost billions of dollars.
* Mental disorders have clear economic costs. While numbers cannot convey the distress accompanying mental disorders, the economic impact can be calculated. Sufferers and their families or caregivers often experience reduced productivity at home and in the workplace. Lost wages, combined with the possibility of catastrophic health care costs, can seriously affect patients and their families’ financial situation, creating or worsening poverty.
* Wherever economic costs of mental disorders have been studied, the figures are staggering. The most comprehensive set of estimates comes from the Unites states. Mental disorders cost the United States more than $150 billion each year for treatment, for the costs of social service and disability payments made to patients, and for lost productivity and premature mortality.
Social Cost: Mental disorders can lead to unemployment, homelessness, incarceration, and poverty.
* Although obviously substantial, this burden has not been efficiently measured. This is because of the lack of quantitative data and difficulties in measuring and evaluating.
* However, in America, fewer than 55,000 Americans currently receive treatment in psychiatric hospitals. Meanwhile, almost 10 times that number — nearly 500,000 — mentally ill men and women are serving time in U.S. jails and prisons. (The New Asylums – A PBS Frontline Documentary).
* An alarming 65% of boys and 75% of girls in juvenile detention have at least one psychiatric diagnosis. (Teplin, L. Archives of General Psychiatry, Vol. 59, December 2002).
* Approximately 40% of the people who re homeless in America suffer from serious and persistent mental illnesses. Many of these individuals also suffer from co-occurring substance abuse disorders. (U.S. Conference of Mayors
Source: ASHA International. ASHA (A Source Of Hope for All touched by Mental Illness)
There is Hope…
Stigma must be overcome, and progress is being made. A recent study found that seeking mental health treatment has become more acceptable over the past decade, and percieved stigma associated with it has declined (Mojtabai, 2007).
These changes in public attitudes have likely contributed to the growing demand for mental health services in the United States (and other parts of the world) and will continue to do so in the coming years.
Reducing stigma must involve programs of public advocacy, public educaiton, on mental health issues, and contact with persons with mental illness through schools and other social institutions.(Corrigan, 2005).
Another way to reduce stigma is to find causes and effective treatments for mental disorders.
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Blessings and Peace,
Source: Stuart, W, 2009, Principles and Practices of Psychiatric Nursing.