Dr Michael Bloomfield is a scientist and psychiatrist, dedicated to driving forward our understanding of mental illness. He argues that stigma is still holding us back – and why we must overcome it.
Enormous progress has been made in tackling mental health stigma. And this progress must be cherished. However, we must not allow well-placed pride in our achievements to turn into complacency.
There is still great stigma against mental illness. And this permeates through many aspects of our lives - the media, politics, hospitals, professions and indeed patients themselves.
We can only celebrate victory against stigma once mental health discrimination and stigma ends, and once there is full parity between mental health and physical health care and research.
In the media, whilst progress in addressing issues related to mental health have been made, we have a long way to go. It is unacceptable that in the 21st century words like “psycho” are used to describe people suffering from severe illnesses, and evil horrific acts are easily explained away as being the work of “nutters” in knee-jerk reactions.
We must not lull ourselves into a false sense of security about the increasing societal openness to discussion around mental health – we must name stigma and discrimination when we see it. Although wider public attitudes continue to shift, surveys indicate that 1 in 10 people would not want to live next to someone who has ever had a mental illness.
And we need to keep in mind that some mental illnesses and disorders are more stigmatising than others, with schizophrenia often being amongst the most stigmatised by the public.
Stigma and discrimination permeates through our institutions – I believe this is why psychiatric care is largely provided in separate hospitals and sites, away from general hospitals, and indeed why so many psychiatric services are facing awful and disproportionate cuts to funding compared to the rest of the health service. These have resulted in massive bed closures, the closure of services and the collective abandonment of some of the most of vulnerable people in our society who find it increasingly difficult to access evidence-based treatments.
In medical research, the fact that we spend considerably less per person affected on research into mental illnesses compared to other medical problems, is a symptom of the stigma and discrimination against people with mental illnesses. This communicates to wider society that people with mental illnesses are not worth the same care and support as people with other illnesses.
Although public understanding around mental illness has increased, the language we use is often misjudged and misinformation is rife. It appears that the mental illness label is so stigmatising, that instead we talk of “mental health”.
This, at best, confuses the issues, and at worse, acts as a double bind and a barrier to proper understanding and acceptance of mental illnesses to tackle stigma. The World Health Organisation defines health as being “more than the absence of illness, a state of total wellbeing”… Yet, we talk about mental health when, in fact, we mean mental illness.
We must not forget that some mental illnesses are unfortunately severe, life-threatening medical emergencies. By restricting the conversation to mental health, rather than health and illness, we risk working against achieving the parity that is desperately needed and overlooking those most in need of help and care.
Now is the time to build on the important advances we’ve seen in public awareness about mental health.
To do this, we need to recognise that mental health and illness are emotive subjects, people will have different opinions – and these should be listened to with compassion and thought.
Science must come into the conversation – only through building support for research will we have the evidence and facts needed to challenge stigma wherever it exists.
Then one day, we will begin to see parity in awareness, understanding, treatment and care for mental and physical health and illnesses.
Last updated: 27 July 2018