The Importance of Eliminating the Stigma Surrounding Mental Illness By Christopher Becker

The Importance of Eliminating the Stigma Surrounding Mental Illness

By Christopher Becker 

Earlier this year, President Barack Obama declared the month of May as National Mental Health Awareness Month.[1] However, mental illness in society is sorely misunderstood[2], and the path to increased understanding and treatment is one littered with obstacles and impediments such as implementing proper health care reform[3] and decreasing the stigma and negativity surrounding the diagnosis of a mental illness.[4] I am not contending this is a novel idea or even one that has not been discussed by a great number of individuals. However, I believe that as many voices saying in as many ways possible that increased awareness and understanding of mental health issues is instrumental can help raise the awareness necessary to compel change. It is my hope that in the coming years those who suffer will not feel alienated, discriminated against, or be dissuaded from seeking help.

According to the latest data posted by the National Institute of Mental Health on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA) on October 8, 2014[5], 51.2 million adults, or some 22.5 percent of the population, suffer from what SAMHSA calls mental disorders.[6] These disorders can be organized into major categories such as Mood Disorders (which include illnesses such as Bipolar I Disorder and Major Depressive Disorder), Anxiety Disorders (including Post Traumatic Stress Disorder and Obsessive Compulsive Disorder), Substance Abuse Disorders, Eating Disorders, Adjustment Disorders, Impulse Control Disorders, and Expressions of Psychotic Symptoms.[7] Unfortunately, only roughly one-third of people with these disorders seek some type of treatment.[8] The stark contrast between the prevalence of these disorders and the frequency of treatment is befuddling, and we are responsible for answering two important questions: why does this disparity between incidences of mental health disorders and treatment exist and how can we fix them?

There are numerous explanations offered for the startling statistics concerning the under-treatment of mental health disorders. Representative Timothy Murphy, a Republican from Pennsylvania and only one of three psychologists in Congress[9], explained during a speech in support of the Helping Families in Mental Health Crisis Act that fewer resources, a shortage of trained professionals, imprudently spent federal money including underfunding of the National Institute of Mental Health, and poor communication between primary health care providers and those who are trained to help patients combat mental illness specifically are only a few of many variables that contribute to under-treatment of the mentally ill.[10]

Additionally, it is contended that health insurance related obstacles contribute to the disparity between mental health disorders’ prevalence and treatment.[11] Specifically, high incidences of unemployment among individuals with more severe forms of mental illness and the inadequacy of Medicaid eligibility requirements pose significant challenges for certain segments of the population suffering from mental health disorders.[12] The effects that the Affordable Care Act has had on insurance related issues will be addressed later.

A third reason that those who would benefit from treatment do not receive it is the stigma associated with being diagnosed with a mental health disorder.[13]  The Mayo Clinic helpfully defines stigma as “…when someone views you in a negative way because you have a distinguishing characteristic or personality trait…”[14] Stigma is then separated into two types; these types are Public Stigma and Self Stigma.[15] Public Stigma can be defined as “the reaction that the general population has to people with mental illness” and Self Stigma as “the prejudice which people with mental illness turn against themselves.”[16]  There are numerous factors that can foster stigma including the fear of violence associated with mental illness, the sensationalizing and stereotypical depictions of mental illness in movies and television[17], a lack of education and awareness concerning the facts about mental illness, and the over-generalization and improper categorization of mental illnesses leading to a misunderstanding of the range and complexity of the different types of mental illness.[18] Not surprisingly, both types of stigma can result in individuals not receiving the treatment they need.[19]

Simply discussing the reasons behind under-treatment of mental illness will do nothing to correct the issue. Along with the explanation provided by Representative Murphy for the inadequacy of treatment, he proposed legislation to ensure that greater access to treatment becomes a reality.[20] Additionally, relief may be found through legislation already in existence in the form of the Affordable Care Act (ACA).[21] ACA can help alleviate the problems of under-treatment by increasing access to health insurance and improving the overall quality of the insurance that is provided.[22] Although several of ACA’s requirements have only started to take effect this year,[23] the requirement to purchase insurance as well as increased access for groups who had previously suffered serious, tangible challenges to receiving adequate coverage will hopefully ensure that treatment for mental health issues increases.[24]

Along with solutions provided through the law and government, it is imperative that the stigma associated with mental health issues be reduced in order to encourage those in need to seek treatment for disorders. Some have asserted that a step to eliminating this stigma is to stop referring to it as such.[25] The reasoning for this is that the word stigma itself and its negative connotation refuse to confront the real sources of the problem such as “bigotry, hatred, unlawful and unjust discrimination.”[26] Others call for a more nuanced understanding of mental illness, greater education, and an increase in protections against discrimination provided by law.[27] Undoubtedly these are important steps to decreasing the role of stigma in preventing those who need treatment from seeking it.

