Why is mental illness so stigmatized in America? Why is there an uneasiness with people who have mental illnesses to receive help?
Storified by shelbystubbs ·
Tue, Dec 01 2015 23:17:30
The first time I was really introduced to mental illness was in middle school when my best friend told me she had depression. At the time, I had no idea what depression actually was, only that it had something to do with being really sad a lot. As I became closer with her, I wanted to know more about depression and what it meant. I knew that when my friend opened up to me, it was something personal, and I shouldn't share it with anyone because I was trusted with it. However, what I couldn't really comprehend was the more complicated reasoning why she didn't want me to tell people. Now I know it was because she feared people would view her differently, and she was right to be wary. The stigma that surrounds mental illness, especially in the United States, has been one the biggest underlying issues that people with any type of mental illness does not get treated. That led me to the question: why is there such a huge stigma in the first place?
Americans have always been independent, whether it's the insistent love for a capitalist economy or the ambition to be the best, self-reliance has always been at the heart of the United States. When someone struggling with a mental illness asks for help, they're often met with a certain amount of surprise and discomfort because when they ask for help, they're suddenly dangerous because they can't function on their own. The distrust in the difference between what both the media and society portrayed as 'normal' and how people with mental illnesses live creates a tension, which ultimately leads to a lack of knowledge from being unable to understand. This is shown in Public Conceptions of Mental Illness in 1950 and 1996: What is Mental Illness and Is It to be Feared? in which it states that, "Early studies found that, not only was the public's orientation to mental illness largely uninformed, by the current psychiatric thinking of the day, but public conceptions were suffused with negative stereotypes, fear, and rejection." The fear and rejection of people with mental illness often caused those with it to either lapse into a deeper depression, or add depression onto their mental illness because they were understood, and instead written off as 'crazy' or 'dangerous.'
In the 1940's, this tension and overall unenlightened state was used by doctors, in their attempts to 'progress' the medical field through experimentation of dangerous and new medical procedures. One of the most famous procedures was the lobotomy, in which an ice pick was inserted through the orbital cavity next to the eye into the prefrontal cortex of the brain. The ice pick lobotomy was invented in 1935 by a Portuguese neurologist, Antonio Egas Moniz, and just ten years later, he received the Nobel Prize for it. The intention of the procedure was to stop violent and abusive behavior exhibited by those with mental illnesses, according to Funk & Wagnalls New World Encyclopedia. Dr. Walter Freeman brought the procedure to the United States, and gained popularity for the lobotomy procedure quickly. One of the people who experienced an ice pick lobotomy was Howard Dully, who was twelve when the procedure took place. In an NPR interview he states, "But I've always felt different, wondered if something's missing from my soul." In Dully's attempt to reconcile with what happened to him, he investigates his past to discover why this was allowed to happen to him. He interviews with Dr. Elliot Valenstein, a professor at the University of Michigan with a PhD who teaches psychology and neuroscience. Dr. Valenstein states, "I think the problem with the whole lobotomy period was that it spread like wildfire; that there was a lot of publicity, a lot of exaggerated success. Initially there was a lot of demand for the operations because there were many parents and family members who were desperately in need of help and not getting any. And it spread not only for seriously ill patients but to a lot of people who were not that seriously ill." This was what happened with Dully; he actually did not look to have any real mental illness, but because of the hype surrounding the procedure, and the stepmother who never wanted him, he was forced to get an ice pick lobotomy. While the treatment worked on some of Dr. Freeman's patients, such as Ellen Ionesco, whom was, according to her daughter, "violently suicidal" before her surgery while afterwards she was complicit, the ice pick lobotomy was been ruled inappropriate after the mid 1950's from the possible and likely horrible side affects that come with it.
'My Lobotomy': Howard Dully's JourneyAdditional interviews, oral histories and information about the documentary: On Jan. 17, 1946, a psychiatrist named Walter Freeman launched a radical new era in the treatment of mental illness in this country. On that day, he performed the first-ever transorbital or "ice-pick" lobotomy in his Washington, D.C., office.
