This is a story of stigmas and stereotypes about a portion of the population in the US.
All the terms below have something in common; can you guess what it is? Read and tell me what it is you see…..
Definition of INSANITY
A deranged state of the mind usually occurring as a specific disorder (as schizophrenia)
Such unsoundness of mind or lack of understanding as prevents one from having the mental capacity required by law to enter into a particular relationship, status, or transaction or as removes one from criminal or civil responsibility
Extreme folly or unreasonableness b Something utterly foolish or unreasonable
Definition of CRAZY
Affected with madness; insane.
Informal Departing from proportion or moderation, especially:
Possessed by enthusiasm or excitement
Immoderately fond; infatuated
Intensely involved or preoccupied
Foolish or impractical; senseless
One who is or appears insane
Definition of LUNATIC
Suffering from lunacy; insane.
Of or for the insane.
Wildly or giddily foolish: a lunatic decision.
Characterized by lunacy or eccentricity.
Extremely foolish or silly.
Crazy; insane.
Definition of FRUITCAKE
A derogatory term for a homosexual man.
Someone who is completely insane.
A cake made with bits of fruit and drenched in scotch
Definition of SCREWBALL
A pitched ball that moves in a direction opposite to that of a curveball.
Crazy; absurd.
Definition of NUTS
Crazy; insane.
Extremely enthusiastic
Did you guess? These are terms used to refer to someone who is crazy. Did you know that these words promote a stigma and/or stereotype that aren’t true? Have you ever used any of these terms about someone or something? I bet you have, ever since you were small you most likely referred to someone as being crazy or insane. These terms are so enmeshed into our society and way of thinking most of us don’t even think about it. Think about it…Read the story below
To Whom It May Concern:
You don’t know me, but you’ve hurt me. I know that you didn’t do it on purpose. But it hurts just the same. You may ask how you have hurt me; let me enlighten you. I am one of those people that is labeled as “crazy, fruit cake, nuts, loony, lunatic and assorted other names”. I have a mental illness. I didn’t ask for this anymore than someone with cancer asks to be sick. I have a disease, a disorder that is treatable but not curable. Just like diabetes, arthritis, chronic joint disease, heart disease. I am not different than other people with a disorder. However, I am afraid to tell my friends and family that I have a mental illness, because someone might label me. I have to live with the stigma and stereotypes that are so enmeshed in every culture around the world. In our own culture (US) we start stereotyping mentally ill individuals as children. Just look at the cartoons that we all watch. Looney Tunes and Disney even stereotype mental ill persons. Look at the name Warner Bros gave their cartoons “Looney Tunes” just screams nut. Disney has movies like Alice in Wonderland and the Mad Hatter or Beauty and the Beasts Maurice the father being accused of being crazy. I don’t blame you, but I would ask you to be educated. Let me tell you a few facts…
One in every four adult Americans will suffer or has a mental illness. This includes bipolar disorder, schizophrenia, autism, ADHD, depression, anxiety disorders, PTSD, anorexia, bulimia. That is about 60 million adults. A new study shows that one in five children 17 and younger suffers from a form of mental illness. Yet because of the stigmas associated with mental illness many of these people will remain untreated. Once you are labeled with being a mentally ill person your life changes forever. Friends look at you differently and some disappear. Family members are ashamed of you and will distance themselves from you. You are looked at like you might do something dangerous that could hurt others. The truth is out of all those people less than 2% will be violent. More crimes are committed by substance abuse users than mentally ill persons. In fact you are more inclined to be held up, robbed etc. by a person dealing with a substance abuse than a person with mental illness.
