It’s time we rethink our attitudes

Concerning mental health stigma

A review in the UK population found the following:

One in five said “anyone with a history of African descent should be excluded from taking public office”.
One in ten said “it is frightening to think of African-Americans living in residential neighbourhoods”.
One in ten said “A woman would be foolish to marry an African-American man, even though he seems fully sociable”.
One in ten said “African-Americans should not be given any responsibility”.

Shocking, isn’t it? One would think we are well beyond such ludicrous statements and beliefs based on ethnicity, aren’t we? That mind-set is a thing of the past, right? We no longer let ignorance and stereotyping guide our judgement of others…surely?

Sadly, this may not be so.

The statements above were modified to replace “people suffering from mental health” with “African-Americans” and the statistics were taken from a 2011 study of 1741 adults conducted by the NHS. In the UK, prejudice, ignorance, and fear about other ethnicities, genders or sexual orientations are more widely recognised and becoming socially unacceptable. So why is this not also the case for mental health?

The Mental Health foundation is the UK’s “leading mental health research, policy and service improvement charity”.

Mental illnesses are just another kind of illness and a startlingly common one at that. It is estimated that, in any given year, up to 1 in 4 people will be suffering from some kind of mental illness, and that 1 in 6 experience a mental illness at any given time (Mental Health Foundation). Yet, people trying to talk about their illness and share their feelings with those around them are often met with disbelief, labelling, lowered expectations or even abandonment and social exclusion.

Most of those suffering from mental health issues will show a full recovery if the adequate treatment and support is provided, but others may struggle for years. Mental health affects every aspect of life — finding and keeping a job, forming and maintaining friendships, even simply going out and performing everyday tasks that require social contact all may be made harder due to the stigma surrounding mental health.

People are reluctant to disclose their illness to others and, more dangerously, some might even be apprehensive about approaching professionals for help and treatment, for fear of reprisals or even simple dismissal of their issues.

Time to Change is “England’s biggest programme to challenge mental health stigma and discrimination”, and is led by the charities Mind and Rethink Mental Illness.

Time To Change is a campaign led by mental health charities to change the way our society perceives mental health and those who suffer from mental health problems. According to their data, over a 3 month period, 63% of references to mental health in TV soaps and drama were “pejorative, flippant or unsympathetic” and often associated with violence towards others or self-harm. This relation has no real-life basis, because evidence shows that mental health problems are not consistently associated with violence. As a matter of fact, recent studies have actually shown that those suffering from mental health are more likely to be victims of a crime rather than perpetrators. Indeed, women suffering from mental health are 10 times more likely to be victims of assault and up to 62% have been victims of sexual assault as adults.

The Sun’s shocking, unjournalistic and harmful front page from Monday 7 October 2013.

Yet, despite these statistics, those suffering from mental health issues seem to be repeatedly connected to incidents of violence. “1200 killed by mental patients”, read the Sun’s front page on Monday 7 October 2013 in a misleading headline deemed “unjournalistic”, “disappointing”, “disgraceful”, “harmful”, and even “irresponsible” by a number of sources.

Paul Bristow, head of Policy and Communications at the Mental Health Foundation, said:

Sensationalist journalism like this contributes to stigma and discrimination in order to sell newspapers, and makes the anti-stigma work of the Mental Health Foundation and other mental health charities even more challenging. Mental health is a seriously under-resourced area of healthcare with people often not getting the treatment and support they need in a timely manner.
“Reporting of this kind reinforces stigma and makes people who are in distress less likely to seek support. With one in four of the population experiencing mental health conditions it is crucial that we ensure support is adequate and as unstigmatising as possible.
Asda’s “psycho ward” (left) and “mental patient” (right) fancy dress costumes for Halloween 2013.