Earnestly, I hope that I have contributed in some way to the awareness needed to improve mental health treatment through my writing because it is necessary for society to understand the causes of under-treatment of mental illness in order to combat it.

[1] Proclamation No. 9112, 79 Fed. Reg. 25,649 (Apr. 30, 2014).

[2] Understanding Mental Illness, CANADIAN MENTAL HEALTH ASS’N, http://www.cmha.ca/mental-health/understanding-mental-illness/ (last visited Oct. 26, 2014).

[3] Health-Care Reform: Psychology’s Role, AM. PSYCHOLOGICAL ASS’N, http://www.apa.org/health-reform/psychology-role.html (last visited Oct. 26, 2014).

[4] Facts About Stigma and Mental Illness in Diverse Communities, NAT’L ALLIANCE ON MENTAL ILLNESS, http://www.nami.org/ContentManagement/ContentDisplay.cfm?ContentFileID=5148 (last visited Oct. 26 2014).

[5] Rhonda S. Karg et al., Past Year Mental Disorders Among Adults in the United States: Results from the 2008-2012 Mental Health Surveillance Study, SUBSTNACE ABUSE AND MENTAL HEALTH SERVICES ASS’N (Oct. 2014), http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-N2MentalDis-2014-1/Web/NSDUH-DR-N2MentalDis-2014.htm

[6] Id.

[7] Id.

[8] Mental Health Myths and Facts, U.S. DEP’T OF HEALTH & HUMAN SERVICES, http://www.mentalhealth.gov/basics/myths-facts/ (last visited Oct. 26, 2014).

[9] Breaking Down Barriers to Mental Health Care, AM. PSYCHOLOGICAL ASS’N, http://www.apa.org/monitor/2014/10/upfront-barriers.aspx (last visited Oct. 26, 2014).

[10] Representative Tim Murphy, General Speech on Helping Families in Mental Health Crisis Act (Dec. 12, 2013), http://www.c-span.org/video/?c4477276/rep-tim-murphy-helping-families-mental-health-crisis-act

[11] How Will Health Reform Help People with Mental Illnesses?, BAZELON CENTER FOR MENTAL HEALTH LAW (June 2010), http://www.bazelon.org/News-Publications/Publications/List/1/CategoryID/8/Level/a/ProductID/54.aspx?SortField=ProductNumber,ProductNumber

[12] Id.

[13] Facts About Stigma and Mental Illness in Diverse Communities, supra note 4.

[14] Mental Health: Overcoming the Stigma of Mental Illness, MAYO CLINIC, http://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/mental-health/art-20046477 (last visited Oct. 26, 2014).

[15] Patrick W. Corrigan & Amy C. Watson, Understanding the Impact of Stigma on People with Mental Illness, WORLD PSYCHIATRY, (Feb. 2002), http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/

[16] Id.

[17] Graham C.L. Davey, Mental Health and Stigma: Mental Health Symptoms are Still Viewed as Threatening and Uncomfortable, PSYCHOLOGY TODAY: WHY WE WORRY (Aug. 20, 2013), http://www.psychologytoday.com/blog/why-we-worry/201308/mental-health-stigma

[18] Paul Heroux, Mental Illness as a Civil Rights Issue, HUFFINGTON POST (May 8, 2013, 5:12 AM), http://www.huffingtonpost.com/paul-heroux/mental-illness-civil-rights_b_2835768.html

[19] Patrick Corrigan, How Stigma Interferes with Mental Health Care, 59 AM. PSYCHOLOGY 614, 619 (2004).

[20] Breaking Down Barriers to Mental Health Care, supra note 9.

[21] How Will Health Reform Help People with Mental Illnesses?, supra note 11.

[22] Id.

[23] Id.

[24] Id.

[25] Mike Smith, The Word ‘Stigma’ Should Not Be Used in Mental Health Campaigns, THE GUARDIAN (Oct. 10, 2014, 5:00 AM), http://www.theguardian.com/healthcare-network/2014/oct/10/stigma-should-not-used-mental-health-campaigns

[26] Id.

[27] Heroux, supra note 18.

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