The Stigma of Mental Illness

By Overton, Stacy L.; Medina, Sondra L. | Journal of Counseling and Development : JCD, Spring 2008 | Go to article overview

The Stigma of Mental Illness


Overton, Stacy L., Medina, Sondra L., Journal of Counseling and Development : JCD


"People suffering from mental illness and other mental health problems are among the most stigmatized, discriminated against, marginalized, disadvantaged and vulnerable members of our society" (Johnstone, 2001, p. 201). Negative connotations and false assumptions connected with mental illness may be as harmful as the disease itself. Schizophrenia may evoke visions of violence and inability to care for oneself. Depression may conjure thoughts of laziness and substance abuse. Societal stigma significantly limits opportunities that are available for people with serious mental illnesses (Johnstone, 2001). In 1999, the Surgeon General's report pointed to stigma as a key variable in understanding the course of illness and outcomes for people who have been given a psychiatric diagnoses (Corrigan, Green, Lundin, Kubiak, & Penn, 2001). In this article, we first review the definitions of mental illness and stigma and then review the literature about the theories of stigma and the impact that stigma has on people with mental illnesses. Using current research as our basis, we suggest ways that counselors can work to mitigate the stigma of mental illness. We conclude with suggestions for dispelling the stigmatizing beliefs that counselors hold.

* Defining Mental Illness and Stigma

Concepts about mental illness can be subjective, and it can be difficult to define. One of the definitions listed for mental illness in the Merriam-Webster Dictionary (1990) is "mentally disordered, mad, or crazy" (p. 506). During the Middle Ages, people with mental illness were considered to be living examples of the weakness of humankind. The common belief was that mental illness was a result of being unable to remain morally strong. People with mental illnesses were jailed as criminals and, on some occasions, put to death (Corrigan, 2002). In 1974, Thomas Szasz wrote about the "myth" of mental illness. He stated that physicians used anatomical and pathological methods to help identify physical illness. There was proof that these illnesses existed because of how they altered the physical body. Szasz's belief was that medical illnesses were being discovered, whereas psychiatric illnesses were being invented. According to Szasz, psychiatrists were inventing diseases based on groups of common symptoms. Most of the symptoms that accompany mental illness are invisible, leading people who experience these symptoms to doubt their reality and to experience isolation within that reality (Glass, 1989).

A broader and more current definition of mental illness refers to the spectrum of cognitions, emotions, and behaviors that interfere with interpersonal relationships as well as functions required for work, at home, and in school (Johnstone, 2001). This definition takes into account a myriad of different functions and how they affect a person's ability to perform the tasks necessary for daily living. This definition is also present in the current psychiatric diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994). Most of the diagnostic categories take into consideration the degree to which the symptoms of a mental illness impede a person's daily functioning when identifying the severity of the diagnosis. With this definition as a criterion, Hardcastle and Hardcastle (2003) found that 30% of all general practitioner consultations involved a mental illness. They also reported that one in four people has a mental illness at some time in her or his life.

As is the case with major mental illness, stigma is also a difficult concept to define. Historically, stigma comes from the Greek word stigmata, which refers to "a mark of shame or discredit; a stain, or an identifying mark or characteristic" (Merriam-Webster Dictionary, 1990, p. 506). Stigma, when it is used in reference to mental illness, is a multifaceted construct that involves feelings, attitudes, and behaviors (Penn & Martin, 1998). …

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