THE IMPACT OF STIGMA ON MENTAL ILLNESS A HISTORICAL THESIS By: Edith Gonzalez California State University, Long Beach May 2012 INTRODUCTION People who have mental illness encounter various challenges that complicate their lives caused from stigma on mental illness, such as lack of social support, housing, employment, and affecting their mental health treatment (Borinstein, 1992; Overton & Medina, 2008). Stigmatization of people with mental illness has continued throughout history in the United States (Araujo & Borrell, 2012). Individuals who have mental illness are perceived to be violent, dangerous, and exhibited unpredictable behavior (Araujo & Borrell, 2012; Bathje & Pryor, 2011). People with mental illness are distrusted, stereotyped, feared, and avoided by others (Borinstein, 1992; Bathje & Pryor, 2011). The stigma of mental illness deprives individuals of their dignity and interferes with full participation in society, and discriminated due to their illness (Anglin, Link, & Phelan, 2006; Corrigan, Byrne, Davis, & Watson, 2005). Purpose The purpose of this study was to explore the public perception on mental illness and examines historical influences from the 19th century to the 21st century to the stigma of mental illness. RELEVANCE TO SOCIAL WORK • Social work is a profession committed to the pursuit social welfare, social change, and social justice, as well as to meet the psychosocial needs of individuals in order to improve their quality of life (National Association of Social Workers [NASW], 2011). • The stigma of mental is vital for social workers since they provide care for a large number of mental health patients The stigmatized views on mental illness hinders social workers to provide and ensure clients have proper services for their psychological needs; it may prevent funding based on the lack of importance of maintaining good mental health and avoidance to treatment (Corrigan, Markowitz, & Watson, 2004). • Effective social work practice advocates for the wellbeing of the individual to be treated with social justice, and dignity. CROSS-CULTURAL RELEVANCE • The stigma of mental illness effect all ethnic groups and cultures. It is necessary to understand that culture has a direct impact in the stigma attached to mental illness. In fact certain cultures such as minority groups are less likely to seek mental health treatment based on negative beliefs on mental illness, such as Latinos, Asians, and African-Americans (Anglin, Link, & Phelan, 2006). • Mental illness is like any other illness that does not discriminate based on race or ethnicity, and misunderstandings about mental illness can stop individuals from seeking treatment, which can lead to other chronic illnesses (Anglin, Link, & Phelan, 2006). METHODOLOGY Historical Analysis Research regarding the contributing elements to the stigma on mental illness in America as well as the consequences of negative perceptions toward individuals with mental illness, was conducted using content analysis. This thesis used content analysis to examine both primary and secondary sources such as qualitative, quantitative, and literature review methods (Rubin & Babbie, 2007). Selection of Time Frame The period time selected for analysis, 1990 through 2010, based on the existence of research primarily on the stigma of mental illness. During this time period, the researcher identified the primary focus of research was on the consequences of stigma, detailing the discrimination and prejudice individuals with mental illness have encountered from having a psychiatric illness (Corrigan, Byrne, Davis, Watson, 2005). Selection of Sources • The primary sources selected included scholarly journals, magazine articles, research journals, and books on the stigma of mental illness. Sources were selected based on the topic of the study focusing primarily on the stigma of mental illness and how the consequences of stigma affect the individual quality of life, such as self-esteem, access to services, and community integration. X Primary Article Mad in America, Bad Science, and the Enduring Mistreatment of the Mentally Ill Whitaker (2002) X X X X X X Primary Article Mental health consumers’ experiences of stigma. Wahl (1999) X X X X X X X Primary Article Voice from the inside: Readings on the experience of mental illness, Karp (2010) X X X X X Negative Portrayal Media Undermine competence Structural Stigma Devalued sense of worth Sufferer’s own fault Social rejection Source Mental Health Practitioners Seconda ry Source Consequences Primary/ Discrimination/Prejudice Effects of Stigma and Experiences X X RESULTS Experiences of Stigma Individuals with mental illness report the occurrence of stigma as one of the most devastating experience of having a mental illness (Borinstein, 1992; Corrigan, Markowitz, & Watson, 2004). People report being felt useless from being discriminated and rejected against, mainly from negative stereotypes of mental illness. The most commonly incidents involved witnessing stigmatizing comments or negative illustrations of someone with mental illness (Borinstein, 