Stigma discrimination remains a hot topic in mental illness circles. In fact, at the National Conference on Mental Health in June 2013, President Obama singled stigma out as one of the major problems facing people with a mental health concern:
" ... [we] whisper about mental health issues and avoid asking too many questions. … And there should be no shame in discussing or seeking help for treatable illnesses that affect too many people that we love. We've got to get rid of that embarrassment. We've got to get rid of that stigma.
Too many Americans who struggle with mental health illnesses are still suffering in silence rather than seeking help, and we need to see it that men and women who would never hesitate to go see a doctor if they had a broken arm or came down with the flu, that they have that same attitude when it comes to their mental health."
Inadvertently, and perhaps even unconsciously, mental health professionals sometimes contribute to that stigma, the foundation of which is prejudice and discrimination.
Professionals do this by sending the message that a person with mental illness is less than someone without. This is especially true for people who grapple with serious mental illnesses, such as schizophrenia or bipolar disorder. In the past, well-meaning professionals and therapists often told people things like
"You can't hold down a job, it requires a regular commitment."
"You'll never be able to live on your own."
"You can't go back to school and get a degree—it's too stressful."
This is the language of defeat and imprisonment, not that of hope and positive change.
What Can We Do to Prevent Such Discrimination and Prejudice?
Professionals in the mental health field often learn such language from their schools, colleagues, and even the people they serve. Because it is a simple learned response, it can also be unlearned. Here are some tips to help change this behavior.
- Each person is unique. While professionals often fall back on their experience with other service users who have similar concerns to help guide them with a new person, everyone is different. No two people with schizophrenia are any more alike than two people with asthma or diabetes. We need to remember the individuality each of us brings to each interaction and not use labels as generalizations that predetermine our expectations for each person. Just because a previous service user couldn't make independent living work doesn't mean the next person won't be able to.
- Emphasize the possible. Sometimes therapists and other well-meaning professionals get bogged down by the details or specifics of a problem or plan. A professional's job is not to problem solve for the person, but to act as his or her guide, helping the person problem solve for him or herself. As far as a professional should be concerned, all things are possible. One of the most valuable assets a professional can bring to the recovery relationship is hope. Hope is such an important component of treatment and recovery.
- Watch your language. How we talk about something is often more important than what we say. Nonverbal communication is picked up just as readily by a person as anything else you say, so it helps to remember people are not the sum of their diagnostic labels. Use language and words that respect the individual and his or her life struggles, strengths, and experiences.
- Stop using shorthand with colleagues and demand the same from them. Sometimes when colleagues talk with each other, they'll inadvertently reinforce prejudices against people with mental illness by using demeaning language or shorthand labels. "Oh, I saw this borderline today who …" People receiving mental health care deserve the same respect after they leave the office as they do while inside it.
- Encourage reasonable goal setting without trampling the dream. A professional can become distracted by a person's "big dream" and quickly label it unrealistic. Instead, focus on small steps toward that dream—reasonable goals the person can readily attain with some effort and changes to his or her life.
- Get involved. Preventing discrimination and prejudice can be as easy as writing a letter to your local newspaper when a publication uses stigmatizing language or repeats falsehoods about people with mental illness. Another option is to become more active in an advocacy organization focused on changing the conversation about mental illness.
Discrimination and prejudice can be prevented by employing these kinds of strategies as early as possible in a professional's career and training. However, even older professionals can change their attitudes toward the people they serve. All it takes is awareness and a dedication to change.
Dr. Grohol is the founder, editor in chief, and CEO of PsychCentral.com. Please contact him at firstname.lastname@example.org.