Stigma and Mental Illness

By David Trend

“The more I became immersed in the study of stigmatized mental illness, the more it astonishing to me that any such phenomenon should exist at all,” writes Robert Lundin, a member of the Chicago Consortium for Stigma Research. “I believe that serious and persistent mental illnesses, like the one I live with, are clearly an inexorably no-fault phenomena that fully warrant being treated with the same gentleness and respect as multiple-sclerosis, testicular cancer or sickle-cell anemia.”[i] Here Lundin names a central of problem in the social construction of mental illness: the misunderstanding of conditions affecting the mind as somehow different from other biological illness. The misrecognition renders mental illness prone to the judgmental attributions discussed by Susan Sontag in her 1973 book Illness as Metaphor.  To Sontag, contemporary society reverses ancient views of sickness as a reflection of the inner self.  In this new view, the inner self is seen as actively causing sickness––through smoking, overeating, addictive behavior, and bad habits: “The romantic idea that disease expresses the character is invariably extended to exert that the character causes the disease–because it is not expressed itself. Passion moves inward, striking within the deepest cellular recesses.”[ii] But as before, the sick person is to blame for the illness.

Such sentiments are especially vindictive when a mentally ill person commits a crime. Understandably perhaps, clinical terms like “mental illness” quickly acquire malevolent meanings in the public mind––even though the mentally ill statistically are no more prone to criminality than anyone else. Sometimes this semiotic slippage causes public panic over commonplace disorders. Consider the case of Adam Lanza, the young man who in 2013 shot 26 children and adults at the Sandy Hook Elementary School in Newton, Massachusetts. While mental health analysts speculate that an acute psychotic episode prompted his violence, Lanza never had been diagnosed with a serious mental illness. As reporters scrambled for a story, much was made of Lanza’s childhood symptoms of Asperger’s syndrome, a form of high-functioning autism. The repeated mention of this disorder in news coverage triggered wrong-headed fears nationally of the murderous potential in other autistic kids. According the Centers for Disease Control (CDC), approximately 1 in 50 people (1.5-million) fall somewhere on the autistic spectrum, 80 percent of whom are boys.[iii] This has prompted improved diagnostic measures, which in turn have resulted in an apparent rise in autism cases in recent years––up 78 percent from a decade ago––and made autism a source of acute anxiety for many new parents. Continue reading “Stigma and Mental Illness”

Mentally ill brutalized in prison

From today’s New York Times, “After being arrested on a misdemeanor charge following a family dispute last year, Jose Bautista was unable to post images$250 bail and ended up in a jail cell on Rikers Island.

A few days later, he tore his underwear, looped it around his neck and tried to hang himself from the cell’s highest bar. Four correction officers rushed in and cut him down. But instead of notifying medical personnel, they handcuffed Mr. Bautista, forced him to lie face down on the cell floor and began punching him with such force, according to New York City investigators, that he suffered a perforated bowel and needed emergency surgery.

Just a few weeks earlier, Andre Lane was locked in solitary confinement in a Rikers cellblock reserved for inmates with mental illnesses when he became angry at the guards for not giving him his dinner and splashed them with either water or urine. Correction officers handcuffed him to a gurney and transported him to a clinic examination room beyond the range of video cameras where, witnesses say, several guards beat him as members of the medical staff begged for them to stop. The next morning, the walls and cabinets of the examination room were still stained with Mr. Lane’s blood.

The assaults on Mr. Bautista and Mr. Lane were not isolated episodes. Brutal attacks by correction officers on inmates — particularly those with mental health issues — are common occurrences inside Rikers, the country’s second-largest jail, a four-month investigation by The New York Times found.

Reports of such abuses have seldom reached the outside world, even as alarm has grown this year over conditions at the sprawling jail complex. A dearth of whistle-blowers, coupled with the reluctance of the city’s Department of Correction to acknowledge the problem and the fact that guards are rarely punished, has kept the full extent of the violence hidden from public view.

