A Modern Scarlet Letter: Marks and Stigma of Mental Illness

We, all of us, have relatives, friends, coworkers or others in our network who are suffering or have suffered from some form of illness or disease all too common in our communities. Conversations about the Aunt with Diabetes, the cousin with Bone Cancer or the coworker with Lupus usually evoke genuine expressions of compassion, care, and concern indicative of an emotional support system. 

It would be unthinkable to assign blame, withdraw support, be fearful of or attach stigma to those living with these or any other diseases just because they have had the misfortune of contracting one or more of them.  Neither would we consider shunning a person because they live with epilepsy or a heart condition.  But, not so with mental illness.

Not too long ago those living with mental illness were referred to in ways that today, are both unacceptable and politically incorrect.  References to the mentally ill as lunatics, psychos, retards, nut jobs, etc. are telling.  How many of these terms have you used to describe someone who—as it turns out—were displaying behavior resulting from depression, schizophrenia, or bipolar disorder?  Someone who in actuality had a disease involving the brain organ;  no more their choice than if the disorder involved the heart, lung, or kidney. 

According to reports cited by the National Institute of Mental Illness (NAMI), one in four adults—approximately 57.7 million Americans—experience a diagnosable mental health disorder in a given year.  One in 17 lives with serious mental illness such as schizophrenia, major depression or bipolar disorder, and about one in 10 children live with a serious mental or emotional disorder. 

In her book “Within Our Reach: Ending the Mental Health Crisis” former First Lady Rosalynn Carter says that stigma is the most damaging factor in the life of anyone who has a mental illness.  According to Wahl Otto, PhD, Professor of Psychology at Hartford University stigma is “A mark or label imposed by others leading to devaluation and discrimination”.   Stigma gives rise to stereotypes that label the mentally ill as weak, violent, dangerous, incompetent, unable to make decisions, etc.   Discrimination and devaluation can be seen in a 2006 Bureau of Justice report:  56% of state, 45% of federal, and 64% of jail inmates had a mental health problem.  With an underfunded fragmented mental health care system jails and prisons have become de facto mental health facilities. Individuals with mental illness are much more likely to experience physical, sexual, or domestic violence.  Stigma is a barrier. 

All of this can be tantamount to a modern day “Scarlet Letter” creating an environment where revealing the illness or its symptoms results in “the mark” , while keeping it hidden prevents treatment and services that, if done with quality, result in a high success rate.  According to the National Advisory Mental Health Council strides have been made in the mental health treatment with high success rates for bipolar (80%), schizophrenia (45%), and major depression (65%)  But less than one-third of adults and one-half of children with diagnosable mental disorder receive mental health services in a given year.  

President Obama and Vice President Joe Biden hosted a National Conference on Mental Health at the White House as part of an effort to initiate a national conversation that increases understanding and awareness about mental health. Improving care for those with mental health issues is among the steps outlined.  

Nationwide, organizations are coming together to create local dialogue with the goal of shaping initiatives for their own unique communities.  Visit http://www.creatingcommunitysolutions.org/  to stay informed about Detroit’s participation in these efforts.

Creating an environment of awareness, acceptance, and understanding requires that each of us extend the same compassion, care, and concern afforded those experiencing disorders below the chin to those experiencing disorders above it relating to the brain. 

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