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Running head: Stigma- Mental Illness 1

The Stigma Placed on Mental Illnesses Alex Mills December 17th, !11

Stigma- Mental Illness

Abstract There"s a stigma #laced on mental illnesses$ This research #a#er %ill su##ort that statement, ex#ress ho% strong the stigma is, gi&e some reasons as to %h' there is a stigma, ex#lain some harm(ul e((ects the stigma can ha&e, and lastl' state a (e% things that can be done to #ossibl' alle&iate the stigma$ In(ormation %ill be #ro&ided (rom &ideos b' leading #s'chologist"s cumulati&e )no%ledge throughout time, based mostl' on (act and stud', and also research done b' a (e% social #s'chologists$

Stigma- Mental Illness * A stigma can be de(ined as, +a mar) o( disgrace associated %ith a #articular circumstance, ,ualit', or #erson$+ -xtremel' o(ten mental illnesses come %ith the de(ined stigma tightl' attached to it$ .o%e&er, better understanding mental illnesses ma' hel# brea) this mar) o( disgrace and could #ossibl' lessen the discrimination and un(air treatment #eo#le su((ering %ith mental disorders recei&e$ There are t%o &ideos / !!7, !1!0 %hich hel# su##ort this statement$ The (irst is a s#eech gi&en b' Ste#han .insha%, +Stigma o( Mental Illness and an Agenda (or 1hange$+ The second is also a s#eech gi&en b' 2eorge S3mu)ler called, +.o% mental health la% discriminates$+ The main #oint o( these t%o &ideos is to #oint out the stigma associated %ith mental illness, and sho% that lessening stigma %ould be bene(icial$ Ste#hen .insha%, the s#o)es#erson o( the (irst &ideo, is a #ro(essor and the chair o( the De#artment o( Ps'cholog' at 41 5er)ele'$ The goal !( the &ideo %as to discuss the stigma associated %ith mental disorders$ .insha% started his #resentation b' sa'ing ho% man' #eo#le are actuall' a((ected b' mental illnesses$ A ma6orit' o( #eo#le deal %ith mental illness in some %a' or in some ca#acit'$ .insha% notes that the' either deal %ith it themsel&es or the' )no% a (riend or (amil' member that deals %ith it, %hether that member is close or distant$ .e also ex#lains that in earl' histor' man' #eo#le thought the reason (or mental illnesses %as that #eo#le %ere controlled b' e&il s#irits or demons$ The' thought a mental illness had a lot more to do %ith %ill#o%er than is commonl' acce#ted toda'$ Peo#le used to belie&e that the %a' to cure these illnesses %as to 7scare8 or 7distract8 the e&il s#irits out o( the host$ The' 7did8 this %ith tactics li)e bloodletting, inducing &omiting, t'ing #eo#le do%n, caging #eo#le in dungeonli)e #laces, scaring or beating #eo#le at random$ .insha% goes (urther into histor' %ith man' s#eci(ic exam#les$ 9ne o( these exam#les

Stigma- Mental Illness : -x#lained ho% ;ing 2eorge the Third o( -ngland %as thought to be insane, and because o( that %as beaten, nearl' star&ed to death, and chained u# constantl'$ A(ter thoroughl' discussing the histor', .insha% brings u# a tough ,uestion %hich %as used to sho% that something doesn"t reall' add u#$ The ,uestion he as)s is 7e&en though %e )no% more about mental health toda', as %ell as, ha&e )no%ledge that mental health disorders are )no%n to be based on genetics and en&ironmental (actors, is there still such a strong stigma against mental illness<8 .e tries to success(ull' ans%er this ,uestion in a (e% di((erent %a's$ .e sa's that, 7#eo#le are #robabl' %ired in some %a' to detect somebod' %ho is chronicall' ill$8 In other %ords, he"s im#l'ing that to some extent it"s a natural thing to detect di((erences, and then create biases based on those di((erences, including mental illness$ .e also sa's that i( 'ou 7(ind a grou# that is reall' de&alued and 'ou #ut them do%n, 'ou get a nice boost o( sel( esteem8$ A(ter those reasons he ex#lains that the main reason is because mental illness is associated strongl' %ith threats, or &iolence$ .e as)s the ,uestion 7is there reall' an association bet%een mental illness and &iolence<8 .e ans%ers this ,uestion b' sa'ing that there is in (act a small association bet%een mental disorders and &iolence, but that the association is actuall' less then the association bet%een being male and &iolent$ A re&ie% done b' De1lue / !! 0 on the boo) 7Rethin)ing Ris) Assessment: The MacArthur Stud' o( Mental Disorder and =iolence8 also su##orts that being mentall' ill doesn"t necessaril' mean somebod' %ill be &iolent at all$ De1lue states that the boo)"s conclusion ex#lains that 7there is no single #ath in a #erson"s li(e that leads to an act o( &iolence8, sho%ing that solel' being mentall' ill doesn"t mean one %ill be &iolent$ >ater on in .insha%"s &ideo he mentions ho% there are stigmas in societ' toda'$ .e #oints

