“Just Get Over It”: The Stigmatization of Mental Illness in American Society

Mental illness is the leading cause of disability in the United States – one in four Americans experience a mental illness every year.  We might think that mental illness is rare, but every one of us has at least one friend, family member, or coworker suffering from a mental health condition.  It affects everyone, regardless of age, nationality, ethnicity, socioeconomic status, or religion.

Yet, the topic of mental illness is one of society’s biggest taboos.  We talk about physical ailments with great ease, but keep our mental health troubles to ourselves, anticipating the negative consequences of our admission.  And our silence is a direct result of the stigma surrounding mental health in American society – a mark of disgrace is attached to society’s perception of mental illness, subsequently assigning a set of predetermined beliefs and attributes to those assumed to fall under the label of “mentally ill.”

What is it?

Stigma is loosely defined by the CDC as “the prejudice, avoidance, rejection and discrimination directed at people believed to have an illness, disorder or other trait perceived to be undesirable”.  In terms of mental health, stigma is considered to be the negative attitudes and beliefs that society possesses towards those with mental illness.

Public attitude toward mental illness is largely negative – a 2007 survey found that while 57% of adults without mental health symptoms believed that people are caring and sympathetic towards those with mental illness, only 25% of adults with mental health symptoms agreed.  Negative public attitudes often take the form of stereotypes, many of which label those with a mental illness as ‘crazy’, ‘irrational’, ‘incompetent’, or ‘dangerous’.

The stigmatization of mental illness in American society places feelings of shame, guilt, and isolation upon those who suffer from mental health conditions.  The stigma attached to mental illness can be described as a campaign of “blaming and shaming”.  People afflicted by mental illness are often blamed for it, their feelings are trivialized and invalidated by microaggressions such as “it’s all in your head” or “just get over it.”

The mental health stigma is often internalized by people with mental illnesses in what is known as a “self-stigma.” Through self-stigma, those with mental illnesses share in society’s belief that their illness is a weakness that renders them ‘lesser’ than those without. As a result, they are reluctant to seek treatment, exacerbating the severity of their symptoms and worsening their condition.

Why is it a problem?

The stigma surrounding mental illness is more than just a stereotype – it’s active discrimination.  Society’s negative perception of mental health problems puts those afflicted at a marked disadvantage, as deep-rooted fear and misunderstanding lead to behaviors and policies that place undue hardship on the lives of those with mental health conditions.  

In America, discrimination towards those suffering from mental illnesses is overwhelmingly systemic.  A person with a mental illness is more likely to be criminalized than receive the help that they need.  A 2010 study found that there are more people with mental illness in jails and prisons than hospitals.  Furthermore, people with mental illnesses have higher rates of homelessness as a result of housing and employment discrimination.

Social discrimination towards those with mental illnesses is especially common – the most prominent example being that of social distancing, or the “exclusion of individuals in a variety of social situations.” As outlined by the graph below, social distancing can present itself in a number of ways – all of which take some form of prejudice and social discrimination.

Image credit: American Psychological Association

How can we combat it?

The best way to end the stigmatization of mental illness is by talking about it.  Stigmas arise primarily from a lack of understanding and awareness about the realities of mental illness.  Those who perpetuate the stigma aren’t doing so maliciously.  They are doing so out of ignorance, and the solution to ignorance is education.  By encouraging people to share their personal stories and struggles with mental illness with others, stereotypes can be counteracted and public attitudes changed.   

Another way to tackle the mental health stigma is by adjusting the language we use when talking about mental illness.  We often don’t realize that the little things we say can be derogatory and invalidating towards those with mental health conditions – for example, using the term “OCD” to characterize an affinity for neatness trivializes the experiences of those who actually suffer from obsessive-compulsive disorder.

Image credit: National Alliance on Mental Illness

A person is not defined by their mental illness.  It is not a character flaw or a weakness.  It is an illness, equally as deserving of our attention as diabetes, cancer, and other physical maladies.  Mental illness is something that no one should be made to feel ashamed of, and hopefully, with increased understanding and awareness, no one will.  

 

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Article Written By: Veronica Correa

Dealing with Mental Health On UNC’s Campus

Hi!  I am one of the over 350 million individuals worldwide who lives with depression.  I have dealt with these feelings for a long time, but I found recently that at a large university that can feel so competitive at times, it is easy for these feelings to resurface.  I also deal with generalized anxiety disorder (GAD), and these two combined can be incredibly difficult to keep up with school and extracurriculars.  The feelings of constant worry and that I have to prove myself or else I could never be successful are overwhelming.  Additionally, depression makes me lethargic, withdrawn from my social sphere, and defeated.  This combination has taken a drastic toll on my physical, emotional, and academic well-being.

Earlier this semester my issues became severe to the point where I ended up in the UNC Emergency Room.  As someone who has always felt uneasy in hospital settings, this experience proved to be unsettling in and of itself.  At a point where I had hit rock bottom, I had no idea what was going on or when I would be able to leave.  I understand that a hospital stay is not meant to be luxurious – yet there is so much more we need to do for mental health care, not just at UNC Hospitals, but as a society.

