By far, one of the largest and most profound obstacles faced by those with mental illness, especially serious and persistent mental illness, is the associated stigma. Often, those living with serious mental illness aren’t seen as individuals with distinct values, and personalities, they are seen as their disease. They are their labels; depressed, schizophrenic, or bi-polar, or crazy, and once labeled, how does a person begin to resume a normal role or position in society? Stigmatized people, including those suffering with mental illnesses, are often discriminated against and targeted by harassment, threats, and even violence, and, sometimes, their own friends and families don’t understand and may tend to devalue the individual.
Compounding the issue, stigma is a two-fold process, there is the public stigma and there is
self -stigma, which is the internalization of the public stereotype. The result of stigma is that it robs people of the opportunities characteristically considered basic to a satisfying quality life such as a good education, decent jobs, safe communities and living environments, decent health care, and associations with diverse groups of people, as well as reduced sense of self-efficacy and self-determination. The stigmatization is justified on a large scale by a misconception that those people,” in this instance the stigmatized group being those with mental illnesses, are somehow responsible for their condition, that it stems from some type of character flaw, poor behavior, laziness, or incompetence, and there is a perception of an inherent danger and criminality in those so afflicted simultaneous with a belief that they are ultimately in control of their disease and disability.
For those with severe mental illness, the discrimination is often obvious and seemingly accepted by a large portion of society. However, for those with less obvious mental illnesses, such as depression, a sense of self-stigma often keeps people from seeking prompt and appropriate treatments which has a negative impact on their chances at a timely and possibly permanent recovery. Though such stigma has become near universal, it exists due to a differentiation between mental illness and physical illness, one which did not always exist and has evolved to become very clear cut. According to an article in the British Journal of Psychiatry, “the distinction between mental and physical illness” is “ill-founded and incompatible with contemporary understanding of disease.” It further states that such distinctions may cause those suffering with illnesses as well as those in helping positions to “ignore what may be important causal factors and potentially effective therapies.”
Anytime stigma is associated with a condition, it allows situations to flourish which devalue entire groups of people and reduce the amount of resources available to such groups. This comes up time and again in social work. Disenfranchised groups and “their” issues are pushed to the periphery of society and with that push, the resources allotted them are often scant and sub-par. In word, health care reform has taken steps to narrow this gulf by allowing equal provisions in coverage of mental illnesses to those afforded for physical illnesses. Let’s hope it carries it out in practice.
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