But you need to also know that mental illness is both physically and mentally painful. Mentally ill individuals are more inclined to explain the physical symptoms over the mental symptoms. But how do you explain mental illness to someone that doesn’t have a mental illness? As stated in Breaking Bipolar Blog written by Natasha Tracy explains “emotional pain, like physical pain, is a matter of degree. Everyone experiences sadness – which is the problem. An average person who experiences sadness thinks they know what it is. And they do. They know sadness of a level 2. Or 4. Or maybe even 5 when a loved one dies. But they don’t know the sadness that is so big that it destroys your world. Similarly, people can get upset and get anxious before a test or a job interview and think they know anxiety. But that isn’t the grating, jagged, writhing beast that eats you from the inside of your flesh. People seem to think they understand severity – thinking that their pain must be the worst pain, and if they got over it then so should everyone else. No one would compare a twisted ankle to a shattered femur and expect the shattered one to “walk it off” but with emotion, that’s exactly what we do.
Unfortunately, people misunderstand all those normal emotions for the ones that a person who’s sick experiences because they’re called the same thing. And all the explaining in the world seems to run up against a brick wall in some people.”
Our cultural understanding of mental illness is that you are just not trying hard enough. We never say that about cancer or heart disease,“ says Joyce Burland, PhD, director of the education, training, and peer support center at the National Alliance for the Mentally Ill (NAMI). “America thinks mental illness is something that can get self-corrected, and that is a vast misunderstanding.”
All of this feeds into the stigma and stereotyping of the mentally ill. Is it any wonder that people with mental illness don’t want to talk about it? But with the help of others the stigma can stop. There are even some famous people that have suffered from mental illness. Did you know that throughout history and even today many famous persons have suffer/suffered with some form of mental illness…Jack Nicholson, Catharine Zeta Jones, Abraham Lincoln, Carrie Fischer, Patty Duke, Princess Diana, Daryl Strawberry, Brooke Shields, Isaac Newton, Ludwig Von Beethoven, Michelangelo, and Billy Joel to name a few.
Here are some published facts that might be of interest:
Mental illness has many faces; can you tell if a person suffers from mental illness? What comes to mind when you think of an individual with a mental illness? Does a misshapen cartoon character come to mind, perhaps a violent criminal, or even a possessed demon? Do you see a stereotype or a stigma that is associated with mental illness? If so you aren’t alone. This research paper will analyze the stigmas and stereotypes that prevalent in society that impact multiple facets of our lives. Starting with popular animated films such as Disney’s Beauty and the Beast, how from childhood the stereotypes of mental illness begin, to how popular media such as the radio, newspapers and internet impacts public opinion of mental illness, and religious views that presume person is sinful, processed by a demon or just sticking to religious edict. But where does this stigma begin? It starts with a brief history of mental illness.
The history of mental illness is nothing new, in ancient times such with the Egyptian or Greeks mental illness was thought as a religious punishment. In the 5th BCE, Hippocrates, the father of modern medicine, treated mental illness by curing the patient’s bad humors with herbal remedies. In the Middle Ages, it was thought that persons with mental illness should be locked away. This type of treatment continued till the mid 1800’s. In the Unites States “In the 1840s, activist Dorothea Dix lobbied for better living conditions for the mentally ill after witnessing the dangerous and unhealthy conditions in which many patients lived . Over a 40-year period, Dix successfully persuaded the U.S. government to fund the building of 32 state psychiatric hospitals,” as cited by Dr. T. Mark whom worked for the World Health Organization. Institutionalized care continued in the US until the 1950’s when an outcry of poor conditions and abuse. This pushed for deinstitutionalization of psychiatric hospitals leading to community based treatment for mentally ill patients.