I am incredibly grateful for the number of students on this campus who do so much work for mental health awareness.  Organizations such as Rethink, who conduct monthly trainings, Active Minds, and the Mental Health Ambassadors program are examples of student organizations who conduct important advocacy work and who try to battle the stigmas surrounding mental health.  It is necessary to realize that some students may come from a background where a lot of stigma came from their families, or they do not have the financial resources to seek care.  From what I have observed, these groups are trying to help everyone in need.

It can also be difficult to keep up with the rest of one’s responsibilities while one deals with a mental illness.  After I was released from the hospital, I realized that taking 17 credit hours, working part time, and the rest of my extracurriculars was too much for me to handle.  My grades were suffering, and I had a hard time keeping up with the rest of my obligations.  I decided to apply for a medical appeal and withdraw from one of my courses after the regular drop deadline for the semester.  During this process, I had to write a statement explaining to the academic committee how I could prevent my situation from happening in the future.  When I spoke to a psychiatrist at CAPS, she said that a good number of psychological appeals get denied because the applicant is unable to elaborate on this.  This was frustrating to me because there are many days where I am not in control of my mental illness.  Even after medications and counseling appointments, I cannot say for certain whether or not I will be able to avoid another severe crisis.  While I wait for the final decision on my application, I will continue to spend the upcoming weeks having to attend my class and do all the assignments for a course I am no longer in due to my mental health.  From the conversations I have had, it feels like UNC itself could care less about students who are seriously struggling.

I have also heard the stories of other students who have been upset and discouraged after seeking help through the school system.  The issues I hear about include having students being turned away for help completely, or they are referred to off-campus providers when they do not have transportation or the financial ability.  While I am very fortunate in that I can access off-campus treatment and get the help I need, not everyone has this privilege.  As a result, people are not able to get the regular help they need on-campus. Even after an initial walk-in at CAPS, it can be a while until somebody is able to schedule a follow-up appointment.  While there is only so much funding available and so many people that are able to work at a given time, but a lack of access can be incredibly detrimental to those who need help.  When somebody hears these negative experiences from somebody else who tried to get help, it can feel like there is nothing else they can do.  The system needs to be accessible and supportive for those who are suffering.

If there’s anything I’ve learned this semester, it’s that a lot of times you get worse before you get better.  I’m still on a long battle uphill, and sometimes I feel frustrated because it feels like I’ve exhausted my resources.  Asking for help is never easy, and it’s hard when you are not believed and turned away.  Despite all of this, I would highly encourage anybody who is reading this and who may be struggling to do so.  I would never want anybody else to close themselves off for so long and to give up on treatment the way I did in the past.

For those who are in immediate distress, there is a 24-hour CAPS hotline at 919-966-2281 in addition to the National Suicide Prevention Lifeline at 1-800-273-8255.

Article Written By: Veronica Correa

Another Trump-Clinton Story: Mental Health Policy

In spring of 2016, I was diagnosed with obsessive-compulsive disorder and generalized anxiety disorder.  Although it wasn’t a complete surprise, it had made me see the people around me a little differently- including politicians.  And what a time to be alive with Trump and Clinton running against one another!  So, I wanted to take a look at both presidential candidates’ policy regarding mental health.  Admittedly, it’s not a sexy topic, like immigration or what offensive Trump said in the last 24-hours, but it still affects an estimated 26.2% of the American population over the age of 18. In order to have a clear understanding on what the candidates had to say about their positions, I only looked at the information listed on the candidate’s websites- not what CNN or Fox News would spin off of something they claimed during a debate.

Let’s take a look.

Trump-Pence

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Click here for the link to the Donald J. Trump website on Health Care Reform.

Note, I said health care reform… not mental health.  Trump obsesses over repealing the Affordable Care Act (or Obamacare), inhibiting the sale of insurance across state lines, allowing individuals to fully deduct health insurance premium payments from their tax returns, allow individuals to use Health Saving Accounts, require price transparency from healthcare providers, grant-block Medicaid, and to remove barriers so drug providers can compete in the market.

Trump claims, on his website, that these preliminary actions will lower the cost of healthcare for all Americans… but you know, only the “legal” ones, as Trump goes on for the next paragraph and a half about “illegal immigrants” being a burden on the healthcare system, thus driving up the prices for current citizens.

But that’s not all!

Trump’s position and future policy also consists of reducing the number of individuals who can access Medicaid and children’s Health Insurance Programs. Of course, he says that all people need is a job, and that will get the economy moving.

Finally, we come to mental health; a small, mediocre paragraph at the bottom of the webpage.

“Finally, we need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bipartisan support.”

That’s it.  He suggests that we should have reform, and that there are already some existing pieces of legislation for reform that should receive bipartisan support.  But he doesn’t say how individuals will receive this mental health support, if it will be accessible to non-citizens, individuals without insurance, or people who cannot afford care.  He does not talk about mental health care accessibility in prisons or schools.