But The Times uncovered details on scores of assaults through interviews with current and former inmates, correction officers and mental health clinicians at the jail, and by reviewing hundreds of pages of legal, investigative and jail records. Among the documents obtained by The Times was a secret internal study completed this year by the city’s Department of Health and Mental Hygiene, which handles medical care at Rikers, on violence by officers. The report helps lay bare the culture of brutality on the island and makes clear that it is inmates with mental illnesses who absorb the overwhelming brunt of the violence. Continue reading “Mentally ill brutalized in prison”

The truth about violence and mental health

After mass shootings, like the ones these past weeks in Las Vegas, Seattle and Santa Barbara, the national conversation often focuses on imgres-2mental illness. But as TruthOut asks, ” what do we actually know about the connections between mental illness, mass shootings and gun violence overall?

“To separate the facts from the media hype, we talked to Dr. Jeffrey Swanson, a professor in psychiatry and behavioral sciences at the Duke University School of Medicine, and one of the leading researchers on mental health and violence. Swanson talked about the dangers of passing laws in the wake of tragedy ― and which new violence-prevention strategies might actually work.

“Here is a condensed version of our conversation, edited for length and clarity.Mass shootings are relatively rare events that account for only a tiny fraction of American gun deaths each year. But when you look specifically at mass shootings ― how big a factor is mental illness?On the face of it, a mass shooting is the product of a disordered mental process. You don’t have to be a psychiatrist: what normal person would go out and shoot a bunch of strangers?But the risk factors for a mass shooting are shared by a lot of people who aren’t going to do it. If you paint the picture of a young, isolated, delusional young man ― that probably describes thousands of other young men.A 2001 study looked specifically at 34 adolescent mass murderers, all male. 70 percent were described as a loner. 61.5 percent had problems with substance abuse. 48 percent had preoccupations with weapons. 43.5 percent had been victims of bullying. Only 23 percent had a documented psychiatric history of any kind ― which means 3 out of 4 did not. Continue reading “The truth about violence and mental health”

Dealing with the narcissist in your life

Love is great, but it’s actually empathy that makes the world go ‘round. According to The Atlantic, “Understanding other peoples’ viewpoints is so essential to human functioning that psychologists sometimes refer to empathy as “social glue, binding people together and creating harmonious relationships.”

“Narcissists tend to lack this ability. Think of the charismatic co-worker who refuses to cover for a colleague who’s been in a car accident. Or the affable friend who nonetheless seems to delight in back-stabbing.

“These types of individuals are what’s known as “sub-clinical” narcissists—the everyday egoists who, though they may not merit psychiatric attention, don’t make very good friends or lovers.images

“If people are in a romantic relationship with a narcissist, they tend to cheat on their partners and their relationships break up sooner and end quite messily,” Erica Hepper, a psychologist at the University of Surrey in the U.K., told me. “They tend to be more deviant academically. They take credit for other peoples’ work.”

“Psychologists have long thought that narcissists were largely incorrigible—that there was nothing we could do to help them be more empathetic. But for a new study in the Personality and Social Psychology Bulletin, Hepper discovered a way to measurably help narcissists feel the pain of others.

“First, she gathered up 282 online volunteers who hailed from various countries but were mostly young and female. They took a 41-question personality quiz designed to assess their levels of subclinical narcissism, checking boxes next to statements like “I like to have authority over other people” or “I will be a success.” They then read a story about a person named Chris who had just gone through a breakup, and then took another quiz to determine how bad they felt for Chris. The more narcissistic among them were indeed less likely to feel empathy for the fictional jilted man. Continue reading “Dealing with the narcissist in your life”

Three-strikes and mental illness

Passed in 1994, California’s “three strikes” law is the nation’s harshest sentencing law.As Mother Jones reports, “Designed to imprison for life anyone who commits three violent crimes, the law has inadvertently resulted in the incarceration of a lot relatively harmless people, for a long time and at great public expense. Crimes that have earned people life sentences:imgres-1 Stealing a dollar in loose change from a car, breaking into a soup kitchen to steal food, stealing a jack from the open window of a tow truck, and even stealing two pairs of children’s shoes from Ross Dress for Less. The law is one reason that California’s prison system is dangerously, and unconstitutionally, overcrowded. More than 4,000 people in the prison system are serving life sentences for non-violent crimes.

