Confronting the stigma of mental illness


Attitudes toward the disease can be as devastating as the symptoms

Imagine you broke your leg and didn’t go to the doctor because you were afraid people would think badly of you. That is precisely what many people living with mental illness feel. In fact, the stigma attached to mental illness can often be more crippling than the illness

“Stigma is the reason two-thirds of Canadians living with mental illness do not seek help,” says Michael Pietrus, the director of Opening Minds with the Mental Health Commission of Canada, which is based in Calgary. “They’re afraid of being labelled or having the association of mental illness—being thought of as crazy or dangerous. The flipside is people might say it’s all in your imagination, or you’re using it as an excuse for attention.”

In its Canadian Community Health Survey in 2002, Statistics Canada found one in five Canadians experience some measure of mental illness every year, including depression and anxiety. Even so, mental illness is surrounded by many misconceptions. Media and popular culture perpetuate negative images of those with mental illness as violent, dangerous or weak-minded. The truth of the matter is people living with mental illness are far more likely to be victims of crimes than criminals, and mental illness is as real and serious a health issue as cancer.

Such stigma is of particular concern for children. Many parents won’t tell anyone their child has a mental illness because they think it reflects poorly on them. Unfortunately, “only one in six kids who are with a mental health problem gets treatment,” says Pietrus.

And then there are all the kids who don’t even get diagnosed. Since mental illness typically begins to manifest in the teen years, early diagnosis and treatment are critical.

So how can you help break down this stigma? You can learn about mental illness and encourage education programs in schools and workplaces. Reach out if you see someone having problems. Pietrus points out, “if someone goes off work for cancer treatment, there is a lot of fanfare—cards, letters, flowers. When people go off work for a mental illness, there is nothing of the sort. Instead, they are often ostracized. For friends, co-workers and even family to react this way, or to tell someone their problem doesn’t really exist and is all in their head is very hurtful.”

AMERICANS, particularly if they are of a certain leftward-leaning, college-educated type, worry about our country’s blunders into other cultures. In some circles, it is easy to make friends with a rousing rant about the McDonald’s near Tiananmen Square, the Nike factory in Malaysia or the latest blowback from our political or military interventions abroad. For all our self-recrimination, however, we may have yet to face one of the most remarkable effects of American-led globalization. We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.

This unnerving possibility springs from recent research by a loose group of anthropologists and cross-cultural psychiatrists. Swimming against the biomedical currents of the time, they have argued that mental illnesses are not discrete entities like the polio virus with their own natural histories. These researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places. In some Southeast Asian cultures, men have been known to experience what is called amok, an episode of murderous rage followed by amnesia; men in the region also suffer from koro, which is characterized by the debilitating certainty that their genitals are retracting into their bodies. Across the fertile crescent of the Middle East there is zar, a condition related to spirit-possession beliefs that brings forth dissociative episodes of laughing, shouting and singing.

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