This fear stems from concern that others will react negatively to their
disorder. Freedom From Fear, a national advocacy group based in New York
affiliated with Columbia University's department of psychiatry, conducted
a survey to determine how stigma adversely affects people with mental illness;
Table 7-16 summarizes the findings of this report. As a result of the negative
impacts associated with having a mental illness, it is reported that many
people suffer in silence (Behavioral Health News, 2000, July 5).
The recent Surgeon General's Report on Mental Health outlines the explanation
for the "roots of stigma" in part from the historical perspective that separates
the mind and body first introduced by Descartes and the 19th century separation
of mental health treatment in the United States from mainstream health. This
genesis has led to manifestations of "bias, distrust, stereotyping, fear,
embarrassment, anger, and/or avoidance" (USDHHS, 1999, p. 6). Stigma impacts
our society by reducing opportunities for those seeking access to services
and obtaining resources. It also leads to decreased self-esteem, isolation
from family, friends, and society as a whole, deters the public from seeking
and wanting to pay for care. It results in discrimination and various forms
of abuse, and one of the most obvious results is the deprivation of dignity
and the denial of participation in society (USDHHS, 1999, p. 6). It is
reported that nearly two-thirds of all people diagnosed with a mental disorder
do
not seek treatment (USDHHS, 1999, p. 8).
The National Mental Health Association conducted a telephone survey of 3,288
adults earlier this year. Many persons experiencing symptoms of clinical
depression or generalized anxiety disorder report turning first to their
primary care physician for diagnosis. Forty-two percent of patients diagnosed
with clinical depression were first diagnosed by their primary care physician.
Thirty-four percent were diagnosed by a psychiatrist. Among those diagnosed
with general anxiety disorder, 47% were first diagnosed by their primary
care physician and 31% were diagnosed by a psychiatrist (NMHA).
Some research finds that in the African-American community, there may
even more stigma related to mental illness. Dr. Paul Organ a child and
adolescent
psychiatrist in Atlanta, Georgia, explains that there is a concern or "distrust" of
the "medical community." This concern is the basis of stigma that results
in fewer African-American's seeking treatment (Candon, 1999, December 15).
New research has found that there are two major reasons for public misconceptions
related to mental illness. First there is a "lack of education and reliance
on stereotypes. Second, current media and popular culture (movies, television,
cartoons, etc.) often "depict people with mental illness as incompetent,
weak and potentially dangerous" (Behavioral Health News, 2000, July). The
Surgeon General's Report on Mental Health cites that "selective media reporting
reinforced the public's stereotypes linking violence and mental illness
and encourage people to distance themselves from those with mental disorders.
In reality, the report found that mental disorders play a very small part
in the overall level of violence in society (USDHHS, 1999, p. 7).
The Surgeon General's Report on Mental Health recommends taking action to
dismantle the barriers that deter people from seeking treatment for mental
illness. Specific to stigma in Travis County, it is recommended that the
community dispel myths about mental illness, provide accurate information
to consumers and the community, and resolve to no longer tolerate stigma
(USDHHS, 1999, pp. 453-454).
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Forum on Mind and Body Health
On May 15, 2000, "A Regional Communities Forum on Mind and Body Health" was
held in search of "Finding Collaborative Strategic Advantage." Over 120
people including community leaders, service providers, educators, and consumers
of services from a myriad of organizations came together to discuss various
issues. One of the issues discussed were the barriers experienced in our
community surrounding Adult Mental Health. Several key concerns or barriers
were identified:
- Access
- Safe and affordable housing
- Employment with adequate compensation
- Achieving mental health in the daily life
- Consumer input
- Stigma
- Health insurance for the working poor
- Fragmented and inconsistent system
- Awareness of the availability of service
- Individual coping skills and strategies
- Denial and isolation
- Identification of problems and linkage to crisis resources
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Texas Department of Mental Health
Mental Retardation
The Texas Department of Mental Health Mental Retardation's Strategic Plan
(2000) identifies Critical Issues for the Future of Mental Health and Mental
Retardation Services in Texas. The following mental health related issues
are being developed in a Legislative Appropriations Request for the 2002-2003
biennium (Strategic Plan, 2000-2005).
- Need additional funds to address cost of providing services to persons
with mental illness.
- Need for additional support services (supported housing, supported
employment, and assertive community treatment) due to the success of
these support
services and new generation medications that have "significantly reduced
the need for hospitalizations."
- Need additional funds for flexible service dollars to divert individuals
who are at high risk for criminal justice involvement due to the
symptoms of their mental illness.
- Need additional funds for development of an integrated outreach program
through education, training, and other forums.
- Need additional funds for rehabilitative services and service coordination
to cover increasing provider costs necessary to maintain existing
service base.
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National Alliance for the Mentally Ill
NAMI lists several barriers that impact persons with mental illness. These
barriers assist in creating disparities; decreasing access to services; impeding
wellness and prevention; and when mental illness is inadequately treated,
can lead to substance abuse and/or death (NAMI, Omnibus Mental Illness).
- Insurance Discrimination
- Restricted Access to New Generation Medications
- Poor Quality of Care
- Criminalization
- Homelessness
- Work Disincentives
- Poverty
- Suicide Due to the barriers related to mental illness, NAMI advocates
for the Omnibus Mental Illness Recovery Act and has proposed a model
system of care (see Best Practices - NAMI, Omnibus Mental Illness).
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