Stigma

So, why is mental illness thought of differently to physical illness. Why do people suffering physical illness get sympathy and support whilst people with Mental Illness are shunned, reviled and considered to be odd or unnatural.

Whether we accept it to be true or not, there is a stigma attached to mental health which does not attach itself to physical illness, though in the recent past illness such as aids certainly had a stigma because of the link with homosexuality, but  even that has now lost its mystique, and lost the stigma to a large extent. The stigma  is felt by the sufferer, the carer and whether consciously or otherwise by the onlooker.

The dictionary definition of stigma is: a mark or token of infamy, disgrace, or reproach.

So why do people continue  to think of mental illness and stigma as partners? Whatever any of us care to think there is still a colossal stigma attached to mental illness and it is a totally unhealthy and unreasonable connection, and is incredibly damaging to both patients and carers.

I have spoken to people in the recent past, and when I have talked about mental health, they have eventually talked about knowing people who have spent time in a psychiatric unit, and were either cured or not. To me it was obvious, but it was many weeks before they admitted the person in the psychiatric unit was themselves. Why was this? I think it is because they felt I would lose respect for them, treat them differently, maybe even cut them… but why would I? They didn’t choose to become mentally ill, nobody does that. Nobody chooses ill health, either physical or mental.

I have a huge respect and admiration for the people doing so much wonderful work in cancer relief, in cardiac repair and huge sympathy for those who suffer, but for me, that sympathy is qualified for people who have contracted a cancer through heavy smoking.

Mental Health is a mystery to all of us still, and only rarely do we get to the bottom of it, find out what caused it. Many cases we can have clues, often circumstantial evidence, but frequently there is no real answer. It has to be said, for some people mental illness is brought on by abuse of narcotics or alcohol, in these cases sympathy is again tempered somewhat, but we should never forget that those addictions are often the result of “a troubled mind”, an addiction, which is in itself an illness.

In order to move on and get Mental Health patients and their carers a proper level of care and support, both in the community and on hospital wards, we have to lose the stigma that unfortunately attaches to mental illness. Only then will people be able to talk about it in an open and honest way, which should lead to understanding followed by ultimately by acceptance. It is the fear of other people’s reactions that stops us from talking openly, as we can about other illnesses.

Those of us involved with mental illness need to start the change, we need to be able to ‘bite the bullet’ and answer people simply and honestly about the illness, its impact on patient, carer and the extended family. Clearly we have to avoid alienating people by talking mental health at them all the time, but I am sure most people would accept honest answers to enquiries, and they may even show some understanding, after all some 25% of the population suffers from mental health problems at some time in their life, by talking about the issues we may lessen the fear for others, we may even liberate them to admit to their own problems. I know from harsh experience that bottling it up, not admitting to the world at large, even worse not admitting to yourself, can eventually do irreparable damage.

Not so long ago, AIDS and Sexuality were virtually taboo subjects, with major stigma attached. Over the years the fact that many celebrities have openly admitted to being gay, and some have even died of AIDS, all of which has brought the subject out into the mainstream, got people talking, and although they may not accept the conditions, at least they are now talked about openly, and the stigma is dramatically reduced.

Could this happen with the stigma surrounding mental health? At present I don’t think so. Although people as diverse as Ruby Wax, Stephen Fry and Alistair Campbell speak openly, with compassion and knowledge about the condition, they remain in the minority. Sadly there are too many celebrities to whom chipped nail varnish is depression, and chipped varnish being restored is bipolar. This simply undervalues the illnesses in the public eye, the public start to think of these conditions as fraudulent, as laughing matters, and the subject gets once again becomes trivialised and people think that depression, bi-polar, schizophrenia and the rest are trivial conditions.

The real nature of mental illness is devastating. The impact is dramatic, on the sufferer, the carer and their family and friends. Mental Illness destroys lives, even though 25% of us will suffer with mental illness, the stigma and lack of understanding, which I believe are mutually dependent, prevent the world at large from understanding, dealing with, or even caring about mental illness.

So, how do we go about changing the situation, about bringing this awful subject into the open and getting its victims the support, respect and understanding that they so need .  One thing is certain, it will not be easy.

The first steps are for carers to become empowered, to accept all the support that is available through the various voluntary support groups. This will lead to knowledge and understanding which will help them to understand what is happening in their lives.

 Carers and the Service Providers must realise that they have the same aims in mind, which is the support of the patient, and understand what each other needs. As a carer it is easy for me to say that Service Providers need to listen to and understand me, but like many carers, can I say that I always listen to and understand the needs of the Service Provider?

To treat a mental health patient effectively it is important to take a holistic view, for the medical team to work with the carers and to treat the patient but to also include the family for information and guidance to support and inform their clinical work. This will also ensure that the carers remain a part of the care process, ease their own stresses by being involved in the process of care.

This will have the effect of normalising the illness, by everyone involved, whatever their involvement, treating each other with respect and dignity, more like the way physical illness is dealt with.

Once we have a situation where it is the normal practice for the patient, medical team and family to

working together, much of the mystique will be shed, and the family will have a greater knowledge and experience, which will then allow them to talk with confidence and knowledge.

Opening the dialogue is often the hardest part, so when the family discusses the illness wit others, they can speak in a more natural and matter of fact way, hopefully removing the mystery from the illness and starting to normalise it.

Ultimately, it would be wonderful to see the major media featuring items about mental illness and caring as they do about so many other dreadful conditions. This would obviously expose more people to the realities of the illness, and help to develop the knowledge and understanding so essential to start to minimise then remove the stigma