out that #eo#le %ho are diagnosed %ith an' mental illness, no matter the si3e, are stri##ed o( their rights to do Stigma- Mental Illness ? man' things li)e #urchase guns, run (or o((ice or be on a 6ur'$ Another reason he gi&es is because 7some o( children"s (irst %ords are %ords li)e #s'cho or cra3'$8 .e sa's that #ro&es ho% 7culturall' engrained8 the stigma on mental illnesses are$ The last main #art o( .insha%s s#eech is used (or ex#laining %a's in %hich he thin)s the stigma could #ossibl' lessen$ .e states that 7%e ha&e to change the &ie%s o( mental health #ro(essionals$8 @urthermore, he insists that %e ha&e to sto# #lacing #eo#le in such a general grou# o( being mentall' ill, and start ha&ing a better understanding that there are di((erent le&els o( mental disorders %hich can &ar' an'%here (rom extreme to almost non existent$ 9ne o( the &er' last things he sa's is that %e, as a societ', need to sto# loo)ing do%n u#on mental illness as much as %e do and be more understanding as #eo#le tend to be %ith #h'sical illnesses$ .e sa's that i( %e can do this, #otentiall' more #eo#le %ho ha&e mental illness %ill see) hel#$ A reason a lot o( #eo#le do not see) hel# is due to (ear o( the #ossibilit' o( being 6udged$ Ste#han .insha% / !!70 does a great 6ob communicating issues going on %ith mental illnesses, including the stigma #laced u#on them$ 2eorge S3mu)ler, a #s'chiatrist %ho has had ma6or research interests in eating disorders and (amil' careers o( #eo#le su((ering (rom a #s'chotic illness, concerns methods o( reducing com#ulsion and +coercion+ in #s'chiatric care, and also researches mental health la%A #articularl' the #ossibilit' o( generic legislation centered on im#aired decision-ma)ing ca#acit' %hich %ould a##l' to all #ersons, regardless the cause o( the underl'ing disturbance o( mental (unctioning$ 9ne #oint Dr$ S3mu)lers tries to ma)e in his &ideo, is that there is a stigma o( mental health disorders currentl', and

this leads to discriminator' la%s against #eo#le %ith mental illness$ In other %ords, #eo#le %ith mental disorders are being %idel' discriminated against based on #retenses$ Another thing he tries to #oint out is 6ust ho% Stigma- Mental Illness B discriminator' those la%s actuall' are, and o((er some solutions to hel# brea) the discrimination$ S3mu)lers starts his #resentation b' ac)no%ledging ho% un#leasant in&oluntar' treatment tends to be (or all #arties in&ol&ed$ .e then goes on to com#aring a #h'sicall' ill #atient to a mentall' ill one$ .is exam#le sho%s that #eo#le %ith mental health disorders are #rone to being (orced into treatment, in com#ression to someone %ith a #h'sicall' disorder, e&en i( the treatment is in the #atients 7best interest8 (or both cases$ That"s one exam#le that clearl' sho%s an un(air #re6udice to%ards mentall' ill #eo#le$ .e goes on to ex#lain that a common &ie% among societ' is that mental disorders naturall' entail some lac) o( com#etenc', %hich is not true$ .e states that b' (ailing to res#ect mentall' ill #atient"s autonom' and b' #ushing legislation that all mental health #atients are incom#etent o( ma)ing rational decisions, it has made current legislation discriminate against #eo#le, and b' doing so, stigmati3es them$ Chen the issue comes u# about &iolence, and ris) o( &iolence, S3mu)ler does a &er' good 6ob at sho%ing ho% current #ractices o( detaining #eo#le %ith mental disorders based on ris) is un(air, and discriminator'$ .e sa's that to be (air or e,ual, all #eo#le %ith the same threat or ris) o( &iolence should be detained, or nobod' should be detained #urel' based on ris) o( &iolence$ .e ex#lains that &iolence is no more #redictable to #eo#le %ith mental disorders, com#ared to those %ithout mental disorders$ Also, the #ro#ensit' (or &iolence is no more treatable in #eo#le %ith mental illness, com#ared to #eo#le %ithout mental illness$ A(ter discussing this, S3mu)ler raises the ,uestion, 7%h' do %e ha&e these )inds o( discrimination (or #eo#le %ith mental disorders<8 .e sa's that it