Community based treatment was developed with a wide range of services to psychiatric teams, group homes, health centers and smaller treatment facilities. Though research shows good results, there are still a high percentage of mentally ill patients that don’t have access to basic medical care such as cancer screenings and vaccinations. The other side of this debate of deinstitutionalization is Trans institutionalization as stated below:
“Others argue that deinstitutionalization has simply become “trans institutionalization”, a phenomenon in which state psychiatric hospitals and criminal justice systems are “functionally interdependent”. According to this theory, deinstitutionalization, combined with inadequate and under-funded community-based mental health care programs, has forced the criminal justice system to provide the highly structured and supervised environment required by a minority of the severely mentally ill population”. (Prins, S.J. (2011). Does Transinstitutionalization Explain the Overrepresentation of People with Serious Mental Illnesses in the Criminal Justice System? Community Mental Health J, 47: 716-722)
Proponents of Trans institutionalization state that due to funding issues, there are not enough psychiatric hospital beds for the severely mentally ill. That due to the high arrest rates for the mentally ill; the criminal justice system is now the provider and keeper of these individuals. This controversy of deinstitutionalization or Trans institutionalization continues today. Once again demonstrating the stigma associated with a mentally ill person needs to be kept from society. Though the US is considered to be progressive in the field of mental health there are still many stigmas and stereotypes that saturate the media and continue to persist in public opinion
Studies of how the media impacts adults have been thoroughly researched, but what about the media’s impact on children? How do children learn these stereotypes about mental illness without being constantly exposed? This study determined that one way was through watching animated characters. Though TV portrays many characters that fit the description of crazy, this study:
“Examined one week of children’s television shows from two channels and they found that 46.1% of the week’s episodes contained one or more references to mental illness. The majority of these references were in cartoons (79.7% common words documented included crazy, mad, ‘dosing your mind,’ nuts, ‘driven bananas’ twisted, deranged, disturbed, wacko, cuckoo, loony, lunatic, loon, insane, and freak (p. 441). The physical attributes of the characters with mental illnesses depicted included unruly hair, widely spaced and/or rotting teeth, a prominent nose, heavy brows with thick arched brows (for villains) narrowed artificial eyes (for villains) and large round eyes (for comedic characters)” as cited by Wilson. C. Natrn, R .• Coverdale.). & Panapa. A. ( 1999). Mental illness depictions 111 prime-time drama: Identifying the discursive resources. Austmlicm & New Zealand Journal of Psychiatry, 33(2), 232-239.
The study indicated that the media was one form of stereotyping mental illness beginning in childhood. These are terms learned while watching cartoons that can be detrimental to mentally ill persons. The imagery of the cartoons depicting mentally ill persons with “distorted” facial features shows how at an early age the “idea” of what a mentally ill person should be. Other studies go on to show that feature length animated films are also stereotyping mentally ill persons.
Disney animated feature films where recently researched for potential imagery and phrases that depict mentally ill characters and what they should look like. In a study done by Andrea Lawson, BA of Communications Gregory Fouts, PhD in Psychiatry from University of Calgary did a study using Disney full length feature films. Disney movies were chosen for their consistent characters and story lines from start to finish. There were 26 Disney animated movies that were used in the study ranging from 1937 to 2001. The results show that “Combining principal and minor characters, a total of 85% of Disney animated films contained references to characters with mental illness. More specifically, 21 % of all principal characters were referred to as mentally ill (for instance, Maurice of Beauty and the Beast, Jafar of Aladdin, and Mrs. Jumbo of Dumbo)” (Lawson, A & Fouts, G 2004)
The study results show that even over a significant period of time stereotyping of mental illness is perpetuated. The references to characters in Disney films that depicted as mentally ill further show stereotypes are learned, that stereotyping of mental illness is introduced in childhood through media exposure.
The study goes on to say that there are references that go to alienate or segregate “mad” characters portraying them in a negative light. One such example is Beauty and the Beast, where the townspeople denote that Belle and her father Maurice are “mentally ill”. This teaches children that mentally ill persons are in some way inferior to them and potentially dangerous. In the summary that children exposed to viewing Disney animated films over a period of time are constantly exposed to negative and degrading stereotype of mentally ill persons. The study show that media impacts adult views on mental illness beginning with Disney films as a reference point from childhood.
Media and the entertainment industry have sway over public opinion demonstrating daily as it comes in over the air waves and internet. The power of the media can inform the public of what mental illness really is or perpetuate the stigma associated with this disease. One such headline that was in the news for weeks in 2007 when a shooting of 32 students at Virginia Polytechnic Institute. The shooter was depicted as a loner and had a history of strange behavior that scared other students and faculty. News sources were quick to find out he suffered from mental illness and had been the hospital. The media determined it was a psychotic break, unfortunately, none knew what a psychotic break looks like. Most people that suffer from mental disorders are not violent. This type of information is interestingly absent from the media.
