Breaking the Stigma Associated With Mental Illness

I just finished reading an article in the January/February 2013 issue of Behavioral Healthcare about Elyn Saks, J.D., Ph.D. If you’re familiar with Elyn’s story, you know that not only is she a brilliant professor of law, psychology, psychiatry, and the behavioral sciences at the University of Southern California’s Gould Law School, but she has also battled with schizophrenia, which emerged as her reality during her time at Yale Law School.

The article, titled “Life, Unrestrained: Escaping the Bonds of Mental Illness Means Loosening the Restraints of Stigma, Too,” shares Elyn’s perspective on the stigma associated with living with a mental illness and also her experience of being placed in mechanical restraints, sometimes for up to 20 hours at a time.

This stigma in our society causes me pause. The primary definition of stigma is a sign of social unacceptability; the shame or disgrace attached to something regarded as socially unacceptable.

I wonder when we can reach parity in treating mental health and physical health in the same way. There are many “silent” physical illnesses and we strive not to judge individuals living with diabetes, chronic pain, lupus, heart disease, epilepsy, etc. But what about bipolar disorder, or PTSD, or addiction, or depression, or schizophrenia? What about “frequent fliers” and “med seekers”?

It’s terrifying to me to think that should I wake tomorrow with a disease of the mind, it might affect the way others treat me—that I might be shunned, I might lose my job, I might lose my friends or family, it might be difficult for me to find affordable quality mental health care—but if I woke up tomorrow with diabetes, heart disease, or cancer, I would be surrounded by love, support, and positive attitudes for my recovery or my ability to live a full life, despite my illness.
  As I recall the article, it’s also terrifying to think that as with Elyn, a critical medical diagnosis could be missed when the behaviors manifesting from a physical condition mimic, in some ways, behaviors associated with a mental health diagnosis.

While I think many people work hard to set aside these stigmas, there is still much distance to go to bridge the gap created by stigmas. Elyn names three main reasons for her status of recovery:
  1. Appropriate treatment
  2. A strong support system of friends and family
  3. An engaging, supportive, and interesting work environment

As we travel this week to be with thousands of emergency room nurses and professionals supporting their work, I know I will hear the terms “frequent fliers” and “med-seekers.”

This is not a critique of the individuals who use those terms, but it might be a challenge for those who do to consider that the individual who is accessing health or mental health care services through your emergency department is likely not as fortunate as Elyn. Perhaps the person doesn’t have appropriate, affordable treatment. Perhaps their family and friends, due to the challenges and stigma of mental illness, have abandoned them in their moment of greatest need. Perhaps they lack positive ways to engage in life because they struggle with employment for any number of reasons.

Meeting the physical and mental health needs of individuals accessing care through the high-paced, high-stress environment of an emergency department is a daunting task, no doubt. I can’t wait to hear the stories of emergency departments that have taken a more person-centered, trauma-informed approach, even in this most challenging environment.

I’m excited to hear stories of collaboration between emergency department staff and mental health professionals in the community and within the hospital who ensure that patients who are both medically and mentally frail are receiving the best treatment and transitions possible. I’m excited to hear these stories because that means there are more people like Elyn Saks who can speak out and help us break the stigma associated with mental illness.
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About the Author

“When you change how you look at a challenge, you unlock its positive potential. If you remain mindful about your ability to control your own behavior, you can make constructive choices that can promote the best possible outcome instead of the worst-case scenario.”

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