Why Dignity Is Our Destination

One of the paintings in 'Untitled, Undated & Unsigned. The Work of Carolyn Anne Watts' on display at Chase Brexton on March 3
One of the paintings in 'Untitled, Undated & Unsigned. The Work of Carolyn Anne Watts' on display at Chase Brexton on March 3, 2015 in Baltimore, Md. Watts took her life in 2010 after suffering years from depression. After her death the family discovered the body of work. Her sister, Cheryl Maxwel, is displaying Watts' work to help raise mental health awareness. (Kim Hairston/Baltimore Sun/TNS via Getty Images)

As the counterpoint to pervasive stigma, discrimination and civil rights restrictions experienced by people with mental health conditions, and the broad range of negative or marginal supports from their communities worldwide, "Dignity" has become the rallying cry for change in mental health services and public perception, domestically and internationally.

Today, Monday August 24, 2015, a historic moment will occur in Washington when, for the first time ever, people living with mental health conditions will lead supporters and dozens of diverse organizations to raise public awareness of the need for change for the millions of Americans impacted by mental illnesses under the banner of "Dignity" for mental health.

The first national Destination Dignity Mental Health March on Washington will be convened at 12 noon with a rally including national leadership from dozens of organizations. Organized by the grassroots Destination Dignity Coalition, the event is being led by people who live with mental health conditions and their supporters to create a "tipping point moment" for progress.

Why do we focus on dignity? Because people everywhere, faced with pain and problems face awful personal dilemma around disclosure, discrimination and shame, including often the restriction of their basic human rights. Because there are not enough positive resources for support when someone feels desperate, even considering suicide. Because in some settings yet, supports and services can feel more like punishment than care.

Dignity is every human's birthright, one value that can cut across all cultures and situations. All too often, those of us with mental health challenges have experienced their dignity being taken , though, by stigma and discrimination, forceful, demeaning and negative treatment, by silencing and shame.

Many millions of Americans, up to 25 percent of the entire population on any given day, live with mental health conditions or psychological distress. Despite often debilitating challenges, the vast majority live successful lives, contribute to their families and communities, and serve crucial roles in every domain and professional field.

Yet people who live with mental health challenges, mental illness symptoms and psychiatric disabilities remain the most stigmatized group of people in many cultures, facing demonizing portrayals in the media, prejudice, ridicule, and shame. Millions of people have reasons to legitimately fear talking about their challenges or reaching out for support in their most difficult moments. In this culture of systematic discrimination in health, education and career, harsh treatment and coercive interactions that are all too often experienced as punishment rather than treatment, over a 40,000 people trapped by isolation and despair die each year by suicide.

Recovery happens. It is happening.

From even the most intensely debilitating psychiatric conditions and trauma people recover lives of meaning and value all over the world. Around us every day and across the world people face their challenges, endure incredible pain and difficulty and still contribute as valuable members of their communities. Recovery with a mental health condition does not mean that people do not continue to experience ill-health, recurring or even persistent symptoms. Even where people are significantly disabled by symptoms for some time, most recover lives that are fulfilling to themselves as well.

But recovery from mental health and substance use conditions is not like recovery from a broken leg or a flu. The mind is subject to the social and personal environment in many ways that can amplify vulnerability and distress on the one hand, or maximize resilience, hope, focus and personal resilience on the other. Even with the best therapeutic services, negative messages that can affect people are everywhere, and for some, can make a difference between a life of hope or one that ends in despair, isolation and suicide.

Recovery thrives in an environment of dignity and respect. And while there are many things that we cannot change about our health systems, governments and mental illness prevalence, everyone can make a difference in creating cultures of dignity that maximize the chances for people to recovery.

One of the reasons the Dignity Mental Health March has attracted so much support in such a short time is because people with experience on both sides of mental health issues realize that stigma surrounding it really is the big issue.

Leaders, advocates, service consumers, researchers, clinicians, even policy makers who have been working in mental health over the years have come to this realization. Sitting back from our work in services, evaluating our efforts in policy change and public health, examining the origins of stubborn barriers to what we know as obvious, indicated and crucial, we come to recognize, as U.S. Surgeon General David Satcher stated over 15 years ago, that "stigma is the most formidable obstacle to progress in the arena of mental health."

We realize that the economics of service funding, the systemic rates of disability and unemployment, the lack of health sector engagement, the very history of treatment of people with mental health conditions, is grounded in biased views, misinformation, shame and fear. We see that stigmatizing views, and the actions that arise out of them, have led us to expect less than we should of our health systems and providers, our educational and legal institutions, our communities and ourselves.

What is worst, this set of pernicious false ideas, has fostered a world in which we believe, as so many of us affected by mental health conditions are often told, that we should not expect too much. That we should accept mockery and poverty as inevitable, suicide and despair as something to be expected.

Status quo assumptions about what is possible have worked for centuries against the health, human dignity, and recovery of people experiencing mental ill-health. Service in public safety net and elsewhere have been built upon this cynical thinking. The resulting legacy is systems in which the only way to get help is to be considered too sick to ask for it. Services which involuntary commitment or suicidal crisis are requirements for access, institutions in which dehumanization is constantly reinforced, societies in which unjustifiable levels of unemployment and disability are seen as givens, in which restraints, abuse, denial of human rights and even death are acceptable.

Changing this dynamic, raising the bar of positive expectations for recovery for Ameica's people, our systems and our communities, is not easy. Shifting institutional practices from containment to support, erasing the real discriminatory issues that keeps people in fear for their livelihood, families and futures are neither not simple. Changing minds and communities to environments in which recovery has its best chance is not cheap. It is not quick.

But it can be done. It must be done.

And this is the crucial part, for the change to be real and lasting, it must be done in public. It must be done by people coming out publicly to defy prejudice and low expectations, to show our strength and voice, to claim their dignity.

The single thing that best disconfirms prejudiced views and bias about people with mental health conditions is when people see that we are them. That we are successful important valuable members of our families, communities and businesses. That we are everywhere.

That is why we are asking Americans today, the millions of us out there who experience mental illness, who live in recovery, who have had to live in fear of discrimination, to come out of the shadows of shame and stigma. To join the movement for dignity.

By calling on the millions out there who live in silence to join their voices and "Come Out for Dignity" we are announcing that we will no longer let cultures of fear diminish our dignity, or keep us and those we love silent. We will stand together against dehumanization and discrimination. We will demand change that can make us and our country healthier forever.

Working together, with people in recovery out in front as the living messengers of hope and recovery, we can reclaim mental health from stigma. We can raise dignity from a concept to a working principle for all affected, in every system that touches us.

We can create a world where everyone affected by mental health conditions has the best chance possible to succeed and recover free from fear and isolation. In this new world of dignity communities will not just support people faced with mental health conditions, but value their strength, resilience and hope as essential.

It is a long way to our Destination Dignity. But we are on the road already. And joining together we will get there.


Eduardo Vega is President and Chief Executive Officer of the Mental Health Association of San Francisco, and Director of the Center for Dignity, Recovery and Empowerment, collaborating partners of the Destination Dignity! DestinationDignity.org