Reducing Stigma and Discrimination
Dr. Dawn-Elise Snipes Ph.D., LMHC, LPC-MHSP
Podcast Host: Counselor Toolbox and Happiness Isn’t Brain Surgery
Objectives
~ Define stigma and discrimination
~ Explore the protections under the ADA
~ List several ways our consumers are stigmatized or discriminated against
~ Identify ways to fight discrimination
Data
~ People experiencing mental health conditions often face rejection, bullying and discrimination. This can make their journey to recovery longer and more difficult.
~ Mental health conditions are the leading cause of disability across the United States.
~ Even though most people can be successfully treated, less than half of the adults in the U.S. who need services and treatment get the help they need.
~ The average delay between the onset of symptoms and intervention is 8-10 years.
What is Stigma
~ People who have identities that society values negatively are said to be stigmatized
~ Thanks to stigma, people living with mental health conditions are:
~ Alienated and seen as “others.”
~ Perceived as dangerous.
~ Seen as irresponsible or unable to make their own decisions.
~ Less likely to be hired.
~ Less likely to get safe housing.
~ More likely to be criminalized than offered health care services.
~ Afraid of rejection to the point that they don’t always pursue opportunities.
Common Stigma Associated with Mental Illness
~ Dangerous
~ The major determinants of violence continue to be
~ Socio-demographic and economic factors
~ Substance abuse, whether it occurs in the context of a concurrent mental illness or not
~ historical (past violence, juvenile detention, physical abuse, parental arrest record)clinical
~ contextual (recent divorce, unemployment, victimization) factors.
~ It is far more likely that people with a serious mental illness will be the victim of violence
~ Research has focused on the person with the mental illness, rather than the nature of the social interchange that led up to the violence
STUART, H. (2003). Violence and mental illness: an overview. World Psychiatry, 2(2), 121–124.
Common Stigma Associated with Mental Illness
~ Lazy
~ 60 percent of the 7.1 million people receiving public mental health services nationwide want to work NAMI
~ Susan (not her real name) received SSDI and SSI with mental health services covered by Medicare and Medicaid. As her recovery from bipolar disorder progressed, she went back to work part-time. Despite the fact that she enjoyed her job and her employer was pleased with her performance, she resigned after seven months because she did not want to lose the medical benefits that paid for the care she needed. She is no longer seeking paid work.
~ Dirty
~ Diseased
~ Weak willed
Mental Illness Myths
~ There's no hope for people with mental illnesses.
~ I can't do anything for a person with mental illness.
~ People with mental illnesses are violent and unpredictable.
~ Mental illnesses don't affect me.
~ People with mental illnesses cannot tolerate the stress of holding down a job.
~ Therapy and self-help are a waste of time. Why bother when you can just take a pill?
~ Children don't experience mental illnesses. Their actions are just products of bad parenting.
Addiction Myths
~ Addicts are bad, crazy, or stupid.
~ Addiction is a willpower problem.
~ Addicts should be punished, not treated, for using drugs.
~ People addicted to one drug are addicted to all drugs.
~ Addicts cannot be treated with medications.
~ Addiction is treated behaviorally, so it must be a behavioral problem.
~ Alcoholics can stop drinking simply by attending AA meetings, so they can't have a brain disease.
What Perpetuates Stigma
~ Television
~ News/Availability Heuristic
~ Lack of awareness/public education
~ Lack of insurance coverage for long-term treatment
~ Widespread belief: the stereotype is argued to be true because it is widely held to be true
~ Prejudicial language: negative value or moral judgement is attached to the stereotype
Perpetuation cont…
~ Intentional exclusion: evidence that would or could disprove the stereotype is hidden or concealed
~ Misleading generalization: the evidence is unrepresentative of the population cited as a whole
~ Emotional appeal: the audience is persuaded to agree through emotion, not through logic or facts
Effects of Stigma
~ Refusal to seek help
~ Worsening of symptoms
~ Development of depression
~ Withdrawal/Isolation
~ 1/4 of adults believe that a person with mental illness can eventually recover.
~ Only 42 percent of Americans believe that a person with mental illness can be as successful at work as others.
Effects cont…
~ Only a little more than one-half (54%) of young adults who know someone with a mental illness believe that treatment can help.
~ 74% of people agree that people are not sympathetic toward individuals with mental illnesses.
~ Current federal law has banned more than 150,000 mothers with past drug convictions from participation in the food stamp program and WIC, the women and infant's nutrition program.
Fighting Stigma
~ Become A StigmaBuster!
~ Speak out and challenge stereotypes
~ Educate society about the reality of mental illness
~ Demystify the counseling process
~ Identify the multiplicity of causes of anxiety and depression
~ Learn more about mental illness
~ Listen to people who have experienced mental illness. Stigma is diminished just by talking with someone who has a mental illness.
Fighting Stigma
~ Talk openly about it. The more mental illness remains hidden the more people continue to believe that it is a shameful thing to be concealed.
~ Watch your language.
~ Don’t use terms and expressions related to mental illness that perpetuate stigma, such as “crazy,” “loony,” or “nuts”.
~ Put the person before the mental illness: instead of saying “the borderline,” say, “the person who has borderline personality disorder”.
~ Support mental health treatment. If you need help, seek it. If someone you know needs help, encourage them to do so.
Fighting Stigma
~ Speak up about stigma. When someone you know misuses a psychiatric term, tell them what it really means. When someone tells a joke that ridicules mental illness, tell them that you find such comments offensive and unacceptable.
~ Respond to stigmatizing material. If a commercial, a show, or a movie is portraying someone with mental illness in a stigmatizing fashion. There are organizations that want to know such as StigmaBusters at NAMI.
~ Demand change from your elected representatives.
~ Provide support for organizations that fight stigma by volunteering.
~ Contribute to research related to mental illness and stigma.
~ Share your experience with mental illness.
~ Help people with mental illness reenter society. Support their efforts to obtain housing and jobs.
~ Respond to false statements about mental illness or people with mental illnesses with accurate facts and information.
Discrimination
~ Americans with Disabilities Act prohibits discrimination against individuals with disabilities
~ Defined as a physical or mental impairment that substantially limits one or more major life activities.
~ Who may not currently have a disabling impairment but have a record of such an impairment
~ ADA statutory definition of disability
~ The extent of the limitation resulting from the person’s physical or mental impairment must be assessed in light of any mitigating measures, including medication.
Addiction and the ADA
~ Drug addiction is considered a disability under the ADA, if it poses a substantial limitation on one or more major life activities
~ Individuals who currently use illegal drugs, even users who are addicted, may be denied employment because of their current use.
~ A person who currently abuses alcohol or prescribed drugs is not automatically denied protection
Fair Housing Act
~ The Federal Fair Housing Act, passed in 1968 to prevent housing discrimination based on race, color, religion, sex, handicap, familial status, and national origin, does nothing to stop landlords from discriminating against people with criminal records, such as past drug convictions or domestic violence
Education and Student Loans
~ Students convicted of drug crimes may be prohibited from receiving federal student loans
Summary
~ Don't label people with words like “crazy,” “wacko,” or “loony” or define them by their diagnosis.
~ Learn the facts about mental health and share them with others, especially if you hear something that isn't true.
~ Treat people with mental illnesses with respect and dignity, just as you would anybody else.
~ Respect the rights of people with mental illnesses and don't discriminate against them when it comes to housing, employment, or education.