Today, I was slapped in the face by a stranger and made to feel less than human. Today, I was marginalized and discriminated against. Today, I felt the weight of an extremist opinion. Although it was just one ignorant person, I know there are more of the same out there, and something must be done.
On Twitter (@unsuicide), I share suicide prevention resources and ways to find help. Recently I’ve also been sharing the National Association of Broadcasters‘ newly launched anti-stigma mental health awareness campaign, OK2Talk.
It’s a series of PSAs and a web site aimed at youth, encouraging them to open up about issues. I thought I was preaching to the choir a bit with my followers, people who are mostly either mental health consumers or professionals, or who have an interest in mental health promotion and suicide prevention.
Imagine my shock, then, when someone replied to say there should be a law to segregate people who have been unstable from the rest of the population.
People like me.
Aside from the utter absurdity and complete ignorance of this opinion (how is a quarter of the population supposed to be segregated, exactly?), it’s flat-out bigotry with no apology. And it hurt.
Although other marginalized populations have made strides in civil rights and public opinion polls, discrimination (not just stigma) against those with mental illnesses and issues still flourishes.
Campaigns like OK2Talk attempt to fight against this tide, but I’m not sure how successful they are or ever will be, on their own. The person who made the segregation remark was reacting directly to that campaign.
Untreated illnesses that produce behaviors that deviate from social norms are what people discriminate against. In the article “Attention Deficit Hyperactivity Disorder as a Social Disability,” (Gentschel and McLaughlin, Journal of Developmental and Physical Disabilities, 2000), researchers found that children stigmatized their peers based on stereotypical ADHD behavior rather than the label of ADHD itself. It happens with adults as well. It wasn’t the bipolar label that caused the loss of so many of my friends, it was things I did while in the grips of severe episodes.
On the flip side, there has also been research indicating that contact with people with personal recovery stories produces an anti-stigma effect. So if the people you know are open about their depression or anxiety, actively working on recovery, and behaving in ways that don’t hurt you, there is a favorable impression.
But if the only consumers you’ve met have been untreated and unmanageable and causing harm to those around them, you will likely stigmatize. That, then, is where it’s challenging to fight stigma. Is a video campaign going to have much of an impact if you’re already prejudiced because a family member was mean to you when unwell?
I’m not saying we shouldn’t have anti-stigma messages. I applaud the National Association of Broadcasters for using their medium, and the web tie-in, to do something that TV does very well: influence public opinion. Encouraging people to talk openly about their issues is a great message. And fighting stigma requires a multi-pronged approach, with media a necessary (if sometimes overemphasized, and questionably effective) component.
But there’s a missing piece of the anti-stigma puzzle: treatment. What will reduce stigma is a reduction in symptoms, and that means access to effective mental health care. At a time when budgets are constantly being cut and wait lists are long and insurance is spotty, this is more of a challenge than ever. It’s a dilemma: stigma prevents some from seeking care, stigma causes mental health care to be a low priority in government budgets, but stigma is then perpetuated by dealing with those with untreated symptoms. Stigma also leads to discrimination, which is hurtful and unfair to those who do seek help.
Until our symptoms are in check and we can talk freely about our mental health, we need organizations like the Bazelon Center for Mental Health Law to fight for our rights, because stigma and discrimination are hand in glove. As important as it is to tell people to talk and be nice to each other, it’s even more important for the courts to protect us against prejudiced views like the one I encountered today. They remain all too common, and are still accepted by many. I’ve had landlords refuse to rent to me and have lost jobs. We need laws in place to protect us, not segregate us.
One of the biggest human rights issues of our time is the rights of those with mental health issues and disabilities. It starts with effective treatment, and includes policies and laws that enable access to care.
Without that care, stigma will never really go away.