This frequent association of mental health with violence is portrayed in the most trivial ways. “Mental Patient Fancy Dress costume”, the name of a Halloween costume “comprising a torn blood-stained shirt, blood-stained plastic meat cleaver and gory face mask” sold by ASDA in September 2013, is yet another example of the flippant application of stigmatising attitudes to mental health. The item was removed from sale as soon as the complaints started flowing in, but not every company reacts as swiftly and favourably.

Despite campaigns and petitions, the problem remains: people suffering from mental health problems are viewed as a danger to society, as perpetrators of violence, and as a group of persons to be wary of even though figures do not support such assertions.

Educating people about mental health problems is one way in which societal misconceptions around mental health could be reduced. In the same way an understanding that, for instance, ethnicity has no impact on intelligence, has been communicated and generally widely accepted, we now have to promote a better understanding of mental health and mental health problems.

More and more, the opinion that mental health should be discussed in schools is gaining popularity. There are several potential benefits to such a scheme. It is commonly accepted that teenagers have ‘ups and downs’, and that their moods are prey to their hormones. While this is partially true, mental health problems in teenagers do occur but are often disregarded or ignored, which may have severe repercussions for the troubled teen.

Up to 1 in 10 people under the age of 15 suffer from a mental health problem, and yet mental health issues in young people remain a taboo subject in health care, perhaps through shame. Parents are often held responsible for their children’s personalities and successes at a young age and mental health issues in a child or teenager can be wrongly seen as a flaw in parenting.

Anger stemming from mental health issues can often lead to forms of self-harm that go unnoticed in teens.

Young age, lack of experience and the fear of being ignored or accused of attention seeking may lead many young people to isolate themselves and avoid seeking help. This could have drastic consequences such as inclining teenagers towards self-harm. Statistics surrounding self-harm are hard to come by, as many cases go unreported, and some forms of self-harm are not always recognised as such – like punching walls in anger. For instance, 90% of self-harm cases treated in A&E are caused by overdoses while the major method used for self-harm remains cutting, suggesting that most of those who self-harm are never officially recognised.

A 2011 survey by UNICEF Ireland reported that 50% of 16 – 20 year olds interviewed had suffered from depression in the past and 20% had self-harmed. The most alarming statistic uncovered in this report remains the 82% of young people suffering some sort of mental health illness and not receiving any kind of help.

Pejorative language to refer to ethnic groups or sexual orientations are mostly considered unacceptable in a school courtyard and one hopes that teachers will react when students use these in conversation. However, when children use words which show a pejorative attitude towards those suffering from mental health problems, it may be less likely that teachers approach them, possibly because they do not know how to the subject of mental health with pupils.

School policies do not often cover the issue of mental health discrimination directly. It is therefore recommendable that schools start addressing the topic of mental health both in and out of classrooms. Scientific explanations of mental health problems will allow pupils to understand the medical reality of these illnesses, as opposed to being a flaw of personality.

Teachers should take the time to discuss mental health with pupils, and school policies should address mental health stigma to the same extent as they do racial prejudice.

Teachers should also take the time to explain to pupils why certain words are not acceptable to use due to the pejorative connotations they carry. Education of the younger generations is typically key to changing how society thinks and acts towards misunderstood groups. This will not only remove barriers to help-seeking in these young people but hopefully will also decrease rates of discrimination and stigma in the future.

So, are you prejudiced regarding mental health? As open-minded and educated as you may be, stereotypes and prejudice are hard to escape. Stigma is often so omnipresent around us that it is nigh on impossible not to have been affected. I mean, I am sitting here writing to you about stigma in mental health, and even I have to admit that it has affected me to some extent.

But this can change. We can fight. Fight for the awareness of the stigma, fight to educate people and explain mental health, fight to rebuke fallacies and debunk popular myths, and fight to provoke a debate on a uselessly taboo subject.

Stephen Fry, who suffers from manic depressive (or bipolar) disorder, said “1 in 4 people, like me, have a mental health problem. Many more have a problem with that.” Truly, it is time to change, and you can help.

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