May 23, 2019

Reducing the stigma of mental illness

Madison, Wis. — Your day has been hectic and you feel like you’ve been pulled in a lot of different directions. Without much thought, you might describe your situation as “schizophrenic”. Or perhaps, you’ve described someone’s behavior as “bipolar,” because of a sudden change in their attitude.

We use these terms causally in conversation and often without much thought. But Rachel Edwards, RN-BC, MSN, nurse manager with UW Health’s Behavioral Health, explains that these terms are often used to describe a negative behavior trait or situation and reflects the perceptions still held about mental illness.

“We use terms and phrases without thinking of their impact,” she shares. “While there has been significant progress in the treatment of mental illness, there frequently remains a stigma.”

The Effects of Negative Perceptions

Despite the advances we’ve made, there remains an unspoken negative perception of mental illness. And yet, 1 in 5 individuals in the U.S. live with a mental health condition making it more common than most individuals realize.

Dr. Ned Kalin, Chair of the Department of Psychiatry and director of the HealthEmotions Research Institute at the University of Wisconsin School of Medicine and Public Health, explains that part of the bias may come from the fact that many don’t understand the struggle of living with a mental illness.

“If someone has a diagnosis of cancer and needs treatment, it’s accepted and supported. Mental illness is no different. Individuals may experience debilitating panic attacks, for example, but instead of being encouraged to seek treatment, may be told to ‘get over it’ or to ‘pull themselves together,’” he comments.

The stigma that continues to exist may even lead individuals suffering from mental illness to feel like they have to hide their condition, and perhaps not even seek treatment.

“Many individuals worry that if a potential employer finds out they have a mental illness, they won’t be able to get a job,” says Kalin.

There are cases where individuals do experience discrimination. Employers may be afraid of hiring someone due to a diagnosis, or not willing to allow the time needed for doctor appointments. Insurance may not cover needed medications or treatments, creating even more of a burden for individuals.

And family members may experience the stigma as well. Employers may not understand when someone needs time off to care for a loved one. Individuals may be reluctant to share concerns with others out of fear of being judged. Or, they may feel the need to make excuses and “cover up” so their loved one’s mental illness is not exposed. Often, they do this because they have experienced negative reactions from those around them – whether through comments or interactions.

And while individuals may intend to be supportive, Edwards explains that often there is a discrepancy in our perceptions – in how we believe we behave –and how those behaviors are actually perceived by individuals or their family.

She points to research conducted by the Centers for Disease Control and Prevention that found 57 percent of adults surveyed believed they are caring and sympathetic toward people with mental illness. But, only 25 percent of adults with mental health symptoms believe people actually were.

Well-meaning individuals may inadvertently reinforce negative perceptions when they say things like, “you’ll get over it” or “you just need to shake it off” to someone suffering from depression or other mood disorders. And media don’t help either.

“When something happens in the news, the perpetrator may be described as having a ‘mental illness’ as though that explains his or her behavior,” Edwards observes. “In the same manner, popular television shows may portray individuals with mental illness as dangerous or villainous.”

Moving the Conversation Into the Open

Changing perceptions can be difficult, Edwards shares, but by raising awareness everyone can help shift the conversation.

“If we can be brave and share our own stories, we can help move the conversation into the open,” she says.

Other ways to help move beyond the negative perceptions include educating yourself on mental health; speaking up when others put forward stereotypes or misconceptions; and talking with friends and family who may have a mental illness to help see the person and not the illness.

“Because of how mental illness has been perceived historically, it can be difficult to change implicit attitudes. But when we acknowledge mental illness as an illness, then we can move beyond the fear and offer compassion and support,” says Kalin.