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Mental Illness and Stigma

The keynote speaker at the Mental Health Symposium* was Dr. David Goldbloom, a psychiatrist with a succulent C.V. The subject of his address was mental illness and stigma.

In terms of how we talk about and treat people with mental illnesses, we’ve come a long way since the days of lunatics and asylums,but we still have plenty of room for improvement. According to a survey of random Canadians conducted in June 2008:

  • 50% of us would treat a family member’s mental illness as a secret.
  • 46% of us believe that mental illness is used as an excuse for poor behaviour and personal failing.
  • 58% of us would socialize with someone with a mental illness
  • 12% of us would hire a lawyer with a mental illness
  • 11% of us would hire a doctor with a mental illness.

Hardly surprising, then, that many people suffering from mental illnesses keep it to themselves, even to the point of not seeking treatment. Or that those who recover from mental illnesses tend not to talk about it later, which in turn perpetuates the myth that people don’t recover from mental illness.

Did you know that deliveries of flowers, gifts and get-well cards to hospital psychiatric wards are about half that of other wards, largely because friends, colleagues and acquaintances are politely averting their eyes from the embarrassing spectacle of mental illness? This is stigma at work.

Dr. Goldbloom pointed out that the most popular show on TV these days is CSI, which depicts stereotypes of people with mental illnesses as axe-wielding psychotic murderers, even though this is clearly at odds with the profile of a typical person with a mental illness. He noted, too, that you’re at far greater risk of being murdered by your partner than by a mentally ill stranger.

Here’s an interesting bit of trivia. The 19th century equivalent of mental illness, in terms of stigma, was tuberculosis. The equivalent in the 20th century (or at least the first 70 years of it) was cancer. This got my attention! I had no idea that 40 years ago people wouldn’t mention cancer in public. People sometimes whispered “The Big C,” but avoided saying the word out loud. Patients were sometimes even protected from any knowledge of their own cancer by their doctors and families!

Times have changed for cancer, thank God, but not yet for mental illness.

The language of obituaries, according to Dr. Goldbloom, is the language of culture. You frequently read in the obituaries the phrase “following a courageous battle with cancer.” But the code for suicide is “died suddenly,” in combination with a request for donations to ‘the charity of your choice.’

In this way, says Dr. Goldbloom, the stigma of mental illness is perpetuated into death.

The Mental Health Commission of Canada just launched a 10-year campaign to destigmatize mental illness, which will focus, initially, on youth and health professionals. It’s called Opening Minds.

Statistics Canada will be conducting regular surveys of Canadians to determine the impact of the campaign on public attitudes about mental illness.

For some interesting reading about mental illness, see the Globe & Mail’s most popular series ever, Breakdown, and their current series about recovery, Breaking Through.

*The Mental Health Symposium took place on October 5, 2009, in Ottawa, and was co-hosted by The Canadian Mental Health Association, The Royal Ottawa Mental Health Centre, the University of Ottawa’s Department of Psychiatry, and the University of Ottawa’s Institute of Mental Health Research. This is the first of two or three posts about this event. The next one will look at Ottawa’s Mental Health Courts.

8 comments to Mental Illness and Stigma

  • It’s interesting to me, ma’am, that so few have commented so far. Usually, your threads fill up fast.

    I wonder if no one knows quite what to say? Thinks mental illness is too intimate to discuss?

    The Canadian Mental Health Association bears repeating here: one in five of us will experience mental illness of some sort. That means all of us know not just one, but several people who have lived, or are living, with it.

    That’s got to be a lot of important – valuable, really – aquaintances, co-workers, friends and family we’d lose, if we were trying to avoid anyone with those kind of issues…

  • sheila

    A few years ago, I went to breakfast with my father and uncle. We talked a little about medical issues and I mentioned my daughter’s hospitalization for depression. My uncle told me about his oldest son’s severe problems with depression and his multiple hospitalizations. Later that day, my mother called me. She was furious that I had shared such a sensitive secret with my father’s brother! I explained that I felt it was no different than if my daughter had been in the hospital for leukemia or pneumonia-she had an illness and needed treatment. I later learned that most of my generation of cousins on my father’s side is on some anti-depressant or other, myself included. Two of my cousins are disabled by the illness. I believe our parents probably suffered with depression as well but they self-medicated with alcohol.

  • Thank you for addressing such an important topic. It’s the stigma that really does the damage. Like Sheila noted, why shouldn’t she state that her daughter was in the hospital? I would also like to see obits say “fought a courageous battle against depression” rather than “died suddenly.” So far, I’ve only seen one. I’ve also discussed mental illness on my blog, here’s the link if you’re interested:

  • felonius bunk

    in catch-22, it’s crazy to be sane in an insane world; definitions of sanity vary by culture and era, but more balanced persons and groups seem less prone to projecting their dis-ease onto the mode du jour and hiding it in a dark corner, or worse, ritualy exorcising it for the public edification; coreless, we define ourselves in opposition: “we’re ok, you’re not” so you gotta buy a better life, with gates to keep out the freaks – if you accept them you to enter the snake house yourself (better not to look into the funhouse mirror too closely!)

  • This is a subject close to my heart as I have three mental illnesses, including one that is even highly stigmatized within the community – BPD.

    Pop culture does society a huge disservice (again!) by their depictions of the mentally ill. In addition to the mentally ill being depicted as violent & murderous, TV shows often depict mental illnesses as easily treatable with meds. This happens ALL THE TIME on Law & Order: SVU, and it drives me up the wall. Some victim or witness is psychotic, or severely bi-polar, or depressed, Dr. Huang prescribes some medications, and miraculously, a few days later – voila, a credible, lucid person emerges to testify! This is as damaging as the depictions of the mentally ill as violence.

    There is a great TV show out there called “The United States of Tara” and it’s about a woman with DID. Though this is a rare illness, the way her family deals with it and the issues that are tackled on the show I think are very well done. I hope it’s been renewed for a second season.

  • DJ, interesting piece, but I disagree. You say there’s discrimination but no stigma? I think the fact that so many people are so secretive about their own and their family members’ mental illness is evidence of stigma. They fear the consequences of people finding out.

    Coyote, I had a feeling there wouldn’t be many comments on this post. I think it’s partly because it was a departure from my usual posts of late so it caught people off guard.

    Sheila, good for you. Hiding depression like it’s some kind of skeleton in the family closet seems counter-productive and punitive. I know a couple of people who self-medicate depression with alcohol too…it doesn’t seem to work all that well.

    Julie, me too, I’d be impressed if I saw an obituary that put the truth on the table and acknowledged the struggle with depression. It would strike me as a courageous, compassionate and respectful way to write an obituary.

    Felonious, it sometimes does feel like a precarious (and shifting) line that we draw between normal/abnormal, sane/insane, real/illusory. The first thing we need to do is figure out the purpose of the line. Too often it’s there to separate Them from Us. Which is useful, I suppose, from a sociological perspective (deviants patrolling the boundaries, and teaching us, by example, the consequences of non-conformity), but kind of pointless beyond that.

    Wandering Coyote, thanks for your insight. I’m totally with you about those TV shows like Law and Order. The stereotyping is so over the top, so insulting, so inaccurate, and so damaging. And people just eat it up. It’s shows like that that made me sell my TV. I’ll see if I can rent the United States of Tara.