“In 2012, with corrections costs consuming ever more of the state budget, the voters in the state had had enough, and they approved a reform measure that would spring many of these low-level offenders from a lifetime of costly confinement. By August of last year, more than 1,000 inmates had their life sentences changed and were released; recidivisim rates for this group has also been extremely low. But further progress in the reform effort is being stymied by one thorny problem: Nearly half of the inmates serving time in California prisons suffer from a serious mental illness such as bipolar disorder or schizophrenia. So far, judges have been reluctant to let these folks out of their life sentences.

“A new report from Stanford Law School’s Three Strikes project notes that the number of mentally ill prisoners denied relief from a life sentence is three times larger than those without a brain disease. The disparity largely stems from the fact that judges and juries tend to give people with brain diseases much harsher sentences to begin with. Continue reading “Three-strikes and mental illness”

Mental illness and life expectancy

According to Oxford University researchers, about one in four people in the UK will experience a mental health problem sometime during the year, while fewer than that smoke cigarettes — around 21 percent of men and 19 precent of women.images

PsychCentral reports that “Many mental disorders have a higher mortality risk than smoking. Yet despite these statistics, say the researchers, mental health still lags behind as a public health priority, especially compared to smoking.

“The study, published in the journal World Psychiatry, was based on the best systematic reviews of clinical studies reporting mortality risk for a whole range of diagnoses: mental health problems, substance and alcohol abuse, dementia, autistic spectrum disorders, learning disability, and childhood behavioral disorders.Twenty review papers were identified, including over 1.7 million individuals and over 250,000 deaths.

“The findings showed that the average reduction in life expectancy inbipolar patients is between nine and 20 years, 10 to 20 years forschizophrenia, between nine and 24 years for drug and alcohol abuse, and around seven to 11 years for recurrent depression. The loss of years among heavy smokers is eight to 10 years.

“People with mental health problems are among the most vulnerable in society. This work emphasizes how crucial it is that they have access to appropriate healthcare and advice, which is not always the case,” said Dr. John Williams, head of Neuroscience and Mental Health at the Wellcome Trust.

“We now have strong evidence that mental illness is just as threatening to life expectancy as other public health threats such as smoking.”

All diagnoses had an increase in early death, though the size of the risk varied greatly. Many had risks equivalent to or higher than heavy smoking. Continue reading “Mental illness and life expectancy”

Guns and mental illness

imgresLawmakers who refuse to support effective gun safety measures often prefer to talk about better screening of the mentally ill to identify deranged would-be perpetrators before they can carry out mass shootings. As a New York Times Op Ed entry today reads:

“This is, of course, a political dodge. Even in the handful of states where law enforcement agencies are trying to confiscate the guns of unstable individuals, state and federal laws too often enable the mentally ill to reclaim their guns as a right under the Second Amendment.

“In Connecticut, which has gun confiscation laws that were tightened after the Newtown school massacre, an angry man who was off his medications for paranoid schizophrenia threatened to shoot his mother and the police if they confiscated his weapons. The police managed to seize his 18 rifles and shotguns and seven high-capacity magazines. But the man expects to reclaim his arsenal in April, asserting he is back on his medications and has had no further police incidents (although he told Michael Luo and Mike McIntire of The Times that he has experienced paranormal activities).

“Similar cases from other states and cities show that seriously troubled individuals are able to reclaim their weapons, despite serious concerns about the threat to public safety. “There is no common-sense middle ground to protect the public,” a law enforcement adviser in Ohio warned.

“Most mentally ill persons are not violent, though The Times’s analysis of 180 confiscation cases in Connecticut (dealing with people posing an imminent risk of injury to themselves or others) found that close to 40 percent of those cases involved people with serious mental illness. The common denominator in gun violence, however, is not deranged individuals; it is the easy access to assault rifles and other high-powered weapons afforded all Americans. A few determined states are attempting to deal with this issue, but real solutions must involve federal legislation and national standards, which are nowhere in sight.”

More at:

Shutting down mental health care

In recent days the news has been filled with reports of shutdown related injustices to families of fallen U.S. soldiers, patients in government cancer treatment programs, students reliant on federal aid. As Forbes Magazine reports, mental health care is also taking a hit.

