Stigma+and+Mental+Illness+-+The+Double+Whammy

Rebecca Whalley n6377904 Tutor: Katie Page

**Stigma and Mental Illness –The Double Whammy** media type="youtube" key="mY27YfstRZA" height="315" width="560" **ARTEFACT** This advertisement, which is currently in circulation on free to air channels in Australia, is a demonstration of the social distancing someone suffering a mental health disorder may experience. The character, Emily, tells of her diagnosis of bipolar disorder and her fears of being treated differently due to her illness. As she walks through her workplace co-workers stop and stare. In the bathroom as she faces her reflection, Emily explains that she went from being Emily to ‘just that wacko from accounts’ and that she can treat her mental illness but not the way people treat her because of it. The turning point in this clip is where a co-worker walks past and says ‘Hi Emily’ to which Emily smiles at the simplistic gesture that is use of her name.

**PUBLIC HEALTH ISSUE** The public health issue being addressed here is mental health in Australia and particularly, the stigma associated with mental illnesses. In Australia, 1 in 5 people are diagnosed with a mental illness each year (ABS, 2011) and yet those with mental illness are still facing discrimination. With a relatively constant number of mental health disorders having been diagnosed each year for the past 40 years (Williams & Doessel, 2009), it is clear that the mental health arena is a difficult aspect of public health to improve upon. So, whilst our government devises a plan for better medical treatment and services, shouldn’t society play its part to improve social interactions and eliminate discrimination against the mentally ill?

**LITERATURE REVIEW** Stigmatising attitudes towards those who are mentally ill are consequential in many ways. Studies have shown that the stigma surrounding mental health disorders can prevent people from seeking treatment, affect employment and housing opportunities and contribute to feelings of loneliness and distress (Hocking, 2003). To understand how stigma affects those with mental health disorders there first must be an understanding of how stigma works. Stigma in the mental health arena is made up of two distinct categories; public stigma and self-stigma (Müller & Garcia-Retamero, 2009). Public stigma refers to society’s response to mental ill health, whilst self-stigma is the reaction incurred in those suffering mental health disorders and is usually a response to public stigma (Bathje & Pryor, 2011). Stigmatising conditions are not the cause of stigma but rather societal prejudice and a tendency to internalise these effects (Bathje & Pryor, 2011). It is due to these factors and the consequences mentioned above that reducing the stigma surrounding mental health disorders is an essential step in the improvement of mental health in Australia.

The Australian Bureau of Statistics (2007) has found that over a 12 month period, 1 in 5 Australians suffered a mental health disorder. This statistic demonstrates that a considerably high number of Australians have the potential to be affected by stigmatising attitudes. One concern for those affected by stigma is that people will be dissuaded from seeking help (Bathje & Pryor, 2011) (Wright, Jorm & Mackinnon, 2011). Bathje and Pryor (2011) conducted a study that examined the relationships between various affective components, such as sympathy or fear in regard to those with mental illnesses and help-seeking attitudes. The methodology used was a variety of questionnaires undertaken by university students. One of the main findings was that people with sympathy towards those with mental illnesses were more likely to seek help themselves, in direct contrast to those who showed little or no sympathy. Another study specifically focussed on depression and the likeliness of Australians to seek professional help (Barney, Griffiths, Christensen & Jorm, 2005). Through randomised mail-out surveys it was uncovered that self-stigma and perceived stigma (public stigma) were indicative of reluctance to seek help. This study also compared people’s choice of health care provider to treat depression and found that general practitioner (GP) was the most common choice; however**,** a barrier existed in that there was still a high expectation of perceived stigma in this field of practice (Barney et al., 2005).

In addition to the aforementioned negative effects of stigma on treatment seeking, there are other detrimental effects that need to be considered. The first is the relationship between mental illness and livelihood. According to a study done by Corrigan et. al (2003) in the United States 51% of people suffering serious mental illnesses experienced discrimination in regard to employment. A further 29.9% of study participants had been subjected to discrimination in regard to housing and 25.7% in regard to law enforcement. Barriers for employment and housing opportunities are an unnecessary stressor for individuals suffering mental health disorders and can contribute to additional mental health issues (Rüsch, Angermeyer & Corrigan, 2005). Research in Australia found that most students studying at a tertiary level who had a mental health disorder were disinclined to inform the university of their mental ill health for fear of stigmatisation and discrimination (Martin, 2010). F ear of being discriminated against had ramifications in the quality of study for those with mental health disorders (Martin, 2010) and is an example of how stigma can affect an individual's advancement in life.

