Mental Health Stigma: Prejudice That Becomes Discrimination

Great blog, Chris! Welcome to HealthyPlace.

I couldn't agree more Chris! If only I had pushed past the wallls if this very same stigma I may have reached out to the resources I needed for help long ago. I had such a huge fear of hearing the door shut behind me as I entered the inpatient mental health unit at soldiers memorial hospital. I felt I was admitting defeat. That I had to throw my hand in the air along with any sense of Control. But know that its actually the opposite. I went in to have the greatest access available to gain control in my life so that I could get better. Yes I fear a day will come where I am no longer well. But I won't carry it with shame. Ill just go get the he'll I need. :)

My posting today looks at the stigma problem. It is sad when someone has to guard against surfacing a mental health diagnosis for fear of discrimination.

I have been. Cyber bullies have attacked me discriminates me no help pa stare cannot figure out where to get IP address. And had to relocate because of this still have not stop a

Hi Chris-
I recently encountered a huge stigma issue at a local pychology counseling visit. I went there for marriage counseling and the psychologist decided within 10 minutes of the conversation, as soon as he found out I had a mental illness, that he would not help us until I had gone to see my psychiatrist. I have been well for two years!

I was diagnosed with Bi Polar in the mid 90's. It cost me a job and almost my life. Then I decided to fight it: I went to college (it took much longer than most people with the medical withdraws I had to do), I did very, very well - that is, when I was well. When I am well I am very articulate and people immediately see that I am intelligent and capable. It is a good feeling. But then I have to disappoint them by appearing very inconsistent. They don't know why, because being bi polar is my dirty little secret. I just drop off the planet: don't answer calls, self-isolate, and when in school, drop out of class when I know I am getting sick (usually in late fall and winter). Then a few months later they see me again, mention it's been awhile, and that's when I have to either be very vague, exaggerate life issues or outright lie. I had gotten so used to being viewed as successful, hard-working and intelligent that I could not bear being viewed differently and losing that admiration. I was an honor student, I did important research, I wanted to "be" something. Then I would get sick and feel like an imposter and without the help of a great counselor, wouldn't even have gone back to school.
After college I quit taking my meds convinced I had been mis-diagnosed and I was going to be "normal" and not "buy in" to the diagnostic labels so I could quit feeling the shame of self-stigma and feel better about who I am. I got a great job as a trauma counselor and volunteer coordinator for a non-profit. I had my own office and had earned the trust in my competence to have complete control of how my program was run. I managed to keep this up for a little more than 3 years. I hid my winter depressions by going in after hours and working nearly all night to make up for my lack of energy and concentration. The hypomanic springs would catch me up. Then I crashed. Years of burning the candle at both ends and not using medications, and basically not having a single person in my life to talk about these things, I had a serious mixed episode and it was obvious to everyone at work there was something seriously wrong with me. I ended up being hospitalized. Then when I shared my diagnosis I pretended that I had been given the diagnosis for the first time. Everyone was great. Or so I thought, when it came right down to it, I was never looked at the same way again. I was micromanaged, lost all authority in my dept, most of my job description was farmed out the other employees. I begged to be some kind of way of "earning" my job back. Some performance and job load milestones of getting back to where I was before. It never happened. Even though I worked with mental health professionals, I was treated like damaged goods. I quit. All this did was teach me that I had to keep my secret. This lead to more frequent episodes, self-isolating, and basically self-loathing. I went back on disability, accepted a monthly income 1/3 of what it was, but mostly I gave up on ever being "normal".
I don't date because I feel no one deserves to get stuck with someone like me. That they will meet me when I am well, have all these ideas of who I am and then I would inevitably have to burst their bubble. Mostly though, I don't want to lie and I don't want to feel so horrified while "outing myself" and face rejection.
I have TONS of insight, I have an educational background in neuropsychobiolgy and trauma counseling for heaven's sake! Yet the stigma hurts me more than my illness and probably keeps me sicker than I need to be (especially at the heart/soul level). I have lost 6 years of my life - more from my nearly full-time self-stigma / shame than from my less than part-time bi polar disorder.
I am in counseling myself and working very hard on trying to overcome my shame and accept my illness but more importantly I am trying to rejoin the human race and better my situation by trusting in people - one at a time. Stigma is an awful thing, it is a debilitating societal disease in itself. When that stigma gets turned inward, it may as well become a sword that metaphorically (or in some instances literally) severs your life.
Thanks for speaking out about this. It is good to know that stigma is possible to overcome.

