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The term “stigma” comes from the ancient Greek verb stizo, which literally means “to carve by night”, “to cause a mark with an incandescent seal for shame or punishment”, “to carve the skin as a mark of dishonor”.
In ancient Greece the stigmata was a mark carved or impressed by burning on slaves, criminals and traitors, used to underline their social inferiority or to show them as “morally inferior”.
Regarding mental illness, stigma is when someone is marked or discredited somehow, or reduced from being a whole person to being a stereotype or labelled as a collection of symptoms or a diagnosis (for example: “psychotic”).
The concept of stigma has been applied to mental illness through decades, with differences among societies, when people begun to see mentally ill people as supernatural creatures, with terrible consequences on them.
Below, the historical backgrounds that brought mental illness to be stigmatized will be presented, considering the misconceptions that have existed (and still now exist) about the concept of mental illness.
Some examples of misconceptions date back to preliterate societies, in which it was believed that mentally ill people were provided with supernatural powers, such as the power of healing or clairvoyance. In this case, the belief was not actually negative, but it could have had a positive connotation.
On the other hand, the concept of mental illness as an abnormal and negative condition can be found during the Middle Ages in Europe, where mental patients were accused of being possessed by demons or evil spirits. As a matter of fact, cruel physical punishments were involved to expel these evil spirits, in addition to isolation to imprison the “possessor”.
Probably these traditional beliefs are responsible for the fear with which mental illness is approached.
Even in modern society, where physiological causes are better known and prejudices are fought, they still exist.
At this point, three misconceptions about mental illness will be presented.
One of the most common myths is that mental illness is an illusion, that is “all in mind”, taking depression as an example. Since depression is associated with sadness, tiredness, and lack of motivation, which can be all considered as normal feelings in everyday life, it’s sometimes difficult to distinguish between natural reactions that occur during life and symptoms of clinical depression. In fact, it is believed that if you can’t recover from mental illness, you aren’t working hard enough.
As a result, patients who suffer from depression and seek for treatment are often considered “weak” or “lazy”. They are expected to control their own illness and to stop feeling depressed. Actually, seeking treatment for mental illness is one of the hardest things that can be done, especially when the voice of the mental illness is saying you shouldn’t.
A second myth is that people who suffer from mental illness are very dangerous and violent. In fact, sensational newspapers headlines perpetuate negative stereotypes of mental illness by linking it with violence, aggression, crime and death. In reality, violence related to mental disorders is very rare and linked to severe psychosis, when an individual loses touch with reality. In fact, according to research, the most common causes of violence are alcohol, drug and abuse, followed a long way behind schizophrenia and depression.
Linked with the previous myth, the last misconception is that mentally ill people are out of touch with reality. Although, this condition represents just a small number of symptoms, such as the ones belonging to schizophrenia, a disorder that may result in illusions, hallucinations, and unreasonable beliefs. In fact, most people with mental illness (including depression, anxiety, phobias, and bipolar disorder), are absolutely in touch with reality.
It is interesting to know how these popular myths are perpetuated in modern society. Asch’s experiments in conformity explain how individuals’ attitudes are influenced by group opinions. Media (including films) is an example of this since it has a powerful influence on popular views and is often responsible for propagating negative stereotypes.
The press is another field of the media which encourages the public to continue believing in stereotypes of mental disorders. As mentioned before, newspapers daily link violent crime with mental illness, and more specifically, use terminology related to mental illness to reinforce negative images.
But how does stigma and self-stigma affect mentally ill people?
Each person with a mental illness is different and, as a matter of fact, may experience the manifestation of the illness in a different way. However, stigmatization and marginalization can affect the perception of a large part of the population.
According to Zen et al., the person with a mental illness is considered part of the “group of those who are ill”, who have the same characteristics and needs and are unable to shake off the stability of their situation, permanently. For these reasons, the stigma of mental illness has been characterized as an additional illness, with similar or even heavier consequences adding to the illness itself.
How can the stigma be reduced?
When negative stereotypes come up in conversations or in the media, people can actively dispel myths and educate others against harmful, inaccurate stereotyping, also speaking up when hearing people making inappropriate comments about mental illness.
Being mindful about the words used when describing someone, avoiding insensitive and hurtful words, and terms which define a person by their condition.
As well, people who are mentally ill must continue getting treatment with no shame, trying not to take it personally and defending, as much as possible, misinformation.
In conclusion, it can be stated that, despite advantages in psychiatric diagnosis and treatment, mental illness is still widely misunderstood. Negative stereotypes, encouraged by media, persist in modern society, and mentally ill people are commonly perceived as weak, violent, delusional, dangerous, criminal, and frighteningly unpredictable. However, there is hope that this stigmatization can be reduced, so that our society will stop misunderstanding and start comprehending their reality.
By Lisa Nespoli
M. Oikonomou, A. Behraki, M. Charitsi, The stigma of mental illness: Historical review and theoretical framing, Psychiatry 2020, 31:36–46.
Medical News Today, Medically reviewed by Taisha Caldwell-Harvey, PhD — By Lois Zoppi on November 9, 2020.
NAMI, National alliance of mental illness, 4301 Wilson Bvld, Suite 300 Arlington, VA, 22203.
Perrin, S. and Specier, C.P., (1981). Independence or conformity in the Asch experiment as a reflection of cultural and situational factors. British Journal of Social Psychology, 20(3), 205-210.
Pescosolido, B.A., Monahan, J., Link, B.G., et al. (1999). The public’s view of the competence, dangerousness, and need for legal coercion of persons with mental health problems. American Jouranl of Public Health, 89, 1339-1345.
SANE Australia (The SANE guide to reducing stigma), National Mental Health Commission (Strengthening community understanding), BeyondBlue (Stigma and discrimination associated with depression and anxiety), Healthy WA (Stigma?), Mental Health Council of Australia (Consumer and carer experiences of stigma from mental health and other health professionals), Queensland Government (Understanding mental health), SANE Australia (Legal rights and responsibilities)
Zen G, Lepri B, Ricci E, Lanz O. Space speaks: towards socially and personality aware visual surveillance. Paper pre sented at 1st ACM International Workshop on Multimodal Pervasive Video Analysis (MPVA 2010), 29 October 2010. Florence, MPVA’10 Proceedings of the 2010 ACM Workshop on Multimodal Pervasive Video Analysis, pp. 37–42.