“In the months leading up to World Mental Health Day, DC has been shaken by a series of violent events that ended with innocent lives lost and our country’s mental health services called into question. imgresDuring this same time period, Washington, DC has been consumed by a government shutdown, with lawmakers and policymakers trying to determine how to rein in our country’s financial burdens and overspending. Unfortunately, as federal and state governments look to cut budgets at every turn, mental and behavioral health services are often on the chopping block first. Financial cuts, compounded with US stigma often applied to mental health troubles and disparate access to services across the county, mean that those who need services most are often those left without proper care.

“August though October brought DC into the spotlight for many reasons, the saddest of which is the violence that was covered by mass media as two shootings occurred. In one case, Aaron Alexis, a 34-year-old, perpetrated a mass shooting that left 12 people dead, in Washington’s Navy Yard. Previous to the shooting, it was reported that Mr. Alexis was treated at the VA for mental health issues including sleep disorders and paranoia, but had not lost clearance.

“Miriam Carey, also 34, reportedly had an unhealthy obsession with the White House when she drove her car into the White House gates and led police on a chase around DC before being killed. Although she had no reported psychosis or supposed violent intent, it was noted in the months leading up to the incident she believed that the President had been stalking her and might have suffered from postpartum depression. When killed by authorities on Pennsylvania Avenue, she had her 18-month-old child in the car.”

“Although societal stigma and knowledge of where to access behavioral and mental services are often barriers to care, budget cuts continue to make seeking care more difficult. Whether this be through decreases in available services, lack of providers due to poor reimbursements or less preventative actions in communities, the impact of mental health funding shortages is great. According to the National Alliance on Mental Illness, “increasingly, emergency rooms, homeless shelters and jails are struggling with the effects of people falling through the cracks due to lack of needed mental health services and supports.” Continue reading “Shutting down mental health care”

White women live shorter lives in the south

Everything about Crystal’s life was ordinary, except for her death, begins a story in today’s American Prospect.images

“She is one of a demographic—white women who don’t graduate from high school—whose life expectancy has declined dramatically over the past 18 years. These women can now expect to die five years earlier than the generation before them. It is an unheard-of drop for a wealthy country in the age of modern medicine. Throughout history, technological and scientific innovation have put death off longer and longer, but the benefits of those advances have not been shared equally, especially across the race and class divides that characterize 21st–century America. Lack of access to education, medical care, good wages, and healthy food isn’t just leaving the worst-off Americans behind. It’s killing them.

“The journal Health Affairs reported the five-year drop in August. The article’s lead author, Jay Olshansky, who studies human longevity at the University of Illinois at Chicago, with a team of researchers looked at death rates for different groups from 1990 to 2008. White men without high-school diplomas had lost three years of life expectancy, but it was the decline for women like Crystal that made the study news. Previous studies had shown that the least-educated whites began dying younger in the 2000s, but only by about a year. Olshansky and his colleagues did something the other studies hadn’t: They isolated high-school dropouts and measured their outcomes instead of lumping them in with high-school graduates who did not go to college.

“The last time researchers found a change of this magnitude, Russian men had lost seven years after the fall of the Soviet Union, when they began drinking more and taking on other risky behaviors. Although women generally outlive men in the U.S., such a large decline in the average age of death, from almost 79 to a little more than 73, suggests that an increasing number of women are dying in their twenties, thirties, and forties. “We actually don’t know the exact reasons why it’s happened,” Olshansky says. “I wish we did.” Continue reading “White women live shorter lives in the south”

OK2TALK vs. mental health stigma

OK2TALK is a media campaign to reduce mental health stigma among teens and young adults.

A new survey from the National Association of Broadcasters (NAB) reveals that two-thirds of young adults have personal experience with mental health problems, states

“Although the overwhelming majority of parents and young adults are supportive of discussing mental illness more openly, more than one-fourth


of young adults (28 percent) and one in six parents (16 percent) admit they avoid talking about it.

“To encourage these critical conversations and let people know that help is available and effective, NAB today unveiled a new public service announcement (PSA) campaign featuring teens and young adults opening up about their experiences with mental illness. The “OK2TALK” campaign includes television and radio ads in English and Spanish, and uses social media to invite teens and young adults to create the conversation about mental health.