But don’t worry, folks, he’s going to make America great again, just like he says at the end of describing his exceptionally vague position on mental health programs.  It’s basically the ID term he forgot to study for and is trying to make something up on his history exam.

Clinton-Kaine

 

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Click here for the link to the Hillary Clinton website on Comprehensive Agenda on Mental Health.

It’s already a different world.  Hillary has a comprehensive agenda on mental health- an entire policy ready to be enacted- while Trump had only the tiny paragraph. Clinton plans to support Americans living with mental health problems and illnesses by integrating healthcare systems in order to get mental health on the same level of importance of physical health.

What’s more, she has a direct plan of action that includes supporting military service members and veterans and ending drug and alcohol addiction.  According to her website, Hillary’s plan will promote early diagnosis and intervention (including launching a national initiative for suicide prevention), integrate mental and physical health care systems, improve criminal justice outcomes by training law enforcement officers in crisis intervention, prioritizing mental health treatment over jail for non-violence offenders, enforce mental health parity to the full extent of the law, improve access to housing and job opportunities, and to invest in brain and behavioral research.

“The next generation must grow up knowing that mental health is a key component of overall health and there is no shame, stigma, or barrier to seeking out care.”

Now, Hillary has a lot of information on her website, so I’ll break it down into short bullets so everyone can get the gist.

Early Diagnosis and Intervention

  • Increase public awareness and take action to address maternal depression, infant mental health, and trauma and stress in the lives of young children.
  • Scale up efforts to help pediatric practices and schools support children facing behavioral problems.
  • Help providers share information and best practices.
  • Ensure that college students have access to mental health services.

Federal Support for Suicide Prevention

  • Create a national initiative around suicide prevention across the lifespan that is headed by the Surgeon General.
  • Encourage evidence-based suicide prevention and mental health programs in high schools.
  • Provide federal support for suicide prevention on college campuses.
  • Partner with colleges and researchers to ensure that students of color and LGBT students are receiving adequate mental health coverage.

Integrate our Healthcare Systems and Expand Community-Based Treatment

  • Foster integration between the medical and behavioral health care systems (including mental health and addiction services), so that high-quality treatment for behavioral health is widely available in general health care settings.
  • Expand reimbursement systems for collaborative care models in Medicare and Medicaid.
  • Promote the use of health information technology to foster coordination of care.
  • Promote the use of peer support specialists.
  • Encourage states to allow same-day billing.
  • Support the creation of high-quality, comprehensive community health centers in every state.
  • Launch a nationwide strategy to address the shortage of mental health providers.

Improve outcomes in the Criminal Justice System

  • Dictate new resources to help train law enforcement officers in responding to encounters involving persons with mental illness, and increase support for law enforcement partnerships with mental health professionals.
  • Prioritize treatment over punishment for low-level, nonviolent offenders with mental illnesses.

Enforcing Mental Health Parity

  • Launch randomized audits to detect parity violations, and increase federal enforcement.
  • Enforce disclosure requirements so that insurers cannot conceal their practices for denying mental health care.
  • Strengthen federal monitoring of health insurer compliance with network adequacy requirements.
  • Create a simple process for patients, families, and providers to report parity violations and improve federal-state coordination on parity enforcement.

Housing and Job Opportunities

  • Expand community-based housing opportunities for individuals with mental illness and other disabilities.
  • Expand employment opportunities for people with mental illness.
  • Expand protection and advocacy support for people with mental health conditions.

Brain and Behavioral Science Research

  • Significantly increase research into brain and behavioral science research.
  • Develop new links with the private and nonprofit sectors.
  • Commit to brain and behavioral science research based on open data.

Of course, she has statistics, facts, and other data to support how and why she will act upon all of the above positions regarding mental health care.  But look at how detailed and inclusive her agenda is.  I’m sure she has left out information that some readers might see more clearly than me, but it looks pretty damn good.

Conclusion

Well, it seems clear to me which candidate understands what mental illness and mental health conditions are and how they affect day-to-day life for individuals.

I was talking on the phone with my mother a few moments ago while I was writing this post.  Her comment was “Hunter, Hillary has been running for president for 8 years now, of course she has a detailed plan.  Trump knows what he wants to do, and he might help to do some reform on mental health care, but he’s just more focused on repealing Obamacare.”  Say that is true, that Trump has a real plan on mental health reform… But he doesn’t seem to want anyone to know about it.  I’m willing to bet that if elected, his position will not change from what is written on his website- a vague, last minute thought that doesn’t get any real attention.

So, voters, if you haven’t already done early voting, make sure you keep this in mind as you go to the polls, especially if you have a friend or family member who is affected by mental illness.  Or, if you are just a good person who wants to make sure that anyone with any sort of illness is given the care they need.

(One more time for the people in the back)

Go forth, and vote.