It’s no secret that there’s a veil of shame surrounding mental illness.
Nearly one in five American adults will experience a mental health disorder in a given year. Yet only 25 percent of people with a psychological condition feel that others are understanding or compassionate about their illness, according to the U.S. Centers of Disease Control and Prevention.
Typically, we refer to this dissonance as stigma, but we have been wrong to do so. The negative stereotypes that shame those with mental illness and prevent them from seeking help don’t just constitute stigma ― they’re discrimination. It’s a blatant, prejudicial outlook on a certain population.
The societal outlook on mental illness doesn’t just result in negative stereotyping, as the term “stigma” implies, says Kana Enomoto, principal deputy administrator of the U.S. Substance Abuse and Mental Health Services Administration. It results in behavior and policy that actually make life more difficult for those with mental health challenges.
“We [at SAMHSA] don’t use the word stigma,” Enomoto said at a National Press Foundation gathering of mental health-focused journalists. “You look the word up in the dictionary and it refers to a mark of shame.”
It is certainly true that people with mental illness are taught to feel shame ― to believe that they have a character deficiency that is disgraceful, “all in their heads” or something to just “get over.” But the way we collectively treat people with mental illness goes far beyond that.
People with a mental illness are more likely to encounter law enforcement than get medical help during a psychological crisis. There are currently more people with mental illness in jails and prisons than in hospitals. They’re blamed for violence when they’re more likely to be the victims. They have higher rates of homelessness. They’re seen as a danger to society, to other people, to themselves.
The Committee on Economic, Social, and Cultural Rights defines discrimination as something that “occurs when an individual is treated less favorably than another person in a similar situation for a reason related to a prohibited ground.” In other words, when a person is mistreated or regarded differently than someone else based on their circumstances.
When it comes to mental illness, doesn’t that sound familiar?
Fear has driven mental health discrimination for 400 years
The idea that mental illness is a flaw dates back centuries. In the 1700s, people with psychological conditions were often thrown in jail or quarantined for their behavior, often because people didn’t know what else to do.
In the 1800s, activist Dorthea Dix began to change the perceptions around psychological disorders by opening up hospitals for individuals who had a mental illness. However, it was around this time that controversial brain surgeries began, performed in order to “calm” patients who displayed signs of serious mental illness. This eventually grew into what we now know as a lobotomy, or the surgical manipulation of the brain’s prefrontal lobe.
While present-day attitudes and methods of care are huge strides away from these earlier days, there’s still a long way to go.
Look at the narrative from politicians. They use terms associated with mental illness as mudslinging insults. They blame mental health disorders for national tragedies. There’s even pushback and debate when it comes to mental health reform. But it’s not just on Capitol Hill. Many facets of life include poor attitudes toward mental illness:
Police: Many law enforcement officials don’t know how to deal with a mental health issue during an encounter. Take, for example, the case of Charles Kinsey, the mental health caretaker who was shot by police while helping a man with autism in Florida in 2016. The incident was a glaring indication, many argued, that law enforcement officials don’t have a clear understanding of how to de-escalate mental health crises ― or of those who work with someone who has a psychological disorder.
The workplace: People who live with a mental illness are terrified to disclose their condition at work for fear of professional punishment. This fear can then manifest in the office and affect a company’s bottom line: Approximately $193 billion dollars in earnings is lost each year due to serious mental health issues.
Medicine: Even doctors don’t take mental health as seriously as they should. A study published in the journal Health Affairs found that primary care physicians often neglect to follow up with their patients after a depression diagnosis and are less likely to help patients manage their illness. But they’re more likely to engage in care strategies with patients who are dealing with a chronic physical illness, like diabetes.
Change starts with precise language
Tackling the unfavorable outlook surrounding mental health starts by encouraging more people to talk about it openly. Otherwise, as research shows, people won’t seek the medical support they need ― support that can lead to recovery. Untreated mental health conditions can lead to a loss in productivity, poor sleep habits and withdrawal from social situations. At their worst they can be a major player in suicide, which is the 10th leading cause of death in the U.S.
Ultimately, it’s more than just changing hearts or minds ― it’s about getting to the root of the problem by fixing systemic issues. That means more mental health training for first responders, more policies that help people with mental illness get the care they need from medical professionals and more workplace acceptance and initiatives that support individuals dealing with a psychological issue.
Of course, not everyone is a legislator, or a company CEO or can implement more programs for first responders. But an average citizen can lend their voice. One way to start small is to by calling out the judgmental viewpoints surrounding mental illness by labeling them exactly what they are: intolerance for a group of individuals. By addressing this outlook in a more pointed way, people may take it more seriously, Enomoto said.
Because you’re not just dealing with a mark of shame, you’re dealing with discrimination. Full stop.
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.