“With unrivaled reach into homes across America, broadcasters have a powerful platform to encourage young people to start talking about mental health and get the help they need,” said NAB President and CEO Gordon H. Smith. Smith’s own family has been profoundly affected by mental illness. His 22-year-old son, Garrett, took his own life in 2003, after a long struggle with depression. He and his wife, Sharon, hope that encouraging conversation about mental illness helps keep other families from meeting the same fate: “I believe that had we known better the signs of suicidal tendency, and sought help and treatment earlier for Garrett, our son would still be alive today.” Continue reading “OK2TALK vs. mental health stigma”

Smoking and the mentally ill

“The lives of people with serious mental illnesses are about 25 years shorter than the rest of the population, on average, and the main causes of early death are tobacco-related diseases.imgres-5

Patients in psychiatric hospitals who take part in smoking cessation programs during their stay are more likely to be smoke-free after 18 months, compared to patients who don’t participate in the programs, says a new study as reported by Reuters today.

“What’s more, researchers found that quitting smoking appeared to be safe for the patients and was tied to a decreased risk of being admitted back into the hospital.

“That’s a new finding and it needs to be replicated, but we’re excited that it didn’t cause any harm and may have supported their recovery,” said Judith Prochaska, the study’s lead author from the Stanford Prevention Research Center in California.

“Prochaska and her colleagues write in the American Journal of Public Health that it’s estimated people with mental illnesses use two to four times more tobacco than the general population. Most U.S. hospitals have been smoke-free since 1993, but at least half of hospital psychiatric units allow smoking and sell cigarettes, according to the researchers. “It used to be that people with mental illnesses had a waiver,” Dr. Steven Schroeder, the Distinguished Professor of Health and Health Care at the University of California, San Francisco (UCSF), told Reuters Health. Schroeder, who was not involved with the new research, said some people believed psychiatric inpatients were not ready or didn’t want to quit smoking and that giving up smoking might make their conditions worse. Continue reading “Smoking and the mentally ill”

The morning after bill

In a society driven by consuming, can shopping mania be an illness?images

For some people, overspending might mean ordering the lobster or splurging on an extra pair of shoes at Macy’s, reports YahooFinance.

“For Julie Fast it’s different. The Portland, Oregon, author woke up one day and decided to go on a trip to China. She obtained a visa, hopped on a flight, enrolled in language school and was conversing in Mandarin within weeks. Along the way, she blew through around $10,000. Shortly after that, and partly as a result of the impromptu and costly spree, she was diagnosed with bipolar disorder. Wild overspending often goes along with the manic highs that, when interspersed with depressing lows, characterize the disorder, which afflicts roughly 5.7 million Americans.

“When you have manias, that voice of caution is literally taken away. It is gone,” says Fast, 49, who co-wrote the book “Take Charge of Bipolar Disorder” and helped advise actress Claire Danes for her role as a federal agent afflicted with bipolar disorder on the popular TV series “Homeland.” One sufferer she knows impulsively spent $40,000 on a piece of art. Another bought an entire mini-mall – the whole building and the shops within it.”I have known people who have used up their whole 401(k)s, who have gambled it all away, who have taken their kids’ college money,” she said. At the time, “it feels so good that you don’t even worry or feel guilty.” Continue reading “The morning after bill”

That crazy time of year

Spring has sprung, at least for most of us, which means sundresses, seersucker and boozy croquet parties on the front lawn. Goodbye happy lamp, hello mimosa.

But it’s not just champagne that’s lifting our spirits and banishing the wintertime blues. According to (and a team of researchers from the University of Southern California, Harvard and Johns Hopkins) mental illnesses — such as obsessive compulsive disorder, depression and anorexia — are far more seasonal than we think.

“The epidemiologists, led by John Ayers, combed through every Google search performed in the United States and Australia between 2006 and 2010, looking for queries like “symptoms of” and “medications for” OCD, anxiety, ADHD, bipolar, depression, anorexia, bulimia and schizophrenia.images-2

“The Internet, the authors note in a study forthcoming in the American Journal of Preventive Medicine, is “the world’s most relied-on health resource. Because of mental health’s complexity, stigma, and obstacles to care, patients are likely to investigate their problems online.” At the same time, tracking a population’s longterm mental health indicators is difficult for epidemiologists; phone surveys are often unreliable — would you want to discuss the voices in your head with a complete stranger? — and cost prohibitive. Google queries, on the other hand, are nakedly honest and free to collect. Continue reading “That crazy time of year”

Banning smoking in psychiatric facilities

A few days ago, presented an item about the high prevalence of smoking among people with mental health diagnoses.

