Is stigma a useful idea?
Discussion about mental health always throws up the idea of stigma or the way that society judges people with mental health difficulties. But what is stigma and is it a useful thing to discuss anyway? Catherine Amey explores
Stigmatisation stems from the historical practice of branding members of society so that they carry a visible sign of disgrace, the mark of shame. Branding individuals in this way instantly conveyed their degraded status so that other members of society could act accordingly. Often this meant creating a distance so that the nonbranded individual could prevent his own social status from being tainted by association.
The mark of shame serves another function. It conveys information about the nature of that person’s disgrace, again informing ‘normal’ people how to behave. To save mental energy, it is easiest to assume that individuals carrying a specific label, such as mental illness, are all the same.
Stereotypes for people with mental health difficulties include that they are unreliable, difficult and weak and at the more severe end of the spectrum unpredictable and violent. If you accepted such a stereotype, you would want to avoid such individuals; you would discriminate. This means you would prevent people with mental health difficulties from joining your workplace, not rent accommodation to them and certainly not enter into a romantic relationship with a person who you knew had a diagnosed condition.
Therefore stigma seems to serve a dual function: it protects people from individuals who pose a potential threat while saving them the trouble of thinking too hard. But what are the downsides of stigmatising?
Them and us
One of the by-products of stigmatising mental health difficulty is the creation of a ‘them’ and ‘us’ scenario where the ‘them’ includes a quarter of the population. This means a quarter of the population may potentially self-stigmatise, that is internalise the negative beliefs that society holds against them. Not only can this cause a tremendous amount of unnecessary suffering to those with mental health difficulties but society as a whole misses out. If you truly believe you are worthless as a person, you are more likely withdraw from society. The talent and potential of up to a quarter of the population is therefore at risk by stigmatising.
Another result of stigma is the unnecessary fear it generates in the general population. Charities such as Mind have done a lot to erase the myth that people with mental health disorders are often violent; however, the unpredictability
element has not been tackled in the same way.
Even serious mental health difficulties, such as psychotic disorders, which can make people behave and talk in an unconventional way, are not especially rare. About 1% of the population will experience psychosis, perhaps the most stigmatised of all mental health conditions, at some point in their lives. If a person is experiencing an altered reality, simple compassion, rather than worrying about social convention, is key.
The Time to Change initiative has made excellent progress in challenging stigma and breaking the taboo around mental illness. Meanwhile, there has been more responsible media coverage, such as the reporting of Catherine Zeta Jones’ disclosure of bipolar disorder.
As part of my own experience of mental health difficulty, I have spent some time in a secure mental health hospital. When my friends came to visit me, they later confessed they were absolutely terrified. It wasn’t that they believed themselves to be in danger but the feeling that they didn’t know how to handle people who break social codes made them extremely uncomfortable. I introduced one of my good friends, who is particularly sociable, to a new friend I’d made in the facility who believed he channelled God. He introduced himself very politely but my very sociable friend went to pieces. What is the protocol for meeting people in communication with a deity? Debretts would have had nothing to say.
Catherine Amey’s book – Psychosis through My Eyes: A Personal and Professional Journey – is scheduled to be available as an ebook in September 2011 from Chipmunka Publishing – www.chipmunkapublishing.com