The entertainment industry also has its share of perpetuating stigmas of mental health. Look at movies such as Psycho and Silence of the Lambs. This stereotyping of mental illness is something to fear, as if people with mental disorders are dark and deadly. The truth is as follows:
“The reason is simple and sobering: An estimated 46 percent of American adults experience some type of diagnosable mental illness or substance abuse disorder during their lifetime, according to the National Comorbidity Survey Replication, one of the nation’s most reliable surveys of mental-health disorders. One percent, one of every 100 adults suffers from schizophrenia. Close to 17 percent battle major depression in their lives” as Cited by Richard A. Friedman, M.D psychiatrist and professor at the Weill Cornell Medical College.
The simple fact is that as adults, someone we know, be it friend or family will suffer from a form of mental illness in our lifetime. This means that this person will be one of those mentally ill and have to face the stigmas associated with mental disorders. The media can help change these stereotypes; there is a history of how the power of the media influenced change for mental health. One such reporter was Elizabeth Cochrane (aka Nelly Bly). In 1887 she pretended to have a mental illness and was admitted into an asylum in New York. While she was in the asylum as an undercover reporter for The NewYork World learned of the intolerable conditions patients were subjected to. Cochrane later published a book called Ten Days in a Mad-House, which led to better funding for the care of the mentally ill.
Another such media story was done by Life Magazine Life in 1946 publishing a photo essay showing the terrible conditions of mental hospitals based partly on the aides’ first-hand accounts titled, “Bedlam 1946: Most U.S. Mental Hospitals are a Shame and a Disgrace” The power of the press helped to improve conditions in psychiatric hospitals. This once again demonstrates how public opinion can be swayed by the media.
Violence is one stereotype associated with mental illness that the media continues to expound on. The truth is that only 3%-5% percent of all violence in the United States can be contributed to mental illness. Substance and alcohol abusers are seven times more likely to commit an act of violence than a person suffering from a mental illness according to the National Institute of Mental Health. The media can change how it reports stories on mental illness.
“In a representative survey of 70 major U.S. newspapers, Dr. Patrick Corrigan at the Center for Psychiatric Rehabilitation in Evanston, Illinois reported in 2005 that 39 percent of all stories published about the mentally ill focused on dangerousness-the single largest area of the media’s coverage of mental health” as cited by Friedman, R 2008
The media is more interested in the dangers of mental health instead of focusing on changing the culture and helping to eliminate the stigma of mental health. The truth is that persons with mental illness have a disease just like diabetes, hypertension coronary artery disease, and arthritis and other chronic illnesses. Mental illness, just like the mentioned diseases are treatable but not curable. Research in Neuroscience has shown that major mental illnesses like depression and schizophrenia are associated with changes in brain function and circuitry. Making psychiatric diseases organic and are beyond the control of the person afflicted with disorders. The media can help to change how mental health is viewed by accurately reporting and not perpetuating the negative stereotype. It should be media practice to check statistical information on mental illness. This will help to reduce the stigma associated with violent crimes associated with mental illness. The media can help to change the stereotype by reporting on persons with mental illness that are high functioning and successful. Reporting accurately will help to change stigmas associated with mental illness.
Stigmas can lead to persons with mental illness to not seek treatment and undermine their quality of life. The label of mental illness can impact an individual’s life by impacting the ability to get a job, housing even a driver’s license. Stigma hurts people in three ways label avoidance, blocked life goals, and self-stigma. Label avoidance suggests that many people choose suffering from some form of mental illness will not seek psychiatric assistance for fear of being labeled. These individuals fear being discriminated against or dealing with prejudges. Blocked Opportunities are labels given to person with mental illness. These labels or stigmas can prevent individuals from getting a job or decent housing. These labels prevent individuals in recovery from fully reentering productive society. Self-stigma is self-explanatory, a person suffering from mental illness buys into the beliefs of widely excepted stereotypes. Self-stigma impacts an individual’s self-esteem and leads to negative self-talk.
