Every year, the Carter Center’s Mental Health Program gathers together some of the leading policy makers, professionals, and advocates in mental health to discuss a given topic. Led by Former First Lady Rosalynn Carter, the program features panel discussions and then working groups to discuss and craft future policy recommendations. This year’s focus of the 28th annual symposium was on the same topic as it was during the first symposium — stigma in mental health.
As Mrs. Carter noted, many things have changed in the intervening 27 years. She noted they didn’t even have a person living with mental illness attend the first symposium, and while the impact of stigma has diminished somewhat, it remains an ongoing problem. She believes social inclusion is “an important anecdote to stigma,” a sentiment that I couldn’t agree more with.
Keynotes were presented by Elyn Saks, a law professor at the University of Southern California, who talked about her own experiences with discrimination and prejudice; and Graham Thornicroft, Ph.D., a professor of Community Psychiatry at King’s College London, who talked about what we mean by stigma and mental illness, and its impact on society.
Here’s a brief synopsis…
Elyn Saks is a moving and engaging speaker, talking of her own struggles with the diagnosis of schizophrenia and the prejudice and discrimination she endured because of it. “When you to go to the hospital for mental illness, nobody sends you flowers,” she noted.
She said she is “pro-psychiatry, but anti-force” (which I agree with), and chalked up her success to the following three factors:
- Excellent treatment — finding the right kind of therapy (psychoanalysis, in her case) and medications
- The support of her family and friends throughout the process
- A wonderful and supportive work environment
She also discussed how, once you are labeled with a mental illness diagnosis, many times future medical problems will be misdiagnosed because of the prejudice and discrimination harbored by most medical professionals and doctors. She shared that when she suffered from a subarachnoid hemorrhage, it was initially misdiagnosed because of her schizophrenia diagnosis (“Oh, she’s just having an episode.”).
It took active and repeated advocacy on the part of her friends and family to finally convince the doctors that her behaviors were not typical of her schizophrenia episodes.
It’s my belief this happens because of lazy doctors who see a mental illness diagnosis in a patient’s chart, and attribute any abnormal behavior to said diagnosis.
She also hit home the idea that forced treatment is not viewed by most patients as treatment at all. “No patients view restraints as a treatment,” she said, and most find it very traumatic. While the mainstream use of restraints in mental illness care has fallen off over the past decade or so, it still remains the standard of care when a patient is in danger of self-harm or suicide in an inpatient psychiatric facility.
As I noted earlier this month, the other keynote speaker spent a lot of time talking about stigma and mental illness in society. Graham Thornicroft, Ph.D. breaks stigma down into what we really mean when we use the word:
What is stigma? Three specific problems:
- Problem of knowledge = ignorance
- Problem of attitudes = prejudice
- Problem of behavior = discrimination
I found his insights to be thought-provoking, and it made me rethink what we mean when we use the word “stigma.” He noted that we’re not going a very good job in getting people to treatment for mental illness — only about a third of people in the U.S. get treatment, only about a quarter in Europe, and in many African countries, the treatment rate is much lower, like 2 percent.
“This is not okay… We are systematically disregarding and not treating the large majority of people with mental illness worldwide,” he noted.
He also talked about what it feels like to be discriminated against because of your mental illness, as well as what we can do in society to help combat such discrimination and prejudice moving forward.
With stigma as the focus, the panel discussions focused on three areas of concern for people with mental illness — housing, employment, and integrated care & wellness. I found each of the panel discussions interesting, but because it would be too lengthy to try and summarize each discussants’ presentation here, I encourage you to watch the video of them:
Every year features a dinner and dinner speaker, too. This year the symposium’s attendees were graced with sisters Jessie and Glenn Close, who are co-founders of the advocacy organization, Bring Change 2 Mind. It was an honor to have Jessie Close talk about her experiences with mental illness, and share some touching stories. Glenn Close was just amazing as well.
They are an inspiration to the mental illness advocacy community, and I believe that some of Bring Change 2 Mind’s marketing efforts have already begun to change the conversation.
Finally, here’s the summary video released by the Carter Center about the symposium: