Mental Illness Stigma

Mental health/Mental illness continuum

Mental illness stigma. It’s something we hear quite often. It’s shared on social media. It’s the topic of monthly mental health themes. It’s frequently blogged about, discussed, and shared. Most of us have seen that green ribbon representing mental health. So, why is stigma still a thing?

That’s a good question. One that I frequently ponder myself. We live in a day and age where mental illness and wellness is talked about daily…and yet misunderstanding is still all too common.

I am not going to pretend to understand every little thing that plays into mental illness stigma. I’m positive there are things out there that contribute to it that I am not aware of. However, I will offer my own personal insight.

Working in mental health for going on five years has given me insight into the world of mental health and mental illness. It’s a blessing and a curse. Understanding the issues that play into mental health in our society gives me the ability to help those in need, but it also gives me a deeper understanding of the barriers in our society that prevent progress. One of these barriers, is a lack of education and understanding of mental health.

This is the part that is so hard for me to describe. But I will do my best. Mental health and mental illness are factors that effect everyone and every thing. Mental health is a continuum (refer to the above picture). On one end, you have complete mental health. On the other end, you have mental illness. Somewhere in the middle is moderate functioning on the health side and illness side. If someone is a healthy individual with no mental illness, they have mental health. If someone struggles with something in their life, they may have mental health issues. For those that have a pervasive and moderate to severe mental health issues, mental illness diagnosis are reserved. We all fall somewhere on the continuum. This means that no matter who you are, no matter how well off you are in life, no matter how great your coping skills are, no matter how well adjusted you are, the umbrella of mental health effects every single one of us. This can be a good and a bad thing. This means that we all have universal connection as human beings. But this also means that because this is a universal experience, so many people have opinions on mental health topics. Frequently, these opinions are based on false facts or personal experiences that may not apply to others.

Another universal human experience is having beliefs and morals that dictate right and wrong. This morality system is present in all of us, but can look different from person to person. Something I have personally seen is that when someone or something questions our understanding of right and wrong, we become uncomfortable. We become unsure. We become nervous and anxious, because the truth we stand on, starts to crumble. This is an uncomfortable process. Being confronted with facts that crumble our own personal beliefs or opinions forces us to acknowledge that we may have been wrong and may need to change our outlook. This is not comfortable for any person. So what happens when we are not ready to accept that we are wrong? We blame others.

According to Brene Brown, blame is the discharge of uncomfortable emotions. Whenever you notice someone is blaming another person, you can bet they are feeling nervous, anxious, frustration, or some other uncomfortable feeling. Blaming is NOT finding out where the source of the problem is. That’s problem solving, which involves an honest examination of oneself. Blaming is refusing to acknowledge wrongdoing and instead shifting the responsibility of wrongdoing onto someone else. This is where a quote I once heard comes to mind. “When presenting facts that discredit someones belief system, be extra empathic. Their world is crashing down.” Essentially, we are shattering someones worldview.

So, how does blaming play into mental illness stigma? Well, so often people have opinions on mental illness that shifts the responsibility of the issue onto the person who has the mental illness. When you combine this with the fact that every single one of us wants our morality to be steadfast and unchanging beliefs that we can firmly rely on, we often become unwilling to truly examine our beliefs to determine if they are based on truth or false information. It is easier to shift responsibility onto another person than it is to reform our own worldview and belief system.

This is why it is easier to state that people with mental illness want attention, they want a crutch, they whine, they manipulate, etc. It is much easier for us to blame these things on the mentally ill than it is to admit we could be wrong and we need to better understand someone or a situation.

Let me give you a recent example. Recently, I was scrolling through comments on a Facebook article/video (I know, that was my first mistake) discussing someone who had suddenly lost their spouse and had developed an addiction due to using the substance to deal with the sudden loss. One comment particularly caught my attention and, if I’m honest, frustrated me. The person commented “I’m so tired of people using mental illness as a crutch.” Essentially, what this person was saying, is that they need to pull themselves up by their bootstraps and be an adult, not avoid responsibility by claiming mental illness. This is a prime example of everything I just described above, a lack of understanding of how mental health and mental illness works combined with blaming–the discharge of uncomfortable emotions. Rather than taking a step back to examine the situation and attempt to understand, it was easier for this person to blame. They did not want to examine the legitimate causes of the resulting addiction, they wanted to blame the problem on the person with the illness. They did not want to understand that mental health is on a continuum, and this individual, sinking in the midst of addiction, is on the unhealthy functioning end.