I was diagnosed with Paranoid Schizophrenia over two years ago and its been difficult but I have finally been able to put my life back together. The hardest thing (I found) was telling both of my best friends about my diagnosis and dealing with the anger and treatment from some of my family members after I was diagnosed. My co-workers and classmates do not know about my diagnosis, I have acute schizophrenia with a good prognosis (I stay on my meds and have had to work around the loss of happiness on them) so I am not too worried about a reoccurring incident. But while I was once viewed as a brilliant, stable, role model and friend, the tables have turned for those who know about what happened to me. Instead of looking up to me, people now talk down to me as if I can't understand what they are saying. While my family does love and support me I can tell that the ones closest to me are very angry about what happened during my psychotic break (I cried a lot and felt persecuted but never posed a danger to anyone). My sister (who was and is the closest person to me) has had a hard time forgiving the fact that I was diagnosed with this disorder, its like to her, I'm not the same.
I came out of the hospital (a 2 week stay) and immediately began to look for a job and try to get myself back in school. I am now working full time and going to school part time with a 4.0 average. I also just got a promotion and a raise last week. My psychiatrist has lowered my meds and informed me that I may have been misdiagnosed (I am african american) because I have such a low form of the disorder and because I was diagnosed at 30, that my prognosis is pretty good. As I said though, the people that know about my disorder wont let me live it down. They try and treat me like an undesirable or as if they don't know if I'll go crazy again (therefore little I say can be taken seriously) and this is hurtful. I am working hard to remove the Mental Illness stigma from my own mind about myself but it doesn't help when others refuse to see you as you once were. This blog entry was very helpful to me, though my personal philosophy is that my mental health diagnosis (as in any other diagnosis) is my business and no one else's. Thanks for posting though.

I suffered post natal depression which then resulted in a divorce. This esculated my illness, and yet, after treatment I bounced back. I reasoned that if I could not have 'mental health' there were many other things I could enjoy - music, getting fit, making friends, dressmaking, art. My friends and family loved me regardless, I was very blessed to have them.
I later encountered some very negative, pidgeon holing types of professionals, who did nothing for me, and whom I suspect, gave out information about me, all to my detriment. Fortunately, I am pretty versitile, and I was able to work around them.
Its not just discrimination that needs to be addressed, but the importance placed on diagnosis, and the stereotyped ideas around about mental illness. Its important to create an environment of acceptance of people as individuals, building on their strengths (abilities and character) rather than emphasizing their illness.
I found it difficult for a long time to get any help with physical ailments, until I moved away, and ultimately found that I needed to be involved in preventative health. Eventually, it was found that there were contributing factors to my 'illness' which could be treated with changes to lifestyle (healthy diet, exercise, stress management, lifestyle planning) I also found it helpful to re-think my attitudes to people, and life in general, and I've read a lot of self development books also. Ultimately, there are some benefits to finding some spiritual fulfilment, and we all have the right to practise our faith (in whatever way we wish).
Health professionals have asked me to write a book about my recovery, which may help other people. I do feel that self-help, lifestyle and a strong faith are the keys to building a new life after mental illness. Good luck to all who are on that road.

[...] our bodies. Alternatively, struggling with physical disabilities can cause mental illness. But the stigma surrounding mental illness can make those of us who live with it feel as if we need to hide our illness, the symptoms of it, [...]

[...] Solutions”, alongside three people who live not only with mental illness but also with the mental health stigma that can come along for the ride – both external and internal. Each person shared the [...]

[...] So why is dual diagnosis treatment hard to find and hard to access? I don’t know. My belief is that it is due to mental health stigma. [...]

[...] everyone has the desire or the luxury to disclose their mental health struggles. Mental illness stigma does exist but not only in the form of alienation, guilt, ignorance or shame but of real [...]

