Stigma: A mark of disgrace or infamy. Oxford English
Dictionary
Mental disorders: Challenging
Prejudice
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For centuries people with mental
illness were kept away from the rest of society, sometimes locked
up, often in poor conditions, with little or no say
in running their lives. Today, negative attitudes lock
them out of society more subtly but just as
effectively. |
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The campaign to increase the understanding of mental health
problems and reduce their [stigma] and discrimination.
Mental disorders affect
everyone.
Chances are you know someone who has or has had a
mental health problem. Mental disorders – like anxiety, depression,
eating disorders, drug and alcohol misuse, dementia and
schizophrenia – can affect anyone, from any walk of life. In fact,
they cause more suffering and disability than any other type of
health problem.
Despite this, people with these conditions often
attract fear, hostility and disapproval rather than compassion,
support and understanding. Such reactions not only cause them to
feel isolated and unhappy, but may also prevent them obtaining
effective help and treatment.
In this – and the other booklets in this series –
we turn the spotlight on the damaging effects of negative attitudes
to mental disorders, and provide information about what we know
about them. We hope to challenge you to think in new ways about
mental disorders, and banish some of the myths and prejudices
surrounding them.
The Royal College of Psychiatrists’ campaign,
Changing Minds: Every Family in the Land, aims to increase
understanding of six common mental disorders, to challenge
preconceptions about them, and to close the gap between what health
professionals and the public perceive as useful treatments.
‘Mental health is a key component of a
healthy active life.’ Our Healthier Nation. Government Green Paper,
1998
What are mental disorders?
The term ‘mental disorder’ covers a wide range of
different conditions affecting the mind. Mental disorders cause
symptoms such as emotional upset, disturbed behaviour and poor
memory. Sometimes illness elsewhere in the body disturbs the mind;
at other times hidden mental upset may fuel other bodily disease or
produce physical symptoms.
What causes mental disorders?
A whole range of different factors – our genetic
blueprint, brain chemistry, aspects of our lifestyle, things that
have happened to us in the past and our relationships with others –
play a part. But whatever the cause, people who develop mental
disorders often feel distressed, helpless and unable to lead their
lives to the full.
Can mental disorders be
treated?
The good news is that there are many effective
treatments for mental disorders. These may include drugs and other
physical treatments, talking treatments (psychotherapy) of various
kinds, counselling and/or supporting people in their everyday lives
in various ways.
A number of different professionals, medical and
non-medical, may be involved in helping people who are mentally
ill: GPs, psychiatrists, psychotherapists, counsellors, social
workers, and voluntary user and self-help groups.
Psychiatry provides a diagnostic approach
that allows the natural course of disorders to be known and
predicted, and the effects of treatment to be more readily
assessed.
What do psychiatrists do?
Psychiatrists are trained doctors who specialise
in diagnosing and treating mental disorders.
A psychiatrist will examine the host of different factors that may
have contributed to someone becoming mentally ill and try to tailor
treatment as closely as possible to his or her individual
needs.
Psychiatrists are qualified to provide a range of
different treatments, including medication with drugs and/or
different types of psychotherapy, often in partnership with other
healthcare professionals. Psychiatrists are also licensed, by law,
to recommend compulsory detention (‘sectioning’) in a mental health
unit. This step is only taken in the interests of someone’s health
or safety or for the protection of others, and if their condition
in these respects is very serious and yet they will not accept
appropriate medical advice. Psychiatrists are unfortunately thus
sometimes regarded as jailers, rather than as doctors with the
interests of their patients in mind.
How can psychiatry help?
The causes of mental ill health are complex and
psychiatrists don't have all the answers. As doctors, they are
aware that some aspects of mental disorder, such as anxiety,
despair and suicidal feelings, are not always easy to pin
down.
Changing Minds: Every Family in the Land will
point out some of the limitations to our knowledge and skill.
However, we believe that by offering a systematic and scientific
approach, psychiatry has an important part to play, involving both
physical and psychological treatments, in relieving the suffering
of people with mental disorders.
What is stigma?
In Ancient Greece bodily signs or ‘stigmata’ were
cut and burnt onto people’s bodies to mark them as different.