1992; Link, Struening, NeeseTodd, Asmussen, & Phelan, 2001). Consequences of Stigma People with mental illness reported the stigma of mental illness has affected their life from being socially rejected, isolated and discriminated against (Link et al., 2001). An overwhelming persistent theme from the results of the research done in the timeframe of 20 years demonstrates that individuals consistently report acts of discrimination and prejudice from having a mental illness (Borinstein, 1992). Secondly, studies illustrated many of the participants also reported being rejected by family members due to their mental illness (Link, Struening, Neese-Todd, Asmussen, & Phelan, 2001). • The individual’s self-esteem is impacted by the constant avoidance and discrimination from others and seemed less of a human for having mental illness (Corrigan, Markowitz, & Watson, 2004). • Research indicated a generalization from the public that people with mental illness are incompetent and do not have hopes and dreams for their future, such as holding a job or maintaining employment (Corrigan et al., 2004). • Another common theme revealed in the analysis is the public’s understandings of mental illness; based on what they have learned through the years from watching television shows and other media information (Wahl, 1999; Wahl, 2003). For instance, Wahl et al. (1999) study reported 89% of its respondents watched television shows and reported being concerned that the people with mental illness were portrayed as violent, dangerous, different, and laughable. • Research revealed stigma interferes with the potential of the individual to be part of a supportive social interaction and openly identify with others about their mental illness. The stigma of mental illness overshadows the individual’s ability to be members of society, participate in the workforce and to be treated as human beings, instead of being labeled by the symptoms of mental illness (Karp, 2010). DISCUSSION The results of the data analysis suggest public’s attitudes toward individuals with mental illness have not been favorable throughout history. This is evidenced by acts of discrimination, rejection, and avoidance the public have manifested against those suffering from the illness (Corrigan, Markowitz, & Watson, 2004) Research indicated stigma as one of the primary barriers for the treatment of mental illness, since it impedes the individual from seeking services and/or participate in treatment (Link, Struening, Neese-Todd, Asmussen & Phelan, 2001). Stigma of mental illness overshadows the individual’s ability to be members of society and participate in the workforce due to undermine competence and prejudice (Borinstein, 1992; Link, Struening, Neese-Todd, Asmussen & Phelan, 2001). Implications for Social Work Stigma impacts every aspect of an individual’s life, from their self-esteem to their personal relationships to their social lives. It is imperative that social workers advocate at every level to obliterate the stigma attached to mental illness by recognizing strengths and potential of individuals who have psychological illness. Social workers can advocate for government policy targeting the media to properly display positive characteristics of people with mental illness and that recovery is possible with support and treatment. REFERENCES Anglin, D., Link, B., & Phelan, J. (2006). Racial differences in stigmatizing attitudes toward people with mental illness. Psychiatric Services. 57(6). Araujo, B., & Borrell, L. (2012). Understanding the link between discrimination, mental health outcomes, and life chances among Latinos. Hispanic Journal of Behavior Sciences. 28(2), 245-266. Bathje, G., & Pryor, J. (2011). The relationship of public and self-stigma to seeking mental health services. Journal of Mental Health Counseling. 33(2), 161-176. Borinstein, A. (1992). Public attitudes toward persons with mental illness. Health Affairs, 11(3), 186-196. Corrigan, P., Markowitz, F., & Watson, A. (2004). Structural levels of mental illness stigma and discrimination. Schizophrenia Bulletin, 30(3), 481-49. Corrigan, P., Watson, A., Byrne, P., & Davis, K. (2005). Mental illness stigma: Problem of public health or social justice? National Association of Social Workers. 363-368. Karp, R. & Sisson, G. (2010). Voice from the inside: Readings on the experience of mental illness. Oxford University Press. New York: NY Link, B., Struening, E., Neese-Todd, S., Asmussen, S., & Phelan, J., (2001). The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services. 52(12), 1621-1626. National Association of Social Workers. (2011). Code of Ethics. National Association of Social Workers, Washington, D.C. Overton, S. & Medina, S. (2008). The stigma of mental illness. Journal of Counseling & Development. 86, 143-151. Rubin, A., & Babbie, E. (2007). Essential research methods for social work. Thomson Brooks; Cole. Wahl, O. (1999). Mental health consumers’ experience of stigma. Department of Psychology, George Mason University. Fairfax, VA. Wahl, O. (2003) Media Madness: Public Images of Mental Illness. Brunswick, NJ: Rutgers University Press.