Now comes word that the problem has been exacerbated in psychiatric facilities that, unlike most hospitals, routinely tolerate or even encourage smoking. All that is about to change, as the New York Times reports:


“After decades in which smoking by people with mental illness was supported and even encouraged — a legacy that experts say is causing patients to die prematurely from smoking-related illnesses — Louisiana’s move reflects a growing effort by federal, state and other health officials to reverse course. But these efforts are hardly simple given the longstanding obstacles. Continue reading “Banning smoking in psychiatric facilities”

Smoking and mental illness linked

imgres-4People with mental illness are 70 percent more likely to smoke cigarettes than people without mental illness.

“New data from the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration show that one of every three adults with mental illness smokes, compared with one in five adults without mental illness,” reports today’s New York Times

“Adults with mental illness smoke about a third of all the cigarettes in the United States, and they smoke more cigarettes per month and are significantly less likely to quit than people without mental illness, the report said. There are nearly 46 million adults with mental illness in the United States, about a fifth of the population.

‘Many people with mental illness are at greater risk of dying early from smoking than of dying from their mental health conditions,’ said Dr. Thomas R. Frieden, director of the Centers for Disease Control, during a press briefing.

“The report is based on information from the National Survey on Drug Use and Health, which interviewed 138,000 adults in their homes from 2009 to 2011. Continue reading “Smoking and mental illness linked”

Horse sense

An American church is promising gay men they will be cured of their homosexuality if they stroke horses, reports a story today in GayStarNews.

“The Cowboy Church of Virginia, led by chief pastor Raymond Bell, believes homosexuality and other ‘addictions’ can be cured by Equine Assisted Psychotherapy.imgres-1

“Horse therapy, in the right hands, can be used to help overcome fears, develop communication skills, and is generally beneficial to mental health.
But Bell says the horses in his church, a cowboy ranch in the south, are part of teaching men to stop being gay and encourage them to be more masculine.‘EAP can help any person who is living the homosexual lifestyle or involved in it in anyway,’ he told Gay Star News.‘The first common misconception is that homosexuality is genetic, or hereditary, or as some say “born this way”. Continue reading “Horse sense”

“I am” Adam Lanza’s mother

The essay below was written by Lisa Long, not the actual mother of Adam Lanza, but a woman whose son has some of diagnoses attributed to the young man who committed the recent murders at the Sandy Hook Elementary School in Connecticut. The essay is about the complexities of living with and caring about a child whose behavior makes parental love a challenge.

“Three days before 20 year-old Adam Lanza killed his mother, then opened fire on a classroom full of Connecticut kindergartners, my 13-year old son Michael (name changed) missed his bus because he was wearing the wrong color pants.

“‘I can wear these pants,”’ he said, his tone increasingly belligerent, the black-hole pupils of his eyes swallowing the blue irises.

“‘They are navy blue,’ I told him. ‘Your school’s dress code says black or khaki pants only.’ Continue reading ““I am” Adam Lanza’s mother”

Now we can talk about mental illness

This doesn’t get talked about much, but the Affordable Care Act guarantees coverage for people with mental health problems – care that would have been eliminated if the republicans had their way. Psychiatric illnesses are surprisingly common, yet receive little attention because they are stigmatized, misunderstood, and definitely not especially photogenic.

Think about this:  20 percent of American adults suffer from a diagnosable mental illness. That’s more than 40 million potential voters. So when you think about it, things like depression, bi-polar disorder, PTSD,  or addiction are not issues that affect anonymous strangers. These conditions face many around us at work, school and  home, even though those who struggle with mental illness often do so in silence.

Not long ago the Los Angeles Times carried a piece entitled “Mental health care at stake in 2012 vote.” It said that “Just to provide a little context, according to the American Cancer Society’s latest numbers, about 12 million Americans are living with some form of cancer; 400,000 Continue reading “Now we can talk about mental illness”