People with mental disorders are no longer physically mutilated,
but critical or derogatory attitudes can be just as damaging to
them. You only have to open a newspaper, switch on the TV or go to
the cinema to spot such attitudes. While the media isn’t wholly to
blame for negative perceptions, every time a programme, article or
film portrays a stereotype or fails to clear up a misunderstanding
about a mental disorder, it helps to perpetuate the myths.
Where does stigma come
from?
Stigma can arise in many ways. Mentally ill
people may behave differently: a depressed person will appear sad
or dull; someone who is in the elated (manic) phase of
manic-depression may be unnaturally happy or irritable. Other
factors, such as being seen visiting a psychiatric hospital or
clinic may also mark someone as ‘mental’ or ‘psychiatric’.
Why does it matter?
The trouble is, once someone is identified as
different, it’s hard for them to be accepted – no matter how hard
they try. They can’t shake off the stigma and as a result they lose
confidence in themselves. In time they come to believe that they
are odd and don’t fit in.
Time for a change of mind
People with mental disorders continue to
experience prejudice and discrimination in every area of their
lives, from finding somewhere to live to getting a job. It’s hardly
surprising that many people with serious mental illness end up poor
or homeless. It is up to all of us to become aware of the harm we
do with our negative attitudes and to do our bit to stamp them out.
Whoever we are and whatever we do, we can combat the harmful
effects of stigma by extending our friendship, support and
understanding, rather than our judgement and discrimination, to
people who are mentally ill.
1. Fact or
fiction?
Fiction. Describing people with mental disorders as 'loony',
'crackers', 'mad', 'barmy' or 'nuts' dismisses them as people not
to be taken seriously, whilst the perception that they are
dangerous - 'psycho' or 'schizo' - can result in them being
excluded from everyday activities.
In fact, people with mental disorders need our compassion.
Labels like these prevent true understanding
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2. Fact or
fiction?
Fiction. Many people believe mental disorders are incurable. They
may even view some treatments, like antidepressants or
psychotherapy, as useless or harmful, - even though in many cases
they have been proved to be effective.
In fact, mental disorders are treatable and are as likely to
respond favourably to medical and other treatments as many physical
illnesses. But the stigma of mental illness can make it harder for
sufferers to seek help and more difficult for other people to help
them.
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3. Fact or
fiction?
Fiction. People with mental disorders are sometimes viewed as weak,
as self-indulgent or as bringing their problems upon themselves.
Even people with mental illness may believe they have themselves to
blame.
In fact, people with mental disorders need you to recognise
that they are ill as much as people with physical complaints.
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4. Fact or
fiction?
Fiction. People with mental disorders often feel isolated and left
out because other people imagine they are difficult to get on
with.
In fact, people with mental disorders need friendship and
understanding just like anyone else.
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5. The future
Scientists are making progress in unravellingthe structure and chemistry of the brain. As a
result we have a better understanding of the mind and how it works.
However, mental illness has many causes. It's not simply a matter
of disturbed chemistry.
The new discoveries raise many questions to do with the nature
of choice and responsibility. We still have a great deal we need to
learn and understand.
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Read the accompanying booklets
to learn what we do know.
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The booklets are published by the Royal College
of Psychiatrists as part of Changing Minds: Every Family in the
Land, a national campaign to counter the stigma of mental
illness.
Copies are available free of charge on receipt of
a stamped addressed envelope (minimum size 30cm x 22cm, postage
64p) from: Changing Minds Campaign, The Royal College of
Psychiatrists, 17 Belgrave Square, London SW1X 8PG Tel: 0207 235
2351.
The Royal College of Psychiatrists is an
educational charity providing a range of booklets free of charge.
Your donation would be welcomed and appreciated.
The Changing Minds Campaign is part of a national
movement to try and reduce the stigma of mental illness.
Acknowledgements
We would like to thank Dr V Y Allison-Bolger and
Dr R L Ramsay for their tremendous help in writing these booklets
and factsheets. Our thanks also go to the Campaign Management
Committee and to the members of the College Faculties and Sections
who have generously given their advice and help.
Professor Arthur
Crisp
Chairman,
Changing Minds Campaign Management Committee
All subjects in photographs are posed by models
Photography by Vaughan Melzer
Last update: 11 September 2003 |