re#resents a stereot'#e in our societ' that #eo#le %ith mental disorders 7o( course8 are dangerous and ha&e a ris)$ The ,uestion in most #eo#les mind is not %hether the' /mentall' ill #eo#le0 are dangerous, but 6ust ho% dangerous the' are$ The current Stigma- Mental Illness 7 mental health la%s are ex#lained %hich sho% discrimination against #eo#le %ith mental illness (or the reasons stated abo&e$ A(ter the current la%s are discussed, S3mu)ler introduces his suggestion (or ne% la%s that hel# brea) that discrimination b' treating mental health disorders, and #h'sical disorders, in &er' much the same %a'$ .e also #ro#oses a more in-de#th recognition to di((erent disorders, and the di((erent le&els o( mental disorders$ The mental health la%s still discriminate in the same %a' as described in this #a#er, and can be a serious #roblem, es#eciall' to the mentall' ill, or #eo#le %ho are seen to be mentall' ill$ Stigmas against #eo#le %ith mental health #roblems relate %ith S3mu)lers reasons, such as the generali3ation that #eo#le %ith mental health disorders ma)e illogical decisions$ Another reason is because la%s get #assed and, as seen through histor', man' #eo#le do not ste# u# to change un-6ust la%s unless the' (eel it directl' a((ects their li(e$ The stigma discussed a##ears based #rimaril' on (ear$ It seems as though almost all human actions are done to create #leasure, or to sustain #leasure$ Sustaining #leasure in&ol&es doing things to eliminate #ain or dis#leasure, and sometimes e&en doing things to eliminate #ossible threats to #leasure$ @or exam#le most humans gain the most #leasure (rom li&ing$ I( someone attem#ted to end their li(e, a lot o( #eo#le %ould do %hat the' could to continue their li(e, and sustain the #leasure the' get (rom li&ing$ I( someone #ercei&es a threat to be serious, the' %ill almost al%a's ta)e action in some sort o( %a' to #re&ent losing that #leasure$ 4suall' de#ending on their le&el o( (ear, and the thing that the' (ear losing, the' tend to act more or less

signi(icantl'$ I( there is a #erce#tion that someone or something is dangerous, #eo#le %ill ma)e sure to 7de(end8 against that threat$ The #roblem %ith #erce#tion is that the' are not al%a's (act based, and in man' cases can be (alse or bear little to no truth &alue$ During times o( Da3i rule in 2erman', there %as a #erce#tion among a signi(icant amount o( Stigma- Mental Illness E #eo#le that Fe%ish #eo#le %ere dangerous, (ilth' creatures %ho %ere to be blamed (or all o( 2erman'Gs #roblems$ This led to massi&e genocide caused b' a (alse #erce#tion, and out o( (ear o( losing things man' #eo#le held dear, including the (ear o( becoming an outsider$ In societ' toda', there are #erce#tions that #eo#le %ith mental illness are dangerous, and are illogical %hen it comes to ma)ing decisions$ Those #erce#tions hold truth &alue to them, but not to the extent most thin)$ S3mu)ler insisted that about (i(t'#ercent o( #eo#le %ith the most se&ere t'#e o( mental disorders are able to ma)e rational decisions$ Those numbers sho% that not e&er'one %ith a mental health disorder is inca#able o( being logical$ .e also states that clearl' e&er'one %ith a mental illness isn"t dangerous, or e&en threatening to 7#leasures8$ An article entitled, 7Mental Illness Stigma -ntrenched in American 1ultureA De% Strategies Deeded, Stud' @inds8 / !1!0 relates to the .insha% and S3mu)ler &ideos #re&iousl' described$ The inter&ie%ee o( the article, Pescosolido, notes e&en though #eo#le ha&e been #ushing hard to tr' and hel# eliminate the stigma #laced on the mentall' ill, it hasn"t hel#ed, and there has been no signi(icant changes in stigma and discrimination o( them, des#ite e((orts$ Pescosolido claimed that in(ormation de&elo#ed (rom studies done b' himsel( along %ith his colleagues, Martin, >ong, Tait, Phelan, and >in)$ Pescosolido goes on to sa' that the stigma not onl' is not decreasing, but in #arts o( the 4nited States, ma' be increasing$ .e then states that a ne% a##roach to tr'ing to

