The Reed House in Savannah, GA is a non-profit clubhouse for people with mental illnesses. It provides opportunities in training, education, employment and housing for adults challenged by mental illnesses. I am a member of the Reed House
The Reedette is a newsletter produced by the members of the newsletter. As you'll find here, we print an outstanding newsletter, and our members are gifted writers.
I am posting this here at Daily Kos for three reasons:
1. This issue tackles socially relevant issues concerning mental health
2. To help gain exposure for the work our members produce.
3. To bring attention to the Reed House, which is still in its infancy, and hopefully to encourage some of you to donate to a worthy cause.
The issue focuses on stigma. I am posting the three articles that deal with stigma in this diary, but providing a link to the newsletter for those who would like to read the rest of the material from the newsletter.
Stigma: A Personal Experience
Anonymous
“The woman is crazy, I mean really crazy—she has bipolar—and she…”
My boss spoke those words, describing a woman who made foolish choices and suffered harsh penalties. But the lady wasn’t the only one hurting.
Sitting among co-workers that day, I felt deep shame hearing about it. I wasn’t ashamed of what that woman did. I was ashamed because I know bipolar illness myself, yet hide it. I set my face to the right reaction, belied empathy, and pretended, yet once again, that this type of news was new to me. And I prayed for my boss to stop talking.
Being diagnosed manic-depressive as a young teen set a guard over my life and pushed a weight against my soul. “Don’t tell anyone,” my parents warned. Family knew, but it was never discussed except with my parents and one aunt. I remember going out of town with a friend in high school. She had to wait for me while I got—something. I had to get something. When it was ready, my mom handed me my medicine hidden in a ball of aluminum foil. No one would guess what was inside.
But in a way, it felt good being linked to this bipolar classification. It helped explain the absurdity of my early life: Some days felt like one more forced step down the dark, fiery corridor of existence (depression). Yet a carnival backdrop would topple over my despair, and suddenly I was the laughing star in the middle of a rich, colorful life (mania).
Smile. Do the right thing. Collapse in bed after school because of medicine’s sedating effect. Cry at home. Keep going. Keep going. Keep going.
But after years of hearing forecasts like I’d always live at home with my parents or always be on medicine, I sought escape. I asked for help.
“Has anyone ever seen a scientific difference in the brains of people with ‘bipolar?’” one pre-med student rhetorically asked me in response. He had a point.
“Bipolar! Why, everyone has mood swings!” one counselor told me. “If I went to the doctor, they’d say I had bipolar, too!”
“There is nothing wrong with you,” two different church leaders said.
Also, many people told me I didn’t need medicine, and one friend hinted at demon possession. And after many prayers, wasn’t I healed? Being healed, never having bipolar, or believing the disorder was bogus seemed better than my life at the time.
I discarded my bipolar classification and lived alone, fully supporting myself for years. I only took heartburn medicine, and to sleep, an occasional Benadryl.
And during those 10 years, I was hospitalized four times. Four times. Three of those times I was committed.
I hate bipolar, but I have it. Yet here’s to a day when doctors believe more for their patients, and the world we live in makes room at the table for kind, honest discussion on a disorder most don’t understand.
Why Stigma Doesn’t Work: It only causes more suffering
By Robert F Reiley
Why do we stigmatize people who are different? The most likely explanation is stigma is used as a form of social control. We figure that if we react negatively to undesired behaviors that fewer people will engage in such behaviors. We can hear it stated in our political debates over teen pregnancy, sex education, STDs, contraception, and homosexuality.
Regarding teen pregnancy, contraception, and sex education, many argue that we should teach abstinence-only to teenagers and this would reduce the incidents of teen sex and teen pregnancy. They also argue that comprehensive sex education that includes instruction on contraception would send a message that teen sex is okay. In other words, it we leave teen sex stigmatized we will reduce this behavior.
In the heated gay rights fight, we can hear the arguments for stigmatizing homosexual behavior. Those opposed to gay rights often make the case that gay rights will normalize homosexuality. In other words, if we leave homosexuality stigmatized we will reduce the behavior.
In these social issues two views are posited. One view is that we should eliminate the stigma surrounding the behavior and then give people the resources to reduce any risks associated with the behavior. The supporters of this view believe that in ending stigma we will create an environment for more openness and honesty, resulting in healthier behavior.
The opposing view supports stigmatizing these behaviors. This view says if we stigmatize these behaviors, people will be motivated to avoid these behaviors, and we will reduce these behaviors. If stigma works, wouldn’t we see a reduction in these behaviors in cultures where these behaviors are most stigmatized?
