A lot has happened since I first wrote about mental illness and stigma 10 years ago. In 2010, efforts to combat prejudice against those with psychiatric disorders were beginning to shift from damage control to proactive attempts to educate the public and start honest conversations about a previously taboo topic. The last 10 years have seen the ongoing work of mental health advocacy organizations like Bring Change to Mind and Give an Hour, which are geared towards educating the populace. Meanwhile, increasing numbers of celebrities like Selena Gomez (who revealed having bipolar disorder), Kristen Bell (anxiety and depression), Ryan Reynolds (anxiety) and Bruce Springsteen (depression) have publicly announced mental health challenges.
Source: Felipe Pelaquim/Unsplash Dr. Ken Duckworth, the medical director of the National Alliance on Mental Illness (NAMI), says the word “stigma” is controversial. Per Dr. Duckworth, negative thoughts about mental illness are multilayered: “The internal experience is shame, the interpersonal experience is prejudice and the legal issue is discrimination.” Shame is a powerful emotion—it can cause us to keep things inside because we are worried about losing our friendships or our reputations. It can cause us not to seek treatments like therapy or medication. At its core, prejudice stems from the belief that people with mental illnesses or conditions are not like us; they are “crazy” or “lunatics” and we are reluctant to associate with them.
Pandemic 2020 seems like the right time to re-examine mental illness stigma in America because people may be more willing to report their distress. The NAMI helpline has seen a 65% increase in calls and e-mails in 2020 compared with 2019. This trend is quite noticeable with Generation Z. While the shift in admitting symptoms and seeking help among younger adults has been gradually increasing over the past decade, the pandemic seems to have accelerated this trend. According to an online study of 6,000 adults by the Centers for Disease Control and Prevention conducted in June 2020, almost 41% of respondents reported at least one mental health condition like anxiety, depression, trauma or substance abuse. Which group reported the highest rate of at least one mental health symptom? Not surprisingly, it’s 18-to-24-year-olds at a startling 75%.
Source: Andrea Piacquadio/Pexels Dr. Randy Phelps, the CEO of Give an Hour, an advocacy organization based in Washington, D.C., says the pandemic may offer a unique opportunity to re-examine our own beliefs: “As a result of nine months of COVID and social isolation getting worse people are now more understanding from their own experience… it’s an opportunity to be educated that mental health disorders are part of the human condition.”
If this seems encouraging, keep in mind that there are still substantial internal and interpersonal gulfs between responding to an anonymous survey and making mental illness part of a matter-of-fact conversation. And those who do seek treatment are confronted with a staggering mismatch between supply and demand. According to Dr. Duckworth, “More people are seeking help and the supply of providers is relatively unchanged. The shortage of psychiatrists I would rate as extreme.” So once internal barriers towards seeking help are reduced, one must confront systemic issues.
Dr. Patrick Corrigan, psychologist and stigma researcher who has written at Psychology Today, says prejudice should be challenged by those who have mental health issues themselves. Dr. Corrigan wrote in 2018: “Perhaps even more insidious is the idea that people with mental illness should be pitied because of their illness. Pity only exacerbates the idea that adults with mental illness are childlike victims. Pity fans the flames of stigma.” In a different post, he has publicly admitted his own battles with mental illness.
While it is useful for celebrities to disclose their struggles, we need more “everyday people” to come forward. So here goes: I have suffered with anxiety and occasional bouts of depression, throughout my adult life. I see a psychiatrist and take medication. Yet I’ve been able to establish successful careers as both a doctor and writer. I certainly don’t want to be pitied, but rather looked upon as an example of honesty and disclosure—trying to move the needle forward on ending shame and discrimination.
Source: Andrew Neel/Pexels Prejudice won’t end because Dr. Corrigan—or I—disclose our own struggles. These actions need to be repeated again and again—and on a much larger scale. And numerous other problems remain. There is the aforementioned mental health professional shortage. Not everyone can—or should—publicly disclose their psychiatric challenges. It depends upon one’s life circumstances. And evidence exists that the public at large is still prejudiced against individuals with so-called “serious and persistent” mental illness like schizophrenia, believing that they are dangerous. But, by some indications, the trends in terms of reporting distress may be improving. Our challenge as both consumers and providers (in other words, as humans) is to move forward with honesty, hope and commitment.