This first full week in
October is being
celebrated as Mental Illness Awareness Week (MIAW). The holiday doesn’t
even exist. More about that later.
But in celebration of this
mythical event, well meaning mental health advocates are busy hosting events to
reduce the “stigma” of mental illness.
Stop. Stop right now. Hold
it. Here’s another reality check: There is no ‘stigma’ to having a mental
illness. There is ‘discrimination’, but that’s another story.
Serious mental illnesses are
real biologically based disorders that are no ones fault. Serious mental
illness is not, “a mark of shame or discredit”, or “a mark or token of infamy
or disgrace”. There’s no stigma to
being mentally ill the same way there is no stigma to being “black”, “gay”, “short”,
”tall”, “lefty”, “righty”, inny, or outy.
There is discrimination. As J. Rock Johnson, a former board member of a
major mental health organization once said, “the most stigmatizing thing we do
is talk about stigma”
The efforts to reduce this
non-existant stigma are harmful because they are designed to work by diverting
attention away from those who need our help the most: the most seriously
The anti-stigma campaigns are
premised on the belief that the key to reducing ‘stigma’ is to convince the
public that “the mentally ill are just like you and me” and “with proper supports can become
productive members of society”.
Those two facts are true, if
you’re talking about the high functioning “worried-well”--the 25% of Americans
who have a “diagnosable mental disorder”. But, hey, who doesn’t?
But what about the others?
The effect of Mental Illness Awareness Week is to divert attention away from the 3%-5% of Americans who are the most
seriously mentally ill--like those suffering from schizophrenia or
treatment-resistant bipolar disorder, the very mentally ill people who are not
“like you and me” and need our help the most.
MIAW intentionally diverts
attention from those who as a result of their untreated illness are homeless
psychotic, eating out of garbage cans, sleeping in cardboard homes, and living
with festering wounds under layer after layer of filthy clothes. Done that lately?
The anti ‘stigma’ campaigns
intentionally divert our attention from the mentally ill who are in jail or due
to lack of treatment are likely to become violent. The advocates attack the
media for reporting on violence, and go through mathematical contortions to “prove”
“the mentally ill are just like you and me”.
Trying to gain sympathy for
mental illness, by only displaying the highest functioning individuals, is like
trying to end hunger by showing the well-fed.
This effort to divert
attention away from the seriously ill and towards the worried-well may be well
intentioned, but it is definitely harmful. It leads to the term “mental
illness’ losing all its meaning. And with no meaning, federal and state
agencies can dilute their efforts and spend money on any project they want.
Rather than provide services
that would make people with mental illness more welcome in the community, the
Substance Abuse and Mental Health Services Agency (SAMHSA) funds ‘anti-stigma’ efforts to change the people
in the community. Say what?
Everything is fair game for
funding if it can be even tangentially connected to mental anything. Funding goes to the “worried-well”
leaving the seriously ill to fend for themselves. The government can even divert
their money to funding, say, PSAs that say, “the mentally ill are just like you
Diverting attention from the
severely mentally ill also diverts the public from addressing the policy
initiatives that can help the seriously ill: like ending health care discrimination
discrimination against the seriously mentally ill, saving
state hospitals, and finding a cure. It
leads to reports by the Surgeon General and President’s Commission on mental “health” that virtually ignore the mentally “ill”.
E. Fuller Torrey of the Treatment
Advocacy Center, and the nations leading mental illness researcher and
advocate has a solution. He suggests that any government mental health program
that doesn’t use at least 50% of the money for the seriously mentally ill
should lose it’s funding. My own solution is a federal definition of “serious
mental illness” that would force federal programs purporting to serve the
seriously mentally ill population to serve that population instead of serving
people “just like you and me”.
How bad is it? Mental Illness
Awareness Week does not even officially exist anymore. Congress first declared
it in 1989 at the strong urging of the National Alliance on Mental
Illness, which still celebrates it.
(Who needs Congress anyway?) It was re-enacted in1990, 1991, 1992 and 1993. But
since then, no one in Congress has had enough interest in the seriously
mentally ill to keep it going.
However even though Mental Illness Awareness Week bit the official dust, stigma groupies will be happy to know Mental Health
Awareness Month (May) is
coming on strong.
So here’s an idea. This week,
while everyone else is celebrating the non-existent MIAW by working to divert
your attention to the “worried-well”, let’s think what we can do for those so
seriously ill, so imprisoned, impoverished and punished by their psychosis,
they are not at all “like you and me”--the 150,000
mentally who are homeless, the
231,000 who are incarcerated due to acting out when untreated, the 5,000
who took their lives this past year, the 70,000
in state psychiatric hospitals, and the 28% who get food from garbage cans.
They don’t deserve to be
ignored. Least of all by those who say they want to help.
10/5/2010: Authors Note:: A paragraph criticizing NIMH for not focusing resources on the most seriously ill was deleted today because it was based on old research. The current Director of NIMH, Dr. Thomas Insel has done a better job than his predecessors in focusing NIMH Research on the most serious disorders.