12/06/2024
STIGMA AND MENTAL HEALTH/ ILLNESS
“It is OK not to OK and it is OK to talk about it”
Mental illness causes severe disability and suffering to patients, their families and the society. Living with a mentally ill person leads to restrictions of social and leisure activities not only for the mentally ill people, but the whole family.
Mentally ill people and their relatives are usually rejected and stigmatised by the society. Stigma is a broad term which is used to describe the negative and stereotypical thoughts, attitudes and feeling about people on the basis of the traits of a person, which can include gender, skin colour, sexsual orientation, religion and mental illness. It has been used to lable certain groups of people as less worthy of respect than others. These attitudes in our communities are supported by ignorance, prejudice and discrimination and are perpetuated when mental illness is represented in an inaccurate way. There are uncomfortable, and these attitudes foster stigma and discrimination towards people with mental problems.
Mental health stigma can be divided into two distinct types:
1. Social Stigma: characterized by prejudice and discrimination directed towards individuals with mental health problems as a result of the psychiatric label they have been given.
2. Perceived Stigma or Self Stigma: the internalizing by the mental health sufferer of their perceptions of discrimination.
Causes of Stigma
• Ignorance/misconceptions- misconceptions about the causes or onset of the disease as a curse from God, punishment of one’s sin, withchcraft etc.
• Cultural factors/belief systems- myths and misunderstandings
• Media – Stigma in the media is especially harmful because the media plays an important role in shaping and reinforcing community attitudes. Spreading wrong information regarding mental illness can easily lead to negative perceptions.
• Fear – people fear the unknown outcome of the condition, the condition itself and the burden of care.
• Lack of treatment facilities – inadequate preventive facilites.
Forms of stigma:
• The patient may be stigmatized by health care providers, relatives and society
• Relatives also experience stigma from the society, given that some communities associate mental illness with a curse or taboo.
• The mental health workers are also stigmatised by other medical professionals as well as society; hence, this compounds the success in treatment of mental disorders.
• Popular attitudes towards the mentally ill are deep- seated and can be seen in the stigmatising language that is often used to describe people who are mentally ill “nuts” or “psycho”. Some people still refer to psychiatric hospitals as “nuthouses” or “loony bins”. These insensitive words referring to people living with mental illness or their treatment centres reienforces the stigma that already surrounds the illness.
Misconceptions on Mental Health/Illness
Many myths and misconceptions about mental illness persist. Most people do not accept mentally ill persons even if they have been treated and are feeling much better.
• People with mental illness cannot work: Fact: People with mental illness work, even if they have symptoms. Studies show that people with major mental illness fare better if they work. Work is a vital part of rehabilitation; it increases self-esteem, reconnects the ill person to the community and provides a meaningful way to fill life.
• People with mental illness are violent: Fact: Mental disorders and violence are closely linked in the public mind. Contributing factors to this myth is the sensationalizing reports by the media, misuse of terms like “Psychotic” and “psychopathic”. The stereotype of the violent mentally ill patient causes public fear and avoidance of the affected. People with mental illness in general are no more dangerous than healthy individuals. Individuals with schizophrenia show a slightly elevated rate of crimes of violence, but such acts are almost always committed by those who are not receiving proper treatment. The contribution of those with mental illness to the overall incidences of crime is relatively small.
• People with mental illness are mentally disabled: Fact: Mental illness and mental disability are entirely different conditions. Mental illness and mental disability are terms that are often used interchangeably to refer to a number of mental conditions. However, mental disability is usually congenital (existing at birth, before birth, or that develops during the first month of life). Mental disability is often a permanent condition that is incurable and can only be managed through different kinds of therapy. On the other hand, mental illness is acquired during one’s life time and is temporary with high probability of successful treatment. However, some mental illnesses are more severe and more or less permanent and may lead to some levels of disability.
• People never recover from a psychotic illness: Fact: Some people with psychosis recover completely from the illness, all symptoms disappear and they return to their previous level of functioning. Others may continue to have minor symptoms, but are able to lead satisfying and productive lives.
• Mental illness is caused by evil spirits or witchcraft: Fact: Mental illness is not caused by curse from God or witchcraft. Mental illness is caused by biological, psychological and social factors.
• People with mental illness are not able to make decisions about their own treatment: Fact: most people with mental illness are able and eager to participate in decision making about their treatment. Usually during the onset of the illness or during periods of relapse, people may have difficulty with decision making. A person’s ability to make decisions may change during the course of :
Effects of Stigma
• Loss of confidence
• Failing to seek medical attention
• Low self esteem
• Loss of job/ lack of employment/ missed opportunities
• Financial problems
• Rejection
• Defensive
• Become withdrawn
• Lack of understanding by family, friends and co-workers
• Health insuarance that doesn’t adequately cover the patients mental health treatment.
Reducing Stigma and Discrimination
In order to reduce stigma and discrimination, it is necessary to change people’s attitudes through education, outreach programs, change public policies and laws to reduce discrimination.
The strategies involved here would therefore include:
• Initiate community educational activities aimed at changing the attitudes towards people with mental illness.
• Improve psycho-education of patients and their families about ways of living with the condition.
• Involve patients and families in identifying the discriminatory practices.
• Mental Healthcare Provision
• Patient centered: care should be personalized, clients ought to be given a chance to talk, to be listened to, be provided with information and offered a choice. Patients should feel engaged and should have a sense of ownership.
• Age Inclusive: the mental healthcare provision should recognize the fact that opportunities exist for prevention at all stages that the origin of most mental problems lie in the early years of development.
• Outcome focused: treatment of mental disorders should be systematic and outcomes should be monitored continuously.
• Recovery-Focused: a recovery focus is essential to effective service delivery. It is our duty to support patients to help themselves and reinforce the message that recovery is possible. It is about communicating hope and restoration.
• Community Linked: primary mental health care should be linked to a range of voluntary and community services that patients can choose from.
• Preventive: interventions should target individuals identified as at risk of developing mental health problems.