These labels associated with mental illness hurt society, by discriminating against psychiatric individuals and allowing them to pursue a lifestyle congruent with today’s living standards. These stigmas are not limited to just the media but also religion. In this study, it will show that stigmas associated with mental illness can be found in religious circles. There is not much research associated with religion and its view on mental illness. The study investigates four types of categories: sinful lifestyle and/or divine punishment, demonic possession, faith and prayer, and treatment mentally ill persons.
Religious persons’ conceptions of prayer and faith also can have an effect on their views of mental illness. Some people may believe that persons who have mental illness are simply not relying on their faith in God, or are not praying for healing effectively (Hill, 1975, as cited in Pittard-Payne, 1980; McGuire, 1975; White et al., 2003).
This study shows that religious beliefs can also impact a person with mental illness. Based on strong religious beliefs the discrimination and labels of mental illness can leave afflicted individuals feeling outcast. This leaves a negative label that is based on secular psychiatric views. In one of the focus groups it was found that men were more likely to hold steadfast to religious edicts about mental illness, whereas women were more accepting of secular views.
Though religious views add to stereotyping of mental illness, the media and entertainment industry continue to perpetuate negative labels. How can these stereotypes be changed in society? The World Health Organization recommends an “optimal mix of services pyramid” where the least expensive services are provided. The WHO suggest a global approach in each country develop mix of services
Limit the number of mental hospitals
Build community mental health services
Develop mental health services in general hospitals
Integrate mental health services into primary health care
Build informal community mental health services
Promote self-care
Giving people access to the most basic of mental health services would require an effort on behalf of the global community to invest in its own people by having governments, donors, multiservice agencies and those who seek medical attention. One way to help get easy access to medical care was formula created by WHO for twelve first, second and third world countries on a sliding scale which can be applied to any nation so that an individual can have the most basic of medical needs met at a reasonable price.
“Chisholm et al. breaks this down for mental health using several nations as examples in their investigation (2007) the level of investment required to scale up mental health care in 12 countries for which data from the WHO-Assessment Instrument for Mental Health Systems (AIMS) were available. The countries studied included four low-income countries (Ethiopia, Nepal, Nigeria, and Vietnam), seven lower middle-income countries (Albania, China [Hunan province], Iran, Morocco, Paraguay, Thailand, and Ukraine), and one upper middle-income level country (Chile). The researchers chose targets for improvement based upon levels of service coverage for mental illness achieved in high-income countries; targets were set at 80% improvement in coverage of services for people with schizophrenia and bipolar affective disorder, 25% improvement in coverage for hazardous alcohol use services, and 33% improvement for coverage of services for depression. To reach these targets within ten years, total expenditures in the low-income countries would need to rise ten-fold, to about $2 per person per year by 2015, and total expenditure in the lower middle-income countries would need to increase between three-fold and six-fold, to about $3-4 per person per year. This would likely require an “initial period of large-scale investment”, a $0.30-0.50 per person per year spending increase, followed by a gradual increase in spending of about $0.10-0.25 per person per year. Although this model does not include targets for scaling up services for childhood mental disorders, and is based on data from a small sample of countries, it can be adapted by other countries to guide investment in mental health care services.” Chisholm, D., Flisher, A.J., Lund, C., Patel, V., Saxena, S., Thornicroft, G., Tomlinson, M. (2007). Scale up services for mental disorders: a call for action. Lancet, 370: 1241-1252
This study demonstrates how providing mental health care services can improve coverage. The costs associated with providing these services are minimal, but the upfront costs may be substantial. However, the long term results will provide desperately needed psychiatric care in many countries. With improved mental care, the stigmas of mental illness can begin to change. Having these services, individuals will be more likely to seek assistance for their disorders in low income countries. While organizations like the WHO continue to provide support and recommendations on improving mental health care services there are still many stigmas and stereotypes that need to be overcome.