It is necessary to undertake an extensive range of studies in relation to the stigma of mental health, however there are countless limitations in a field such as this. Majority of studies performed in this discipline utilised survey and questionnaire methodologies (Martin, 2010) (Corrigan, et. al., 2003) (Barney, et al., 2005). An example of a limitation in stigma research is a lack of information of participant treatment-seeking history, which could affect their perceived stigma in regard to various health professions (Barney, et al., 2005). This is easily overcome by including additional questions within the surveys, however if a thorough history is to be obtained as well as answers to the questions in relation to stigma then the time length on data collection could become impractical.

For mental health in Australia to be improved upon it is necessary for stigma to be addressed (Link, et al., 2004). Those suffering mental health disorders should feel comfortable seeking treatment, just as any person suffering a physical disorder would, however due to the stigmatising nature of such illnesses this is not the case (Bathje & Pryor, 2011). Stigma and discrimination in the fields of employment, accommodation, tertiary study and law enforcement are common for those with mental ill health (Rüsch, et. al., 2005) (Martin, 2010) and this affects individual’s lifestyles. In a country where 1 in 5 people suffer a mental health disorder annually, it is imperative that stigma be treated as a high priority health issue to be addressed.

**CULTURAL AND SOCIAL ANALYSIS** The influence of society and culture in regard to mental health stigmatisation are critical. This is due to public and self-stigma being consequential of societal and individual belief (Bathje & Pryor, 2011). Public stigma includes the negative attitudes of the community in respect to mental health disorders and directly impacts perceived stigma (Barney, et. al., 2005). Barbara Hocking (2003) raises the point that health professionals should be the first to reduce stigmatising attitudes and negative labelling of those with mental health disorders. Hocking (2003) also states that communities need to be more educated when it comes to mental illnesses such as schizophrenia. If a reduction of stigma within the medical and community settings occurs**,** then it is likely that self-stigma, or perceived stigma, will consequently be diminished and individuals with mental illness will have an improved quality of life.

The obvious cultural and social group affected by mental health stigma are those diagnosed with mental illnesses and their families. Less obviously, however, are the people within society who are experiencing symptoms of mental ill health and do not want to risk the humiliation of seeking professional help, especially help associated with mental health disorders, such as psychiatrists and counsellors (Bathje & Pryor, 2011). This attitude stems from public stigma and the misconstrued beliefs that those who are mentally ill are “homicidal maniacs who should be feared; they are rebellious, free spirits; or they have childlike perceptions of the world that should be marvelled” (Rüsch, et. al., 2005). These misconceptions often arise from the media and as such, programs are currently in place in Australia such as Sane StigmaWatch to monitor media coverage for damaging accounts of mental health disorders (SANE Australia, n.d).

For those who are diagnosed with mental health disorders, self-stigma is a hindrance to their mental well-being. The reality of self-stigma is where those with mental illnesses are subjected to some form of social prejudice and begin to inwardly reinforce these beliefs (Rüsch, et. al., 2005). As expected, this has harmful effects on an individual’s confidence and self-esteem (Rüsch, et al., 2005) and unfortunately in many cases**,** can induce suicidal tendencies (Hocking, 2003). When suicide occurs in these instances, there are a few social theories that may provide explanation. The first is Durkheim’s theory of anomie whereby “society fails to provide sufficient regulation of an individual” (Pridmore & McArthur, 2010). This theory identifies with the concepts of public and self-stigma as society does not provide adequate support or understanding of those with mental illnesses. Another possible explanatory theory is Durkheim’s ‘egotistic suicide’ where the individual is not adequately integrated into society (Pridmore & McArthur, 2010). This is applicable to those with mental illnesses who become ostracised due to public stigma.