[...] wish I could tell you mental health stigma in the workplace does not exist and that if you were to be truthful about your mental illness it [...]

[...] Congratulations on your recent victory. Now, as you plan the next four years, I’d like to offer a few suggestions on how you can help those of us living with mental illness. Fight for parity in mental health treatment, work to reform the fragmented mental health system, and attack the stigma behind mental illness. [...]

Anyhow, stigma on mental ill persons and their care-takers exhibits the main mutilation difficulty on current psychiatric treatment and management; everywhere and at all times. This condition in complex mental health service has got many bad consequences on both direction:it aggravates the course of mental disorder and decreases the probabilities for satisfying prevention of mental illnesses, at all. In this case, I would to stress my indignation on contemptuous attitude of community toward psychiatry, as competent and deserving medical branch on complete and comprehensive treatment of mental disorders.Indeed, this ill-approaching to psychiatry remains till nowadays, even catastrophic man-made repercussions has became our daily sadness.As long as we didn't understand the functional recommendation of World Health Organization that mental welfare indicates the foundation of individual and collective well-being, we would to sprain after horrible acts, that commit person with mental difficulties.

[...] often catch myself sitting back and thinking what the world could look like if mental health stigma was a thing of the past and mental health care was a right and not a privilege. I don’t know if I [...]

[...] and mental health services in general. Unfortunately, these misguided beliefs seem to stem from mental health stigma that exists and the humbling task of asking for [...]

I have suffered a lot of misunderstandings because of my Borderline Personality Disorder. I am now trying to raise awareness of reduce the stigma of BPD. Please check out my website here:
http://makebpdstigmafree.wordpress.com/
and this post:
http://makebpdstigmafree.wordpress.com/2013/06/19/i-have-borderline-personality-disorder-…

[...] year and a half, I’ve been talking about things we can all do to instigate change in the realm of mental health stigma. One unifying theme that I keep mentioning is the need for people to come out of the metaphorical [...]

"Everyone is different and everyone should come out about their own mental health issues at the right time for them and, preferably, with proper support".
CHOICE is key. Unfortunately, sometimes mental health episodes come out in the most inopportune times and you are left stranded with minimal or no support to even begin recovery. My saving grace is that the family structure in my culture will rally behind you, though it is often done with very little understanding and has its own share of stigma within it. But at least I did not end up homeless. Very grateful for that.
Reason I am writing is to say that a person's experience is so individual and personal. Whether someone chooses to be open about their illness or disclose is their perogative. I am a deeply private person, and this is the main basis for my decision to not disclose. I don't appreciate being called "dishonest" simply because I choose not to (and I've seen that word bandied about healthyplace, which is annoying). Choice is really the thing that is empowering. When you get to choose, you are mentally and emotionally prepared to defend that choice.
I have defended other people with mental health issues in the past, and will continue to do so if I see someone maligned because of it, but so what if I refuse to put myself out there? Just not comfortable with it, will probably never be comfortable with it, and I'm just not in a position that makes it conducive to a positive outcome.
Thank god the stars aligned in your favor that allowed you to step out of your shell. You sound very dedicated and you do good and important work. From what I've read, you are a voice for people who would simply disappear into the ether that is the penal system. Many studies have demonstrated that the mentally ill simply do not belong in the harsh world of the prison system, but not many people know this.
(Side note: just noticed this link. Glad to see the sentiment is shared after all. http://www.healthyplace.com/blogs/bipolargriot/2012/10/10/the-value-of-choice-in-disclosi…
Now I feel better.)
@dina. I read somewhere that cyber-bullies suffer from some sort of dysfunction - be it sexual, social, what have you. Driven by some sort of rage for sure, but that's an article for another day.

