Are Some Mental Illnesses More Stigmatized Than Others?

Recently I sat on a panel of mental health consumers. Our goal was to educate people about mental health through drama and a question-and-answer session. When it came my turn to speak, I said that some mental illnesses were more stigmatized than others, fully knowing this would be controversial. Much to my surprise, I saw several heads nodding in agreement!

The Three Most Stigmatized Mental Illnesses

Another person on the panel said that the three most stigmatized mental illnesses were schizophrenia, dissociative identity disorder, and borderline personality disorder (BPD). Based on my experience, I would agree. In journalism, it's okay to suffer from depression or bipolar disorder. Many journalists have come forward about their diagnosis with one of these disorders.

BPD, however, remains taboo. Very few people have come forward about a diagnosis of BPD; Brandon Marshall is a notable exception. Most celebrities with a diagnosis of BPD are self-injurers who have been open about their self-injury but not their diagnosis.

BPD is even stigmatized among mental health professionals. I remember becoming acutely suicidal while at Richmond State Hospital. I told staff and showed them my note--they did nothing. After my attempt and a subsequent battle to see the doctor, I got my answer as to why I was ignored. "We had another borderline here and every other word out of her mouth was suicide, so we just assumed you were the same way."

Even more recently, I was at the hospital to be evaluated for self-harm ideation. The crisis counselor told me "That's your baseline, Rebecca. So what do you want me to do?"

Public Perception and Stigmatized Mental Illnesses

Recently one of my analogies was ruined by Halloween. Some costumes have a "violent psych patient" theme, and haunted mental institutions are also popular. I used to say that we wouldn't have a "violent cancer patient" or "haunted heart disease ward". Then someone came out with the "sexy Ebola nurse" costume.

But the difference is there's been a major public outcry over "sexy Ebola nurse." I'm still waiting for the same outrage over the blatant mental illness stigma.

On the TV show X-Men, a recurring line is "People fear what they don't understand." That's part of the problem--most of our "education" about mental illness comes from the media, not from doctors. As a result, perception is warped.

For example, according to a National Mental Health Association (NMHA) survey,

• only 27% of the general public believes that successful treatment exists for schizophrenia, compared to 47% of caregivers and 58% of people with schizophrenia.
• Fifty percent of the general population thinks people with depression can hold jobs and 49% of the general population thinks people with depression can raise families,
• but only 14% of the general public feels that a person with schizophrenia can do either.

Sadly, I don't have the statistics for borderline personality disorder.

How to Handle Stigmatized Mental Illnesses

According to National Alliance on Mental Illness of Indiana, Dr. Otto Wahl of George Mason University has the following 10 suggestions:

1. Learn more about mental illness. Knowledge is power.
2. Talk to individuals who have experienced mental illness. Many can share stories of what is stigmatizing, how stigma affects them, and how they would like to be treated.
3. Avoid using stigmatizing language, such as “nutcase,” “lunatic,” “maniac,” “psycho,” etc. Also, avoid using depersonalizing language. Refer to a person as “a person with” instead of just by their diagnoses. For example, “person with BPD” instead of “borderline.”
4. Monitor the media. NAMI StigmaBusters, the NMHA, and the National Stigma Clearinghouse protest such material by contacting the people responsible for the material. Consider joining one of these organizations.
5. Respond to stigmatizing material in the media.
6. Speak out about stigma. Educate others. Silence is often complicity.
7. Talk candidly about mental illness. How can we fight stigma if we don’t address the issue?
8. Demand change from elected officials.
9. Support stigma-fighting organizations. Even if you can’t contribute financially, encouraging mail could help.
10. Contribute to research. If mental illness can be understood and treated, stigma will be reduced.

Fighting stigma is up to us. And we can start by helping people understand that there should not be degrees of stigma toward mental illness.

You can also find Becky Oberg on Google+, Facebook and Twitter and Linkedin.