Misconceptions about mental illness create stigmatizing attitudes: Deeper public understanding is needed

HOUGHTON -- When Keweenaw County Sheriff Curt Pennala began organizing the Mental Health Presentation in early May, it was time for the community to have a conversation in regards to mental health and the stigma attached to it, he said.

Just one of Pennala's goals was to help the public reach a clearer understanding of mental health, to begin the elimination of the social stigma regarding mental illness and those who want or need professional help, but are afraid to seek it. Why?

Patrick W. Corrigan and Amy C. Watson, provided the answer in their Feb. 2002 scholarly article, "Understanding the impact of stigma on people with mental illness," published in World Psychiatry: Official Journal of the World Psychiatric Association, when they wrote:

"Many people with serious mental illness are challenged doubly. On one hand, they struggle with the symptoms and disabilities that result from the disease. On the other, they are challenged by the stereotypes and prejudice that result from misconceptions about mental illness. As a result of both, people with mental illness are robbed of the opportunities that define a quality life: good jobs, safe housing, satisfactory health care, and affiliation with a diverse group of people."

The article continues by stating that stigmas about mental illness seem to be widely endorsed by the general public in the Western world. Studies suggest, it states, that the majority of citizens in the United States and many Western European nations have stigmatizing attitudes about mental illness. Furthermore, stigmatizing views about mental illness are not limited to uninformed members of the general public; even well-trained professionals from most mental health disciplines subscribe to stereotypes about mental illness.

During the May 27 Mental Health Presentation conducted at the Keweenaw County Courthouse, Michelle Morgan, MD, and former medical director at Copper Country Mental Health (now retired), said that to begin reducing stigma, the public needs to hear both from family members of people with mental illness, as well as individuals who have those illnesses, so that the public can better understand illnesses and become better equipped to discuss mental disorders.

"And you can argue about where it all started," said Morgan, "or why, or which president was to blame, or whatever you want, but what it really comes down to is stigma."

That resources for mental health treatment, and substance abuse treatment, are not adequately funded, she said, is because they are viewed as lesser problems, or something they neither want to discuss or address.

"They're considered to be things that people should just 'deal with,'" said Morgan, "and many people who hold the purse strings don't really understand or want to champion the causes that are needed to (address the issues.")

Corrigan and Watson explained the negative impacts of stigma caused by public misconceptions.

The impact of stigma is twofold, they wrote.

– Public stigma is the reaction that the general population has to people with mental illness.

– Self-stigma is the prejudice which people with mental illness turn against themselves. Both public and self-stigma may be understood in terms of three components: stereotypes, prejudice and discrimination.

Stereotyping, prejudice, and discrimination all share the common roots of lack of knowledge and lack of compassion.

"One of the things that is not understood," Morgan said, "is that most people who have a mental illness or substance abuse disorder, or who even have suicidal thinking, do not need to be in a hospital."

Morgan said they do not need to be hospitalized to get treatment or to recover, and in fact, but, she added, unfortunately, the process of getting better through treatment is something that takes weeks, sometimes months, or sometimes years.

"The purpose of a hospital is primarily to provide a safe place where the person is supervised 24/7," said Morgan, "and in some cases, there need to be a locked door, because a person is at an acute risk of leaving and harming themselves or others. There are just a couple of treatments that require a hospital setting in order to begin treatment. Other than (those), all the other treatments are available outside of the hospital."

Morgan said another public misconception involves psychiatry.

"It's true that psychiatrists are trained to treat mental illness," she said, "but the vast majority of people who need treatment with medication, even, do not need to see a psychiatrist."

Rather, she said, they are treated by primary care, and that has been true for decades. 90% of anti-depressants are prescribed by primary care providers.

"Primary care providers are trained in how to assess and treat depression, anxiety, and substance use disorders," Morgan explained. "That's not to say that psychiatrists are not necessary in some cases, but there is a lot of treatment that can happen locally through primary care."