While the ice pick lobotomy fad ended when less intrusive forms of treatment such as psychotherapy drugs coming into market, and therapy counseling sessions, the stigma surrounding mental illness didn't. One of the biggest controversies in the psychiatry history is the topic of sexuality, and if being gay is a mental illness or not. According to "Homosexuality and Mental Illness" by J. Michael Bailey, numerous studies have shown that "[...] the association between homosexuality and psychopathology, [...] both converge on the same unhappy conclusion: homosexual people are at a substantially higher risk for some forms of emotional problems, including suicidality, major depression, and anxiety disorder." This article suggesting that those who are homosexual suffer from other mental illnesses illustrate that those on the outside of society, whom are viewed different because they don't fit into the media's portrayal of the norm are therefore wrong and dangerous. The shift from the ice pick lobotomy to aversion therapy grew in popularity in the 1970's to treat homosexuality. Aversion therapy was using negative reinforcement in order to convert people's sexual orientation from gay to straight. In the article "Just Because They Volunteered Doesn't Mean It's Not Torture" by Mickey Weems, they state, "The result of such abuse can convince the patient to implement a mini-Final Solution and kill themselves." These results were seen, but not truly acknowledged until twenty years later in 1996, in the court case Pitcherskaia v. Immigration and Naturalization Service in which a Russian woman fought for the right to stay in the United States so she didn't have to go back to Russia where she would be treated with aversion therapy. The court decided that Pitcherskaia had a right to stay in the country, as aversion therapy was not truly beneficial to the subject, and all to similar to torture tactics. As the treatment for mental illness shifted more towards psychotherapy drugs, the public's opinion shifted that mental illnesses were dangerous and that was why those with it had to be on medication.
The fear associated with mental illnesses is more often than not fear of the unknown, and not being able to understand. According to the article Mental Illness, Mass Shootings, and the Politics of American Firearms, "On the aggregate level, the notion that mental illness causes gun violence stereotypes a vast and diverse population of persons diagnosed with psychiatric conditions and over simplifies links between violence and mental illness." This over simplification that the article discusses, further illustrates that those with mental illnesses are not all the same, and grouping nonviolent people with mental illnesses, with people who are psycho or sociopaths only increases the stigma against those with mental illnesses. The notion that all those who are mentally ill are capable of hurting and killing others is a stretch that is used to explain how someone could do something so horrific, and instead of separating those who are nonviolent and harmless it creates an even wider net of stereotype, and encourages those with with mental illness to not get treated, in fear of being seen as a 'freak.'
As the United States has grown to try and be more understanding of those with mental illnesses, it's still an ongoing struggle. One of the biggest, more obvious changes is the fact that more and more people are seeking medical help for their mental illnesses, according to the article Public Conceptions of Mental Illness in 1950 and 1996: What Is Mental Illness and Is It to be Feared?. California is also pushing to reduce the stigma of mental illness in its state, as it passed the Mental Health Service Act in 2004, which "[...] funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual level," according to the article "California's Historic Effort to Reduce the Stigma of Mental Illness: The Mental Health Services Act" found in the American Journal of Public Health. As Americans are becoming more educated, with the easy accessibility to online sources as well as public education of mental illnesses in schools, the United States is slowly starting to see a change in how mental illness is viewed. While there is definitely still stigma surrounding those with mental illness, instead of regarding someone as the illness, it has shifted to identifying someone with the illness.
Works Cited
Clark, Wayne, et al. "California's Historic Effort To Reduce The Stigma Of Mental Illness: The Mental Health Services Act." American Journal Of Public Health 103.5 (n.d.): 786-794. Biological Abstracts. Web. 19 Nov. 2015
Phelan, Jo C. et al.. “Public Conceptions of Mental Illness in 1950 and 1996: What Is Mental Illness and Is It to Be Feared?”. Journal of Health and Social Behavior 41.2 (2000): 188–207. Web...
Bailey J. Homosexuality and Mental Illness.Arch Gen Psychiatry. 1999;56(10):883-884. doi:10.1001/archpsyc.56.10.883.
"Just Because They Volunteer Doesn't Mean It's Not Torture." Outlook: Columbus 16.6 (2011): 22. LGBT Life with Full Text. Web. 23 Nov. 2015.
Norris, Michelle. "'My Lobotomy': Howard Dully's Journey" National Public Radio 21 Aug. 2012. Print.
Parcesepe, Angela M, and Leopoldo J Cabassa. "Public Stigma Of Mental Illness In The United States: A Systematic Literature Review." Administration And Policy In Mental Health 40.5 (2013): 384-399. MEDLINE. Web. 23 Nov. 2015.
"Lobotomy." Funk & Wagnalls New World Encyclopedia (2015): 1p. 1. Funk & Wagnalls New World Encyclopedia. Web. 28 Nov. 2015.
Metzl, Jonathan M., and Kenneth T. MacLeish. "Mental Illness, Mass Shootings, And The Politics Of American Firearms." American Journal Of Public Health 105.2 (2015): 240-249. Health Policy Reference Center. Web. 29 Nov. 2015.
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