brea) do%n the stigma could be needed and that currentl' 7mental health ad&ocates end u# #reaching to the choir$8 The &ideos ex#lained #re&iousl' %ere mo&ements done a (e% 'ears bac) tr'ing to sto# the stigma on mental illness and recentl' /Se#tember 1Bth, !1!0 seems li)e those e((orts are not hel#ing at all, according to Indiana and 1olumbia 4ni&ersit' researchers, Pescosolido, Martin, Stigma- Mental Illness H >ong, Tait, Phelan, and >in) $ This stands to sho%s ho% huge the stigma actuall' is, and that it %ill not be an eas' (eat to li(t or crush$ To (urther su##ort the &ideos, there are also t%o 6ournals$ The (irst 6ournal is entitled 7Measuring Perce#tions o( Stigmati3ation b' 9thers (or See)ing Ps'chological .el#: Reliabilit' and =alidit' o( a De% Stigma Scale %ith 1ollege Students8 and the second 6ournal used %as, 7Mental .ealth 1onsumersG -x#erience o( Stigma8$ 5oth continue to #ress the idea that the stigma on mental illnesses must be reduced$ The goal o( the (irst 6ournal /=ogel, Cade, Ascheman, !!H0 %as to de&elo# a scale o( stigmati3ation that measures the #erce#tion o( %hether see)ing #s'chological hel# %ould be stigmati3ed b' #eo#le the #erson interacts %ith, examine the reliabilit' and &alidit' o( the scale scores among college #o#ulationsA and begin to examine the role that stigmati3ation b' those the #erson interacts %ith #la's in the hel#-see)ing #rocess$ A #re&ious theor' the' relied on %as that (ear o( being stigmati3ed is the main reason %h' indi&iduals a&oid #s'chothera#'$ The inde#endent &ariables o( the ex#eriment %ere the mix o( the #artici#ant"s gender, race, and 'ear o( stud'$ In all ex#eriments the' %ere extremel' similar$ The de#endent &ariable %as the ,uestion as)ed 7ho% %ould 'ou (eel about someone i( 'ou (ound out the' had a mental illness$8 The sub6ectsI#artici#ants o( the ex#eriment %ere college students mixed in gender, race, and 'ear o( stud'$ Data (or this ex#eriment %as collected o&er a t%o 'ear time #eriod$ All the #artici#ants %ere

&oluntar', and ga&e consent be(ore ans%ering an' ,uestions gi&en to them through the ,uestionnaires$ At the end o( the ex#eriment, =ogel, Cade, and Ascheman concluded that the stud' the' did, did in (act sho% that (ear o( being stigmati3ed is the most common reason %h' indi&iduals a&oid #s'chothera#', and the' (ound ne% e&idence that social stigma b' those a #erson interacts %ith does actuall' #redict attitudes Stigma- Mental Illness 1! about #s'chological hel# see)ing$ The (irst 6ournal article is &er' rele&ant to the &ideo #resentations tal)ed about earlier$ 5oth o( the &ideos ex#lain that stigma #laced on mental illness e((ects man' mentall' ill #eo#le in a negati&e %a'$ The' both sa' at some time in their &ideo that stigma can #re&ent treatment$ In .insha%"s &ideo he actuall' goes in de#th ex#laining %hat a huge im#act it can ha&e on not acce#ting treatment$ .e reads a letter that a #erson %rote to his %i(e"s (amil' and (riends a(ter his %i(e lost the battle o( se&ere de#ression that lasted her (i(teen 'ears and she ended u# )illing hersel($ In the letter, the husband that lost his %i(e, ex#lains that e&en though he begged her to get hel#, she %ouldn"t out o( (ear o( being stigmati3ed and changing the close relations she had %ith #eo#le that res#ected her at %or), and in her (amil'$ .e ex#lained in the letter ho% he honestl' thin)s things could ha&e been di((erent i( she %asn"t so a(raid o( being stigmati3ed and got hel#$ That along %ith =ogel, Cade, and Ascheman"s 6ournal hel#s to sho% that the (ear o( being stigmati3ed is not uncommon and actuall' an extremel' common reason to not see) #s'chiatric hel#$ In the second 6ournal, Cahl and Masons goal %as to ex#and )no%ledge o( mental illness stigma through a large-scale, nation%ide in,uir' about the ex#eriences o( #ersons %ith diagnosed #s'chiatric disorders, and in doing so, em#o%er consumers %ith the o##ortunit' to describe %hat li(e has been li)e (or them$ A #re&ious theor' the researchers relied on /1am#bell and Schraiber, 1HEH0, sho%ed that there actuall' %as