Yes, being out has its benefits, but being honest with the wrong people can cost you your job. In certain industries if you reveal that you have a mental health issue you can will be black listed - nursing is a good example. People have gone crazy with being out and open about their private health information to the point it is scary. What about those of us who are not comfortable with the world knowing our private business? Are we to be stigmatized for being private with our lives? I have seen a change with society over the past 13 years since 9/11. I want my privacy and I believe it is my right to have it. I have lost two jobs because "word got out." This blogger, I believe, lives in a fantasy world. It is going to take a tidal shift to end stigma and it is no where near. I was in a psychology workshop yesterday with psychology students. Schizophrenia was mentioned in regards to an teenager with it. The young man, when having an attack and off his meds would always take to brandishing a machete. His parents did not know what to do on one faithful occasion and called the police. The police put, if I recall correct, 4 or 5 bullets in him - he is dead. Ending the stigma around mental health is going to take more than just people telling the world about their private business. It is going to take on going education and people receiving proper treatment without fear of being out(ed). I am attempting nursing school. I am over half way there and I can tell you that stigma among young people is still extremely strong. I live in fear of being found out. Being too honest with some people can cost you EVERYTHING. Sad, but all so true.

Thanks for the post Chris.
The unfortunate reality is that the stigma is still very real, even within healthcare professions, which in itself is beyond discouraging.
I have been a medical equipment repair technician for 16 years. I had suffered with migraines for years, when in early 2013, I had a migraine that lasted for 3 weeks. I became suicidal, and admitted myself to a psychiatric ward at a hospital affiliated with the one I worked in.
After I was diagnosed with major depressive disorder, they began building their case to terminate.
Once diagnosed, the long and arduous process of trial and error to find the right combination of meds and treatment began. For that year, I lived in a fog, at times oversleeping, accidentally taking the wrong meds, being put on meds that altered my abilities so much, that I was scared to try and drive myself to work. Every mistake I made, while doing my best to be a proactive participant in my recovery, was held against me.
I was terminated for absences, when I had fewer absences than their policy states are grounds for termination.
I believe had I been untruthful about my diagnosis, I would still have my job. But, my relationship with God is far more important to me than any job. I know He's allowed these events so that I can help others in similar circumstances in the future.
So, now I'm looking for a job, and deathly afraid potential employers will find out about my diagnosis.
Thanks again for the post.
WH

Stigma and discrimination can have real life consequences. They prevented me from having a 'career'. In Australia Disability Employment services are manditory for dole recipants who have a mental illness, but most of the staff are not trained in mental health. I suffered from the soft bigotry of low expectations, discrimination and coerced disclosures. I have given up having a career as such and now do volunteer work.
I have known two cases of bullying from mental health organisations because of a person's mental health issues, and many workers who are consumers are expected to overwork because otherwise they might lose their job. If there isn't even safety in workplaces where staff have training what hope do the rest of us have?
I frequently disclose my illness now because often I just don't give a dam what people think anymore in the most part, but I have friends who won't use support groups or even discuss mental health for fear of being tarnished.
The only thing I fear now is that my children (who are not born yet) may face discrimination due to my disclosure.
The best advice I can share is if you want to be open about your illness as you have every right to be, go to support groups and join the consumer movement that way you make friends with people who won't bail because of mental illness even if other people do. Most of my friends are consumers who are intelligent and empathetic human beings