<span style="color: windowtext; font-family: Arial,sans-serif;">In light of the information provided here, it is imperative that changes in societal outlooks occur to reduce the effects of social stigma. The broader community must be educated in mental illness and made aware of the effects stigmatising attitudes can have (Hocking, 2003). In addition to this, those suffering mental health disorders should ideally be aware of public prejudice and choose to inwardly refute it, thus decreasing their chance of succumbing to self-discrimination (Rüsch, et. al., 2005).

<span style="color: #800080; font-family: 'Arial Black',Gadget,sans-serif; font-size: 120%;">**ANALYSIS OF ARTEFACT / LEARNING REFLECTIONS** <span style="color: windowtext; font-family: Arial,sans-serif;">The advertisement shown above is a great example of the Australian Government’s efforts in reducing stigma. The character, Emily, talks honestly and openly about her mental illness and her fears that people will see her differently. When faced with the truth that people do in fact see her differently, it is a hard dose of reality for the audience. //How is this __normal__ person, who is speaking __normally__ to us, being so obviously discriminated against?// Well, the answer is stigma. The concept of Emily having a mental health disorder immediately puts her into the ‘them’ basket. She is separated by social barriers from the ‘rest of us’. With one-fifth of Australians suffering from mental illness each year the likeliness of a close friend or family member having a mental health disorder is high. So why is it that when someone bravely admits to having a mental illness, labels such as ‘crazy’, ‘psycho’ or in this case ‘the wacko from accounts’ are applied?

<span style="color: windowtext; font-family: Arial,sans-serif;">This assignment has broadened my knowledge of mental illnesses and the stigma that surrounds them. I will admit that in the past I have used the word ‘crazy’ without realising the possible ramifications. After researching the effects of stigma on those who have mental illnesses I now know the damage one word can do to a person’s confidence, self-esteem and quality of life. With this knowledge in mind I will do my part in reducing the stigma associated with mental illness and I hope that with increased awareness the rest of Australia will do the same.

**<span style="color: #800080; font-family: 'Arial Black',Gadget,sans-serif; font-size: 120%;">REFERENCES ** <span style="color: windowtext; font-family: Arial,sans-serif;">Australian Bureau of Statistics. (2007). National Survey of Mental Health and Wellbeing: Summary of Results, 2007. Retrieved from: http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/4326.0Main%20Features32007?opendocument&tabname=Summary&prodno=4326.0&issue=2007&num=&view=

<span style="color: windowtext; font-family: Arial,sans-serif;">Barney, L., Griffiths, K., Christensen, H. & Jorm, A. (2009). Exploring the nature of stigmatising beliefs about depression and help-seeking: implications for reducing stigma. //BioMed Central Public Health//, //9//(1), 61. DOI: 10.1186/1471-2458-9-61.

<span style="color: windowtext; font-family: Arial,sans-serif;">Bathje, G. & Pryor, J. (2011). The relationships of public and self-stigma to seeking mental health services. //Journal Of Mental Health Counseling//, //33//(2), 161-176. Retrieved from: http://web.ebscohost.com.ezp01.library.qut.edu.au/ehost/pdfviewer/pdfviewer?sid=ac2259a5-4d6f-40e2-a61d-d4952ad4c558%40sessionmgr113&vid=2&hid=127

<span style="color: windowtext; font-family: Arial,sans-serif;">Corrigan, P., Thompson, V., Lambert, D., Sangster, Y., Noel, J. & Campbell, J. (2003). Perceptions of discrimination among persons with serious mental illness. //Psychiatric Services (Washington, D.C.)//, //54//(8), 1105. DOI: 10.1176/appi.ps.54.8.1105.