indeed a stigma attached to mental illness$ The sur&e' conducted b' Cahl and Mason examined mentall' ill #eo#les #ercei&ed treatment (rom others, and sho%ed that there is a de(initel' a stigma #laced on mental illness$ The sam#le o( sur&e's most #rominent disco&er' sho%ed that almost eight' #ercent o( the sur&e'ors ha&e o&erhead #eo#le ma)ing hurt(ulIo((ence Stigma- Mental Illness 1! comments about mental illness$ 9ut o( those #eo#le, about (i(t' #ercent o( them said these comments occur o(ten, or &er' o(ten$ That alone sho%s ho% common and clear the stigma on mental illness is throughout societ', es#eciall' to the mentall' ill$ The stigma on mental illness is real$ It is a #roblem in societ', and can cause mentall' ill #atients to not see) the hel# that the' need$ The t%o &ideos, b' .insha% and S3mu)ler, and the t%o research 6ournals, the (irst being b' =ogel, Cade, and Ascheman, %ith the second being b' Cahl and Mason, are exam#les o( #ublished literature that bac)s u# the theor' that mental illness has a negati&e stigma on mental illness and hel# see)ing$ The' all sho%ed the modern #lacement o( this stigma currentl' in societ'$ 2eorge S3mu)lers and Ste#hen .insha% did this b' ex#laining the common m'th that all or most mental health #atients are dangerous, or ha&e a ris) o( being &iolent$ The' both %ent on to ex#lain that one reason (or this &ie% is because o( (ear, and another is because o( all the negati&e media attention the small #ercentage o( &iolent mentall' ill #atients ha&e gotten, %hich has in a #ushed a (alse belie( on societ'$ Again, both these #s'chiatric s#ecialists agreed and concluded that the stigma leads to un(air treatment and discrimination to the mentall' ill #eo#le$ Cahl and Mason"s research also hel#ed to strongl' su##ort these claims$ Chen it comes do%n to it, the stigma #laced u#on #eo#le (acing mental disorders needs to be decreased signi(icantl' and ideall' eliminated$

Stigma- Mental Illness 11 Re(erences De1lue, 2$ / !! 0$ Rethin)ing Ris) Assessment: The MacArthur Stud' o( Mental Disorder and =iolence /5oo)0$ Journal Of Psychiatry & Law, 30/:0, ?H*$ Retrie&ed (rom htt#:II#rox'$h&cc$edu: 7!IehostI#d(&ie%erI#d(&ie%er<sidJd*c(bHHc-7 e*:BbHabE -7eb(acc (e:dK:!sessionmgr11L&idJ?LhidJ1: .insha%, S$ / !!7, A#ril nd0$ Stigma o( mental illness and an agenda (or 1hange M=ideo (ileN$ =ideo #osted to htt#:II(ora$t&I !!7I!:I IStigmaOo(OMentalOIllnessOandOanOAgendaO(orO1hange Indiana 4ni&ersit' / !1!, Se#tember 1B0$ Mental illness stigma entrenched In American cultureA ne% strategies needed, stud' (inds$ Retrie&ed (rom htt#:IIne%sin(o$iu$eduIne%sI#ageInormalI1?:::$html S3mu)ler, 2$ / !1!, Do&ember 1?th0$ 2eorge S3mu)ler: .o% mental .ealth la% discriminates M=ideo (ileN$ =ideo #osted to htt#:II(ora$t&I !1!I11I1?I2eorgeOS3mu)lerO.o%OMentalO.ealthO>a%ODiscrimin ates =ogel, D$ >$, Cade, D$ 2$, L Ascheman, P$ >$ / !!H0$ 7Measuring Perce#tions o( Stigmati3ation b' 9thers (or See)ing Ps'chological .el#: Reliabilit' and =alidit' o( a De% Stigma Scale %ith 1ollege Students8$ Journal of Counseling Psychology, 56/ 0, *!1-*!E$ Retrie&ed (rom htt#:II#rox'$h&cc$edu: 7!IehostI#d(&ie%erI#d(&ie%er<sidJd*c(bHHc-7 e*:BbHabE -7eb(acc (e:dK:!sessionmgr11L&idJ1 LhidJ1: Cahl, 9tto and Mason, 2eorge /1HHH0$ Mental health consumersG ex#erience 9( stigma$ 4S: Dational Institute o( Mental .ealth$ Retrie&ed (rom htt#:IIschi3o#hreniabulletin$ox(ord6ournals$orgIcontentI ?I*I:B7$(ull$#d(

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