This article really touched a nerve. As did many of the replies. Stigma and prejudice against mental illness are, sadly, very much still a huge problem today. You don't even have to have mental health problems, yourself, to suffer. Alas, some of the WORST places and people for stigma and discrimination are those that ought to know better. I have seen several comments above that show people being discriminated against by HEALTH PROFESSIONALS, and I know from ugly personal experience that people like NURSES and TEACHERS can be some of the cruellest and nastiest of all when it comes to mental health stigma and discrimination.
It is very sad that, in this day and age, people are still made to view mental illness as a taboo subject - that we still cannot be open and talk freely about it. Yes, I would like to think that honesty pays dividends, but I can tell you for a fact that it may not. Like so many people, I know that when some individuals get to know things about you that are sensitive and personal they can be incredibly insensitive and inhuman.
I am the daughter of a parent who has Bi Polar disorder. I do not have this disorder myself, but despite this fact, have had a lifetime of stigma and prejudice. This started in infant school, because some of the parents of kids I was at school with got to know my parent was mentally unwell. I then got bullied, because of this. I was accused of cheating at schoolwork, of having a tutor (which I did not have), and of getting extra help (which I did not get). All of this because I did well and got good grades, but some people (parents, kids and even teachers) thought that because my parent was mentally ill, this should somehow make me stupid, unintelligent or 'retarded'. My parent does NOT have learning disabilities, and nor do I! It is so insulting, being judged as somehow intellectually incapable, because you have a parent who has a mental illness. Even my parent is not intellectually incapable - Bi Polar does NOT make you ignorant! I mean, Robin Williams, Carrie Fisher, Steven Fry all have/had Bi Polar, and all are/were super intelligent and talented. Mental illness is NOT to be confused for things like learning disability - it is NOT an impaired IQ! Many mentally ill people (and, presumably, their offspring) can be highly intelligent, capable and even gifted. Examples include Winston Churchill, John Cleese, Princess Diana, Virginia Woolfe, Abraham Lincoln, Sylvia Plath... Would anyone dare to say that any of these people was unintelligent, or accuse them of 'cheating' if they did well? So how do people think I feel when I hear such things said to me? My parent's illness does NOT make me stupid!
This stigma and prejudice continued as I grew up. Indeed, the more I succeeded in life, the worse the discrimination got. I sense that some people like to judge others - and those who judged me negatively wanted to believe they were correct. So, any evidence to the contrary had to be stamped out! Each time I had success in life, I was again subjected to negative conjecture. Accused yet again of cheating - or worse, of being stuck-up, arrogant, spoiled, even narcissistic.
I have spent my childhood and adolescence having people poke fun at me, and try to accuse me of being 'mental like my parent' simply for behaving NORMALLY. Doing well at school and University was 'proof' of my 'narcissism', or of my 'weird geekiness'. I was accused of being a 'nerd' or 'swot'. Kids don't like to associate with the class swot, so then I got accused of 'having no friends' which was further 'proof' of my 'weirdness' and of being 'antisocial'. Nobody stopped to consider the fact that, actually, I had plenty of friends through school and college - but often these same friends would end up dropping me as soon as they found out about my mental parent. Surely their inability to stay friends with me once they knew about my parent's illness is THEIR problem, not mine - is evidence of THEIR prejudice?
By the time I started work, I felt I had to hide my own ability, just to avoid attracting negative attention. I also felt I had to hide my family background, because people gossiped negatively about me if they found out about my parent's Bi Polar. Negative gossip of a personal and hurtful nature circulated around several of the places where I have worked - ALL of which have been in the Health Service or Local Government. Do people not realise how hurtful it is for somebody to hear their family being talked about as 'nutters'? Just how insensitive is a boss, who asks 'are you like your... (ill parent)'? I mean, would I talk and ask questions like that about somebody whose family member had cancer? No way! It is just SO RUDE!
The most sickening part about all this is that the people who have been prejudiced towards me in this way were - apart from some ignorant kids who were once my classmates - NURSES, TEACHERS, CIVIL SERVANTS, DOCTORS AND SOCIAL WORKERS. People who really ought to know better! It seems to me that these are some of the MOST prejudiced people on the planet.
Sadly, stigma about mental illness does not just affect people who are mentally ill - it affects their families too. Especially their kids, as I know. It is almost as though, because your parent is mentally ill, you (their child) become 'tainted' by association. People go about assuming the whole family is 'crazy'. Assumptions can be so problematic. Just like people assuming I must be stupid because my parent has Bi Polar.
I wish I knew more about what to do to tackle and combat stigma, prejudice and discrimination. I have gone on to undertake Postgraduate study in a research-related area, yet I still struggle to believe that tackling stigma will ever be simple. Prejudiced people are majorly ignorant - and they rarely want to see either their ignorance, or their prejudice. That is probably why they are so hard to reach. Because they see themselves as 'normal'. The courageous amongst us may speak out about our experiences, but it takes a lot of bravery to do so. Sadly, this sometimes also leads to yet more stigma, prejudice and discrimination. Not everyone we may open up to has the empathy, compassion or simple decency and common-sense to try to understand things from OUR perspective, on the receiving-end of stigmatising behaviours or remarks.