<span style="color: windowtext; font-family: Arial,sans-serif;">Hocking, B. (2003). Reducing mental illness stigma and discrimination - everybody's business. //Medical Journal of Australia.// //178 Suppl// (s47), 8. Retrieved from: http://www.mja.com.au/public/issues/178_09_050503/hoc10581_fm.html

<span style="color: windowtext; font-family: Arial,sans-serif;">Link, B. G., Yang, L. H., Phelan, J. C & Collins, P. Y <span class="citationdate" style="color: windowtext; font-family: Arial,sans-serif;">(2004) <span style="color: windowtext; font-family: Arial,sans-serif;">. <span class="citationarticleorsectiontitle" style="color: windowtext; font-family: Arial,sans-serif;">Measuring mental illness stigma. <span class="citationsource" style="color: windowtext; font-family: Arial,sans-serif;">//Schizophrenia bulletin.// <span class="citationvolume" style="color: windowtext; font-family: Arial,sans-serif;">//30// <span class="citationissue" style="color: windowtext; font-family: Arial,sans-serif;">(3) <span style="color: windowtext; font-family: Arial,sans-serif;">, <span class="citationspagevalue" style="color: windowtext; font-family: Arial,sans-serif;">511 <span style="color: windowtext; font-family: Arial,sans-serif;">. Retrieved from: http://schizophreniabulletin.oxfordjournals.org/content/30/3/511.full.pdf+html

<span style="font-family: Arial,sans-serif; font-size: 11pt;">Pridmore, S., & McArthur, M. (2010). An observer's typology of suicide. //<span style="font-family: Arial,sans-serif; font-size: 11pt;">Australasian ////<span style="font-family: Arial,sans-serif; font-size: 11pt;"> Psychiatry //<span style="font-family: Arial,sans-serif; font-size: 11pt;">, 18(1), 46-48. DOI: 10.3109/10398560903314591

<span style="color: windowtext; font-family: Arial,sans-serif;">Martin, J. (2010). Stigma and student mental health in higher education. //Higher Education Research & Development//, //29//(3), 259-274. DOI: 10.1080/07294360903470969.

<span style="color: windowtext; font-family: Arial,sans-serif;">Müller, S. & Garcia-Retamero, R. (2009). Stigma susceptibility. In //Encyclopedia of Medical Decision Making.// Retrieved November 2, 2011 from http://sage-ereference.com/view/medical/n309.xml

<span style="color: windowtext; font-family: Arial,sans-serif;">Rüsch, N., Angermeyer, M. & Corrigan, P. (2005). Mental illness stigma: concepts, consequences, and initiatives to reduce stigma//. European Psychiatry//, //20//(8), 529. DOI: 10.1016/j.eurpsy.2005.04.004.

<span style="color: windowtext; font-family: Arial,sans-serif;">SANE Australia (n.d). How StigmaWatch Works. Retrieved November 2, 2011 from http://www.sane.org/stigmawatch/how-stigmawatch-works

<span style="color: windowtext; font-family: Arial,sans-serif;">Williams, R. & Doessel, D. (2009). Improving mental health inequality? Some initial evidence from Australia. //Applied Economics Letters//, //16//(2), 131-136. DOI: 10.1080/1350485060101813.

<span style="color: windowtext; font-family: Arial,sans-serif;">Wright, A., Jorm, A. F. & Mackinnon, A. J. (2011). Labeling of mental disorders and stigma in young people. //Social Science & Medicine (1982)//. //73//(4), 498. DOI: 10.1016/j.socscimed.2011.06.015

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<span style="color: #800080; font-family: 'Arial Black',Gadget,sans-serif; font-size: 110%;">Reflective Comments

//<span style="color: #404040; font-family: Arial,sans-serif; font-size: 10pt;">Dying for Cultural Safety //

<span style="color: #404040; font-family: Arial,sans-serif; font-size: 10pt;">Hi Sarah. Great job on your WIKI! Health care workers in Australia absolutely need to practice cultural safety and it’s sad that other countries are so much further along with this concept than we are. I liked the relevance of your artefact to your whole case; it tied in beautifully with cultural safety in regards to death and dying.

<span style="font-family: Arial,sans-serif;"> //<span style="color: #404040; font-family: Arial,sans-serif; font-size: 10pt;">Adolescent Girls too Afraid to Play Sport due to Body Image Issues // <span style="color: #404040; font-family: Arial,sans-serif; font-size: 10pt;">This is a very interesting topic. I am curious as to whether separating males and females for physical education classes at high school would help girls to overcome these body image issues. If males aren't present then perhaps girls would not fret over how they look and whether what they are doing is 'too masculine'. Then they could just relax and enjoy the sport.