In a recent post, I discussed “5 Simple Steps to Reduce Stigma About Mental Illness.” In case you missed it, the 5 steps were:
1) Don’t label people who have a mental illness. Use ‘person-first’ language. For example, say “she has schizophrenia” instead of “she’s a schizophrenic.”
2) Don’t be afraid of people with mental illness. Despite inaccurate media stereotypes, people with mental illness aren’t scary or prone to violence.
3) Don’t use disrespectful terms for people with mental illness. There are an abundance of terms related to mental illness that are offensive and inappropriate.
4) Don’t be insensitive or blame people with mental illness. People can’t just “get over” their mental illness, and they need our support and reassurance.
5) Be a role model. Model appropriate behavior and teach others how to treat people with mental illness with respect.
It’s really prejudice and discrimination
The feedback on my post was consistently positive and supportive. However, I did receive some insightful comments from several outstanding mental health advocates about the language I used. I was reminded that when we talk about stigma, what we are really discussing is prejudice and discrimination toward people with mental illnesses.
I have to admit I had to stop and ask myself, “What are the differences between stigma, prejudice, and discrimination?” I found this clear description from the “Here to Help” project, sponsored by BC (British Columbia, Canada) Mental Health & Substance Use Services:
“Stigma originally meant a physical mark of shame. Now, it’s an invisible mark that sets you apart from others. The problem with the word ‘stigma’ is that it puts the focus on the person’s difference instead of on the people who are setting them apart. Using the word stigma makes it seem different than racism, homophobia or sexism. It isn’t. So it’s time to talk about stigma for what it really is: prejudice and discrimination. Prejudice is holding negative attitudes or beliefs about people who are viewed as different. Discrimination is acting on these ideas or beliefs.”
The experience of discrimination
Next, I wondered, “What do we know about how discrimination is experienced by people who are dealing with mental health issues?” I didn’t have to go far to find The “Stigma Shout Project,” sponsored by Time to Change, which bills itself as “England’s biggest programme to challenge mental health stigma and discrimination.”
The project surveyed people with mental illness and their caregivers throughout England to find out how discrimination is experienced. Results were obtained from 3,038 service users and 661 caregivers. The findings were remarkable.
Nearly 9 out of 10 (87%) service users reported a negative impact in their lives from discrimination and two-thirds stopped doing things because of either the discrimination itself or because of their fear of discrimination. Similarly, 68% of the caregivers identified problems related to discrimination.
The respondents reported negative impacts in all of these areas of their life:
- Building and retaining relationships
- Joining groups and taking part in community activities
- Feeling confident to go out in public
- Being able to openly disclose their mental illness
- Ability to communicate effectively with mental health professionals
- Being able to report a crime and be believed
- Accessing educational opportunities
How to make a difference
The survey then asked which groups should be targeted for messages to reduce discrimination. Among the highest rated target groups were family, employers, friends, health care professionals, work colleagues and the local community. The most frequently cited locations for anti-discrimination messages were the media, schools, and mental health service sites.
As for what to include in key messages to reduce discrimination, the most popular themes were:
- We are people – see me, not the illness
- Having a mental health problem is a common part of life
- People with mental health problems can and do recover to lead rewarding and fulfilling lives
- We should have the same rights as everyone
And what to say to help people change the way they behave toward individuals with mental health problems?
- Show some understanding – increase knowledge and awareness
- Treat us with respect
- Mental illness can happen to anyone
- Don’t label us
- It’s just like a physical illness
- Don’t isolate us
- I am not threatening
In the project summary, several important “lessons learned” were outlined:
1) The overwhelming majority of people with mental health problems report negative effects from discrimination, which stop them from engaging in activities, seeking jobs or education, developing relationships, and achieving life goals. Or as the report stated, “people are being denied opportunities to be people.”
2) Many people also reported multiple levels of discrimination when living with a mental illness and other issues such as ethnicity, sexuality, or physical disabilities that can also attract prejudice. People with more severe forms of mental illness reported more problems than those with a milder course of illness.
3) Many opportunities exist for getting pro-mental health and anti-discrimination messages out to a wide audience of target groups.
One final lesson to remember is that discrimination is an additional burden along with the effects of the mental illness itself. As a result, people are not only finding criticism, blame and abandonment from the world around them, but they are also grappling with an internal struggle fueled by thoughts of inadequacy, poor self-esteem, and lack of motivation due to their illness. Is it any wonder that so many suffer so greatly and that some choose to end their lives prematurely?
Make a commitment
This problem is well known. But the answer is also crystal clear. We must change our beliefs, attitudes, language, and behaviors toward people with mental illness. Only through the collective dedication and persistence of all of us can we make a lasting difference to ultimately stop discrimination.
This is obviously a very tall order. But we can start with a personal commitment. Promise to support and advocate for our brothers and sisters with mental illness. Tell them we are here for them, we care about them, we will not desert them, and we will not give up until discrimination is just a sad and distant memory from the past.
Here’s a question: What is your message to reduce discrimination about mental illness and who are your target groups? Please leave a comment. Also please consider subscribing to my blog and feel free to follow me on Twitter, “like” my Facebook page, or connect on LinkedIn. Thanks!
Stigma Shout: Service user and carer experiences of stigma and discrimination. https://www.time-to-change.org.uk/sites/default/files/Stigma%20Shout.pdf