The umbrella, or continuum, of mental health and mental illness is not full of “lazy, entitled, selfish, drama-filled” people trying to manipulate to get out of taking responsibility. Yes, mentally ill people manipulating, lying, and acting lazy is a thing, but this is a symptom of a bigger and deeper mental health issue, this is not THE problem. The difference between the general public’s understanding of mental illness and professional mental health clinician’s understanding is this: behavior is a symptom of deep rooted issues. Behavior is not the one and only issue. When the general public stops at a persons actions (lying, manipulating, etc), us mental health clinicians look deeper. You see, what most people see as despicable behavior, we see as symptoms of deep rooted issues. Lying, manipulating, disrespecting others, violating others rights, are symptoms of something going sideways in mental health or mental illness. We don’t stop at WHAT the person is doing, we move forward to understand WHY. When most people see mental illness as frustrating, immoral behaviors, we see underlying issues–which is typically a result of brain chemicals gone awry, life experiences/trauma, and a lack of life skills and access to resources. And after we understand why, we hold the person accountable for their own well-being while, at the same time, being empathetic. Yes, it is possible to be both at the same time.

This brings me to one more point that I believe plays into mental health stigma. You see, our world is full of dichotomies. Belief systems that are either/or.

“You’re either mentally ill or you’re not.”

“You’re either for the second amendment or you’re not.”

These are just two examples of false dichotomies. A false dichotomy that I frequently see is the belief that you cannot be empathetic and hold someone accountable at the same time. You cannot be understanding and offer empathy to the person while also holding them to a higher standard that prevents enabling. This is absolutely and entirely FALSE. I engage in this dynamic on a daily basis. I employ empathy to put myself in my client’s shoes to understand how I would react to situations, how I would feel if something happened to me, and how I might respond to it. And, I also hold my clients accountable for their own well-being. I make it known that they are responsible for getting to a better place in their life, for managing their own mental illness in a healthier way, for getting themselves clean and sober, for learning the skills they need to survive and thrive in this world. Yes, this approach is possible, and it works! While some of my clients may not be ready to face their issues or put in the effort to grow, majority of my clients do make progress with this approach. This approach, also, has much more research back up than the “tough love” approach the general public frequently employs with mentally ill people. Hence, whey us counselors are taught empathy skills in graduate school!

So, yes, the lack of education/understanding combined with blame and false dichotomies is a frustrating thing for me. These belief systems effect my clients on a daily basis. This influences public policy, state and private funding, and access to resources. It is beyond frustrating to see fellow human beings providing even more obstacles for the mentally ill than necessary. How do I handle this? Well, I employ empathy! Just like I do with my clients, I employ understanding. Not all of us have the access or drive for higher education like I do. Not all of us have the passion for understanding mental health issues like us clinicians. And, as I stated before, blame came often feel good as it takes the responsibility off of us and provides venting at the same time. We human beings also tend to feel comfortable in those dichotomies, those either/or belief systems. Because, well, we feel we can better predict people and situations if it is more black and white. Don’t you like to be able to predict? I know I do!

This brings me to my last, and, I believe, most important point. Understanding is being vulnerable. Employing empathy is being vulnerable. Honestly examining our own faults is being vulnerable. We are opening ourselves up to the possibility of being wrong, of potentially needing to help someone, of getting our hopes up, of rocking the belief systems beneath our feet, of change. This is uncomfortable for every single one of us. But, it is our duty, to one another and to ourselves, to lean into this vulnerability. If we don’t, our mental health is at stake. Our friends and family members mental health is at stake. Our countries will continue to spend the recorded 1 trillian on lost productivity due to mental illness (World Health Organization). Depression will continue being one of the top reasons for the filing of disability. Our society–local, state, and federal, will continue to suffer. We will continue spending money on addiction, depression, incarceration, and the war on drugs.

This issue is huge. It goes above mental health professionals. To truly change mental health stigma, we all must play a part. And we must start with vulnerability and empathy.

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