Stigma is fundamentally about fear. Fear of mental illness, leading to a loss of control, and “losing one’s mind” has permeated nearly every society in every era, including this one. While I don’t believe it will ever be eliminated, I do believe that the number one way to reduce stigma is to recognize that mental disorders, as well as the mortality of mental disorders (that is, suicide), are part of being human. American psychiatrist and psychoanalyst Harry Stack Sullivan once stated that, “we are more human than otherwise” when discussing patients with psychosis. Once this is recognized, society can begin to exhibit the compassion necessary to reduce stigma and encourage those needing help to seek help.
Coverage for People with Mental Illness
To reduce stigma, we must provide access to effective care and treatment for those who suffer from the symptoms and consequences of mental illness. The effort to bring about insurance parity for coverage of this treatment in all public and private insurances is ongoing, despite laws stating that discrimination should not be allowed, whether in the form of excessive managed care or outright violations to the parity law. Because coverage for mental health care is consistently a challenge, people are not getting the help they need to achieve high levels of functioning, thereby contributing to stigma. And so, this effort must continue.
Talk About Mental Health
It is also imperative to empower families and society to talk freely about mental illness and its consequences, with the expectation and understanding that every family has been affected by mental illness and has had someone close to them who has suffered from a mental disorder.
To paint a picture, approximately 1 in 5 adults and nearly 1 in 4 children in America are living with a mental disorder, according to National Alliance on Mental Illness. That means that in your standard public primary school classroom of approximately 23.6 students, 5 or more students are struggling with a mental illness. And of that same classroom’s parents/caregivers, 9 or more are struggling with a mental illness.
One of the biggest obstacles to reducing stigma and talking about mental health in an accurate manner is the portrayal of mental illness in Hollywood and the media. Television, movies, and the media identify nearly every violent act as a product of mental illness. Getting the word out that the mentally ill are no more violent than the general public is critical. But then just as critical is talking about access to care rather than exaggerating fears about a particular disorder when someone with mental illness does commit a crime.
The antidote to stigma is compassion.
Steven S. Sharfstein is president and chief executive officer of Sheppard Pratt Health System, where he has worked for 29 years. He is also clinical professor and vice chair of psychiatry at the University of Maryland.