There is little doubt that teen sex is highly stigmatized among white evangelicals. However, Dave Sessions, in an article for The Daily Beast entitled “Evangelicals Struggle to Address Premarital Sex and Abortion," wrote:
“Despite almost universal affirmation that premarital sex is a sin, 80 percent of unmarried evangelicals are having it, and 30 percent of those who accidentally get pregnant get an abortion... U.S. states where abstinence is emphasized over contraception in school sex ed—almost all in the heavily evangelical South—have teen birth rates as high as double those of states with a comprehensive curriculum... white evangelicals are sexually active at a younger age..."
OnlineAthens.com reaffirmed the trend for southerners who are most exposed to stigma on matters of sexuality in an article by Erin France entitled “Southern Teens have highest rates of STDs, Pregnancies study says." The point of the article is clear. The stigmatizing abstinence-only education is failing.
What about homosexuality? It may not be surprising that more gay men are closeted in the south where anti-gay stigma is high, but in a New York Times op-ed titled “How Many American Men are Gay,” Seth Stephens-Davidowitz discussed his research that demonstrates while anti-gay stigma might result in fewer openly gay men, it doesn’t discourage homosexual behavior. In fact, he found that men in the south were more likely to place internet ads looking for casual encounters with men than in more tolerant states.
Stephens-Davidowitz concludes that “a huge amount of secret suffering in the United States that can be directly attributed to intolerance of homosexuality.” Secret suffering, indeed. The Daily Texan published an article by Jerry Thomas titled “HIV diagnoses highest in the south.” The title speaks for itself.
While stigma may drive various behaviors underground, it doesn’t reduce those behaviors. Arguably, it increases those behaviors and results in worse outcomes. On the other hand, in an article in The Advocate entitled "Can San Francisco be the First AIDS Free City?" Jeremy Lybarger writes “San Francisco halved its number of new infections between 2004 and 2011..."
The evidence suggests that eliminating stigma gets better results than continuing or exacerbating stigma. Stigma does not result in eliminating or reducing the undesired behavior. If anything stigma increases those behaviors relative to cultures where stigma is less prevalent.
Applying these lessons to mental health, it becomes clear that it is incumbent upon community, and mental health leaders, and consumers to do all we can to reduce or eliminate stigma. In this issue, we discuss stigma and mental illness. Stigma reduces the likelihood that mentally ill people will seek care in a timely manner, or that they or their families will seek resources and information to get needed help. Stigma doesn't work. It clouds our judgment, and as Stephens-Davidowitz said in reference to closeted gay men in the south, stigma causes "a huge amount of secret suffering."
Stigma: an historical look
By Warren Sparrow
Dictionary.com defines stigma as: a distinguishing mark of social disgrace; the World English Dictionary defines stigma as a: mark of disgrace or infamy. The stigmatization of the mentally ill has been occurring for centuries. Some societies equated the strange and incoherent babblings of the person experiencing delusions as demonic possession .
The unique symptoms associated with mental illnesses lead to strange theories to explain the illnesses, and equally strange treatments: bleeding, ice baths, forms of isolation, and punitive measures.
As we became more enlightened, the era of institutions developed, which led to overcrowding, neglect and abuse. Much of the neglect and abuse can be attributed to ignorance, misinformation, or arcane beliefs that contradict the science we know now to explain what a mental illness is.
Just a few months ago I spoke with a family member who was convinced their brother’s “troubles” was a direct result of him “moving away from God.”
For a hundred years people with mental illnesses in this country were isolated from communities, being placed for long periods to entire lifetimes in institutions. In 1965, the State Hospital in Milledgeville, GA reached a peak of 12,205 patients, and was thought to be one of the worlds largest mental institutions.
The Kennedy Administration passed legislation in the early 1960’s that de-institutionalized tens of thousands of people who were severely ill. The promise was to shift support from the most restrictive to the least restrictive environment. The community mental health system was born with this initiative. Although people were released in droves into the community, the money didn’t follow. As some institutions were decommissioned the funds used to operate them were not transferred to develop and support community based services to people who had been institutionalized for years and years, to the extent that it was needed.
Once again the community was confronted with the strange and unusual. Mental illness was not something families wanted to talk about, it was and still is a cause of shame and embarrassment for many. A general lack of understanding by many view mental illness as a personal weakness, or the family’s fault or assume the person is responsible for the condition itself because poor decisions, laziness, or something else.
With access to media sources as it is today, one would think we could stamp out stigma simply by saturating the market place with good information.
But this has not been the case. For some it is difficult to distinguish between fiction and non- fiction. The often negative portrayal of people with mental illnesses that popularize the notion that a per- son with mental illness is dangerous, unpredictable, devious, and deceptive, is apparently too strong a storyline to let go. It leads to confirming our deep seated beliefs. It makes us comfortable to think we can predict who is dangerous. We know then who we can avoid in order to stay safe, and protect our families.
Stigma is still with us. It is still unfair. It is still incorrect. It is still damaging to those who are the target. It thwarts each person’s potential. It continues to ostracize. Continues to harm and hurt people. It needs to stop.
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