Mental Illness and Stigma: How Far Have We Come?

Mental illness was once, and to some extent still is, a taboo subject that most people feel uncomfortable talking about within familial or societal spheres. However, because of the superfluity of media coverage and cinematic portrayals of people afflicted with mental illness, it has gone from private whispers behind closed doors to public dialogues. However, the one issue that has not dissipated is the stigmatization of persons afflicted with mental disorders, particularly marginalized groups like the poor and the homeless.

According to Merriam-Webster.com, the word ‘stigma’ comes from the Greek word ‘stizen’ which means to tattoo or to brand. I can most definitely identify with the whole idea of being “branded” and I’ll tell you why.

I figure if I am going to write an article about mental illness and the whole idea of whether or not to seek treatment or disclose one’s diagnosis for fear of dire repercussions, I might as well start with myself. Because I want to help shed some light on this most sensitive subject matter and hopefully help someone else who maybe experiencing a similar fate, I am prepared to disclose to you, my readers, that I have been diagnosed with depression.

As a Haitian and particularly a Haitian male, admitting to having any type of mental disorder is extremely taboo within the Haitian family and community. Admitting to having a mental disability is analogous to admitting to having a severe weakness as a human being, but particularly as a man and even more so a Haitian man. The notion of equating admitting to being mentally ill with being weak caused both my family and I to hide and ignore my depression for years. My mother recognized some of the signs, such as oversleeping, overeating, irritability and anxiety for months at a time, behaviors that ended up disrupting our entire family structure. Another reason why my family kept me from seeking help was because of fear of what a formal diagnosis would entail. Some of the many possibilities were fear that I might not be able to get into college, get a job, health insurance, etc. But mostly, my mother feared that the rest of my family would be ashamed of me and therefore ostracize me. My mother claims that she was only trying to “protect” me from experiencing prejudice from narrow-minded people.

My mother’s reason for keeping my mental illness a secret was that she felt the odds were already stacked against me for being a young Black male. Why make life even harder by professing my debilitating mental health status? Of course, my mother’s fears of me being “labeled” with mental illness have validity. Even I find myself judging others based on their disclosure of having a mental illness. I don’t do it intentionally; it’s more like a visceral reaction than anything else. Once I know of someone else’s mental incapacity, my reactive brain begins to immediately wonder about how “crazy”, dangerous or unpredictable that person’s behavior may be. When I catch myself doing that, I think to myself: “Hey, you too have a mental illness. Would you want someone thinking these thoughts about you?”

“Labeling theory proponents and the theory’s critics have different views on stigma and thus differ on the consequences of labeling for people with mental illnesses,” says Sarah Rosenfield of Rutgers University in her article published by the American Sociological Review, Labeling Mental Illness: The Effects of Received Services and Perceived Stigma of Life Satisfaction. She goes on to say that, “The labeling perspective posits that because of stigma, official labeling through treatment contact has negative consequences for mental patients.” This ideology reflects that of my mother’s concerns about me being “labeled” with depression due to her fears of societal and personal repercussions; like being turned down for a job or being rejected by a potential intimate partner upon disclosure.

“In contrast, critics of the labeling theory claim that stigma is relatively inconsequential. Instead they argue that because labeling results in receiving needed services, it provides significant benefits for mental patients,” says Rosenfield. She elaborates that, “Labeling theorists examine that mental illness as a form of deviance: the label rather than the behavior per se shapes the fate of mentally ill persons…by compromising the life chances of those so labeled.” For example in my instance, once I was officially diagnosed or “labeled”, I immediately began to think of my limitations and perceived disabilities. I started to think that I was going to have to contend with the fact that I may never be able to fulfill my dream of becoming a published writer. As it turned out, my fears were unfounded since I have published my first book “Sparks in the Dark,” and am currently working on my second. I was able to achieve success principally because of my family’s steadfast support, namely my mother. As I navigated in and out of hospital psychiatric wards, the fire that once burned bright in me began to die. I was ready to surrender to my depression and be content to just be “mentally ill” and all that it encompasses. But my mother repudiated the whole idea of me giving up and she—through love, patience and understanding—encouraged me to obtain my college degree in liberal arts and publish my first book. Publications allowed me the opportunity to be a featured author at Harvard University, North Eastern University and many other places. However, I am glaringly aware of the sad fact that not many people are as lucky as I am in receiving that kind of support. Many with mental illness, particularly the homeless, are abandoned or neglected by their families and ultimately by society at large. Many have dual diagnoses in the form of mental illness and substance abuse.

“One of the tragic consequences of stigma is the possibility that it engenders a significant loss of self-esteem—specifically that the stigma of mental illness leads to a substantial proportion of people who develop such illnesses to conclude that they are failures or that they have little to be proud of,” says Bruce G. Link, Ph.D. et al. in the article Stigma as a Barrier to Recovery: The Consequences of “Stigma for the Self-Esteem of People With Mental Illnesses,” published by the American Psychiatry Association. This was the case for me, and still is to some extent. I can’t disregard the fact that sometimes, during depressive periods. I feel “less than” those without a mental illness.

Today, I am learning to differentiate between what’s real and what I perceive to be real. When I’m not in a depressive state, I don’t feel like a failure. I know that when I do feel like a failure, it’s my sick mind telling me that I am, while my healthy mind tells me that I’m not; when I am functioning normally. Link goes on to say, “According to the stigma theory…people develop conceptions of mental illness early in life from family lore, personal experiences, peer relations and the media’s portrayal of people with mental illnesses.” How many times have you heard someone in your family or circle of friends talk negatively about those afflicted with mental illness, maybe even refer to them as “crazy people”? How many times have you found yourself perpetuating the same act, in spite of the fact that you may or may not have a mental illness yourself? How many times have you seen the news featuring a sensational story about a person with mental illness committing a violent act, which results in inducing fear in the general public?

Those afflicted with mental illness are not always easily identifiable at least on the prima facie level or based on aberrant behavior. It may help to point out that very famous people, like Janet Jackson, Robin Williams and Roseanne Barr, have mental illnesses, but you wouldn’t know it just by looking at them. According to a Duke University study, 49 percent of U.S. Presidents suffered from mental illness and substance abuse. There was Richard Nixon’s alcohol abuse, Calvin Coolidge’s hypochondria, Ulysses S. Grant and Thomas Jefferson’s social phobias. However, mental illness did not keep them from living fruitful life filled with joy, dignity and accomplishments. Why should it impair you or me for that matter?

So, how far have we come when it comes to mental illness and stigma? I suppose that depends on you, and your thoughts and reactions regarding either yourself as a person living with mental illness and/or the next time you encounter a mentally ill person; whether your assessment of them will be based on their perceived disabilities stemming from stereotypes or stigma or their actual realities based on their abilities, accomplishments and capacity to live a fulfilling and dignified life in spite of their mental illnesses?

Jacques Fleury is a Poet, Author and Columnist; his book “Sparks in the Dark: A Lighter Shade of Blue, A Poetic Memoir” about life in Haiti & America was featured in the Boston Globe. Sample or buy the book at: www.lulu.com. 20% of proceeds will go to Haiti charity Partners in Health. For personal appearances or comments contact Jacques at: haitianfirefly@gmail.com.