Persistent Stigma, Skepticism About Mental Illness Causes Real Harm | CommonHealth

But why? Why, in this day and age, does this scenario so stubbornly persist?

I think it’s because plenty of people still feel that psychiatric suffering isn’t real. And this causes genuine harm. If Sally encounters resistance to the fact that she’s suffering, she’ll almost certainly be less likely to seek care. If she feels that her non-psychiatric doctors don’t take her suffering seriously, then she’s going to suffer quietly and dangerously.

There’s even evidence that doctors themselves don’t believe this type of pain is real — and they sometimes wonder whether depression results from a moral failing.

Looking at the problem from another perspective, consider this anonymous comment I got from a medical student in the psychiatry course I teach: “Dear Dr. Schlozman: The psychiatry course convinces even the biggest skeptics.”

This comment, entirely well meaning, is also deceptively profound. Whenever I contemplate the vexing world of stigma with regard to mental health, I think first of this comment.

Let’s deconstruct what this student is saying.

“The psychiatry course convinced skeptics.”

Does the doctor teaching cardiology have to convince skeptics? Does anyone refuse to believe in nephrology? The burdens placed on psychiatric patients stem largely from the skepticism that many in the community, including the medical community, still patently feel and express. Simply put, quite a few health care providers do not believe that many psychiatric illnesses are real. This is despite data-laden policy papers from the Office of the Surgeon General, from the CDC and even from the World Health Organization.

Doctors, policy makers and the general population still have a long way to go toward accepting psychiatric suffering as part of the medical canon.

That’s not to say that we haven’t made huge strides. In fact, one might argue that the increasingly vocal debates that are happening now with regard to psychiatric suffering are happening precisely because we have allowed ourselves to discuss these issues in open forums. To that end, these discussions are absolutely necessary if we’re to move forward.

Persistent Stigma, Skepticism About Mental Illness Causes Real Harm | CommonHealth

A Phrase To Renounce For 2014: ‘The Mentally Ill’ | CommonHealth

I wince every time I read it. So does the president-elect of the American Psychiatric Association, Dr. Paul Summergrad, he says.

I saw it most recently in The New York Times, in the headline pictured above and a recent masthead editorial: “Equal Coverage For The Mentally Ill.” It’s all over, from The Boston Globe — “New Era for the Mentally Ill“ – to The Wall Street Journal — “Crime and The Mentally Ill.” Just about any media outlet you care to name.

What’s so bad about “the mentally ill”? Isn’t it reasonable shorthand in the usual headline space crunch?

In a word, no, says Dr. Summergrad, psychiatrist-in-chief at Tufts Medical Center and chair of psychiatry at Tufts University School of Medicine. He sees two main problems with it. First, the definite article, “the.”

[,,,]
Second, Dr. Summergrad said, “there’s the denotation of what mental illness means, but there’s also the connotation. When people ask me, is it really possible that 25 percent of the population is mentally ill, what do they mean by that question?”

[,,,]
I’d add a third argument against “the mentally ill”,,,Some newly minted peer specialists sat me down and re-educated me about the wrongness of using “the mentally ill” and the rightness of using “people first” language. A person is not defined by a diagnosis, they said. If you have a mental illness it doesn’t define you any more than your heart disease defines you if you’re a cardiac patient. A person is a person who happens to have depression or schizophrenia; the correct term is “people with mental illness.”

[,,,]
Virtually all illnesses have biological, environmental and psychological components. We could say the same for migraines, ulcers, asthma or diabetes. But it does not make one feel uneasy if we say, “He has asthma.’ On the other hand, ‘He has depression or obsessive-compulsive disorder feels so very different. Is that because it is labeled ‘mental?’ Certainly. ‘Mental’ is an arbitrary negative label that segregates something psychic, personal or ‘in the head’ from the body and the environment. It also is very scary.”

A Phrase To Renounce For 2014: ‘The Mentally Ill’ | CommonHealth

Shameful Profiling of the Mentally Ill - NYTimes.com

This is one of those articles that got lost in the shuffle, as it was originally brought to my attention earlier in the month. A friend and I got into a discussion concerning the how's and why's with my conclusion being an over zealous agent assuming more than should have; she does have a book out, and there is a record of the 2012 call placed by her mother to 911.  In my mind I was/am thinking that someone assumed a bit too much (her 3 prior trips being uneventful) based on a faulty notion concerning mental illness and physical disabilities.  Although her self report that they cited her diagnosis of "clinical depression" is a bit disconcerting:

He cited the U.S. Immigration and Nationality Act, Section 212, which denies entry to people who have had a physical or mental disorder that may pose a “threat to the property, safety or welfare’’ of themselves or others.

The agent gave her a signed document which stated that “system checks’’ had found she “had a medical episode in June 2012’’ and that because of the “mental illness episode’’ she would need a medical evaluation before being accepted.

The difficulty for me personally, "who exactly is defining what a 'mental disorder' is?"  For those more outside the box, they would go one step further, " In a police state, a mental disorder can be any pattern of thought that the government thinks is not accepted by the state. Today they may use conventional definitions to discriminate against those with episodes of mental distress, but tomorrow they will expand that definition to include any pattern of thought conducive to being an enemy of the state." 

At the time of my original discussion I stated that this incident would bare watching to see what if anything would develop; since that time I have not come across any "new" news. 

But, back to the highlighted article, there is an issue that the author of points out that needs to be discussed:

Much more troubling, however, is the notion that information about a person’s depression, no matter how legitimately obtained, might have any bearing on her ability to visit the United States.

People in treatment for mental illnesses do not have a higher rate of violence than people without mental illnesses. Furthermore, depression affects one in 10 American adults, according to estimates from the Centers for Disease Control and Prevention. Pillorying depression is regressive, a swoop back into a period when any sign of mental illness was the basis for social exclusion.

This is the "faulty" notion I was referring to above, that those of us with a mental illness are "prone to violence."  In actuality the exact opposite is true, people with a mental illness are more likely to be the victims, rather than the perpetrators of violence.  Numerous studies indicate that people living with mental health conditions are no more likely to engage in violent behavior than the general population.

Regretfully this "myth" is one the is perpetrated and kept alive by popular culture as Aaron Levin wrote an article entitled, “Violence and Mental Illness: Media Keep Myths Alive”.  The example given in that article, the hockey mask as a symbol of dangerousness and insanity.  

What it boils down to is this mental illness has been shown to be a poor predictor of violence, 80 to 90 percent of people with mental illness never commit violent acts.  But the policy is there, and whether the border agent was being over zealous or not, it is a policy that needs to be changed.  Further stigmatizing a person with a mental illness, will not solve the problem.  If anything it will make matters worse as many will internalize their illness for fear of being shunned (or worse, refrain from seeking treatment that could make a significant beneficial impact on their lives) in order to avoid what happened to Richardson.

Shameful Profiling of the Mentally Ill - NYTimes.com