As demonstrated by the research the stigma and stereotypes are propagated in many different forms. The discrimination of persons with mental illnesses is documented as far back ancient times. During these ancient times mental illness was looked as a punishment sent from the gods. The Middle Ages provided little improvement by locking away people afflicted with mental disorders. It wasn’t until the mid-1800’s that changes began to change, when an activist named Dorothea Dix witnessed the dangerous and unhealthy conditions in which many patients lived. This started the institutionalized care in the US and lasted till the 1950’s when psychiatric care was in terrible state. This was the start of deinstitutionalization in America leading to a community based care system. This brought about the argument of Trans institutionalization states that due to funding issues, there are not enough psychiatric hospital beds for the severely mentally ill. That due to the high arrest rates for the mentally ill; the criminal justice system is now the provider and keeper of these individuals. This is just an example of how mental health is riddled with stigmas.
Many of these stigmas are perpetuated by the media starting as early as childhood. One such example of these stereotypes is shown in cartoons and animated movies. The imagery of the cartoons depicting mentally ill persons with “distorted” facial features shows how at an early age the “idea” of what a mentally ill person should be. Even well-loved Disney animated films continue to preserve the perception of the stereotype of a mentally ill person. In this study of Disney animated films goes on to say that the references alienate or segregate “mad” characters portraying them in a negative light. These Disney animated films that have been around for several generations provide exposure to the negative stereotypes that start in childhood.
The power of the media does not only impact children, it has sway over public opinion. The media and entertainment industry perpetuate stigmas and stereotypes associated with mental illness. This is shown in movies like Psycho and Silence of the Lambs. The News media also sensationalize violence with mental illness. The fact is that only 3%-5% percent of all violence in the United States can be contributed to mental illness. Persons with mental illness have a disease just like diabetes, hypertension coronary artery disease, and arthritis and other chronic illnesses.. While recognizing that mental illness is a disease the media can help to change stereotypes be checking facts and printing stories of a more positive image of what mental illness really looks like.
Stigmas associated with mental illness have tremendous impact on individuals. These stigmas impact the individual’s ability to obtain a job or find adequate housing. Stigma hurts people in three ways by label avoidance, blocked life goals, and self-stigma. Mental illness and its associated stigmas impact society, people with psychiatric disorders are less likely to seek help. Until the labels are removed in all aspects of life, mental illness will continue to be a hidden disease.
Even religion discriminates against people with mental illness. One study investigates four categories that impact mentally ill persons. The four categories are: sinful lifestyle and/or divine punishment, demonic possession, faith and prayer, and treatment mentally ill persons. Religious beliefs are a part of many people’s life, the discrimination and labels of mental illness can leave afflicted individuals feeling outcast.
Though the media, entertainment industry and religious groups continue to propagate negative labels on mentally ill persons, there is hope for good health care. One organization that helps to make global changes is WHO. This group wants to improve mental health care on a global scale. WHO recommends the “optimal mix of services pyramid” where the least expensive services are provided? This pyramid can help provide psychiatric services on sliding scale. The costs associated with plan are cost effective for many different countries of varying wealth. Then based on this plan, desperately needed mental health care can be offered. Then with improved mental care, the stigmas of mental illness can begin to change.
While stigma and stereotypes continue to follow mentally ill people, there is hope that changes will come. The media, the entertainment industry and religious person can provide more positive images of mental illness. The stigmas and stereotypes for mental illness need to be brought into the public eye so that individuals suffering from mental illness can seek help without feeling like an outcast. After all doesn’t everyone deserve to have a quality of life like you?
So maybe the next time you call something or someone nuts, lunatic, fruitcake etc. you will think twice. Help to stop the stigma and stereotyping of mental illness. Maybe once the stigmas and stereotypes are changed, more individual will seek help.