Exploring Stigma and Its Impact
“A civilization should be judged by how it treats its mentally ill: discrimination is about the conditions in which our patients live, mental health budgets, and the priority to which we allow these services to achieve.”
–Peter Byrne, former Director of Public Education, Royal College, UK
May is Mental Illness Awareness month. While I am not always in favor of these arbitrary month by month focus on issues as it seems superficial, I WILL leverage it to talk about the real impact of mental illness.
First, were you aware that four hundred and fifty million people worldwide have a mental illness? (The population of the United States is 321.4 million.) Sixty percent of people living in developed countries with mental illness do not receive treatment and for those living in underdeveloped countries, 90% do not receive care.
Also, were you aware that undiagnosed and untreated mental illness represents the biggest economic burden to our country and to the world? The World Health Organization estimates that by 2030, costs to society due to undiagnosed and untreated mental illness will be six trillion dollars. The majority of that cost is due to disability and to loss of work.
Clearly the issue is significant. Researchers, psychologists, sociologists, and many health care professionals agree that the major barrier to getting the treatment that is needed is stigma. Stigma has been defined as, “a sign of disgrace or discredit, which sets a person apart from others.” The experience of stigma manifests itself mainly as shame. Shame leads people to eschew seeking help, which leads people to try to conceal their illness.
It is not a new concept to compare the diagnosis and treatment of mental illness unfavorably with other physical diseases. When one has been stricken with a chronic disease like asthma or arthritis or cancer, friends, family, and the medical community are quick to lend support and to respond with care. But there is no such outpouring of support for those with mental illness. There is confusion about what to do. There is shame within families. There is fear among friends and moreover, the community.
We held a very powerful Solution Series in New Hampshire recently where one of the panelists talked about the employer being one of the most important players in helping individuals to identify and treat their mental illness—in a safe and supportive atmosphere. Both employer and employee benefit. Helping individuals with mental illness obtain and maintain employment is key to advancing their economic well-being and their equity. Employment results in the establishment of connection to others through working relationships. It means individuals are covered by health benefits, which offer some coverage for the treatment of mental illness.
I concur with Patrick Kennedy that the diagnosis and treatment of mental illness must become a top national public health priority. Through the Kennedy Forum, Patrick has laid out an extensive platform for ways to address issues around improving access to mental health services, including prevention and early treatment. (https://www.thekennedyforum.org/vision) The actions Kennedy outlines would lead to better care for those suffering with the pain of mental illness and could help advance a new understanding of mental illness—and reduce stigma. What would it look like to live in a world where we move toward one another in an effort to help rather than shy away in fear?
Psychologist Peter Byrne had it right when he said:
People must also be courageous enough to help fight a battle that is not entirely theirs; to fight an established institution in order to create positive change. It is the basic quality of a human– to help each other– that people must find and use in order to make the world a better and safer place.
As always, I welcome your thoughts.