COVER LETTER
Before beginning to write this essay, I found myself pretty excited with the fact that I was able to choose my own topic. And I felt like I chose an interesting one as it can someday relate to anyone who reads it. However, as I began writing it and doing my research, I felt a little overwhelmed with all the information I wanted to include in the final essay, which I consider it to be normal since it is a new project for me to write an essay of this length and type. As I continued writing I was able to narrow it down more and more. I still found myself wanting to make a lot of changes to it since it was a bit freer than the first essay, but I tried my best to keep it focused on one topic. As I was writing I also found it difficult to keep all my information relevant to my research problem, which is something that I struggle with at times. But I feel like doing this essay was a good way to keep myself focused instead of simply throwing in all the information I can find just because I find it interesting. I feel like I still could have made my essay a bit more organized and focused with my information, but overall I consider it to be pretty clear and to be coherent and cohesive for the most part. One thing I had a lot of difficulty with was creating a conversation between my sources since most of them agreed on the same things. Some had more information that I was able to use on different parts of the essay, but they all ultimately agreed on the point of my essay. Overall, I found this essay a very interesting one since I felt comfortable with the topic I was writing and I felt like I had to step out of my comfort zone in order to follow the guidelines and make it more focused and structured.
Amanda N. Bonet
04/02/17
ENG 2150
Prof. Martin
The Hidden Burdens of Stigma
Stigma. A word that can be defined as, “a mark of disgrace associated with a particular circumstance, quality, or perjson.” Society nowadays has many stigmas regarding disabilities, sexual orientation, values, wealth, level of education, amongst others. However, a strong part of society that suffers from stigmas, often going unnoticed or unattended, are the mentally ill. Stigma does not only produce shame in the individuals suffering from it, it also decreases their chances of better life opportunities due to diminished job offerings, distorted image of oneself, and lack of social contact with those around them (Yang) Although the stigma of mental illnesses has gone through many changes throughout history, it is still very much present in society and many suffer from it on a day to day basis, often due to the lack of available medical treatments for these type of diseases.
Yet many, especially those individuals who are not directly affected by these mental illnesses, do not realize how stigma is still present in the society we live in. An interesting way of assessing the level of stigma prevailing in our society can be understood by an example posed by Jeffrey Lieberman, professor and Chair of Psychiatry at Columbia University, in a video titled “Imagine There Was No Stigma to Mental Illness.” He asks the audience to imagine that they were invited to their boss’ 50th birthday party and that they were selected to give the toast. But, on the day of the event, they get sick and have to call to excuse themselves. He then asks, “Would you prefer to say that you couldn’t come because you had a kidney stone or that you were depressed and suicidal?” Even though it is a hypothetical example, chances are we would not choose the second option over the first one because we unconsciously do know the prejudices that follow behind openly saying you suffer from a mental disorder. Many people might see it as something that is not too serious since it is not something they believe affects people physically, such as heart disease or cancer, or because they associate it as a mood rather than an actual illness. And although it has been proven scientifically that mental illness are quite serious and have many negative effects, both mentally and physically, society still has many stigmas about them, often degrading their level of severity.
According to the National Alliance of Mental Health, 1 in 5 adults in America experience a mental illness, which is as many as 43.8 million people. By being aware of the great amount of people that suffer from mental illnesses annually, some might wonder why is it that these people still have stigmas attached to them. Stigmas that have been going on for centuries, even though information about these illnesses has become easily accessible due to the advances in technology and the efforts of the people that suffer from them, as well as professionals in the field, to bring awareness to them and their effects. Perhaps it is because we are conditioned to categorize these illnesses as “crazy” or “weird”, or because those who do not suffer from them do not realize, and too often do not care, the impact they can have on an individual’s life, and even on society as a whole. Whatever the reason may be, there is no doubt that these stigmas are a contributing factor to the limits in the quantity and quality of treatments for the mentally ill, which further intensifies the prejudices associated with their illnesses. Thus, why is it that society fails to put a stop to this cycle? Why are there so many preconceptions about the mentally ill yet, paradoxically, the limited mental health treatments available force them to continue suffering from the uncontrollable symptoms caused by their diseases?
Those who suffer from mental illnesses often suffer from the consequences of stigma in the workplace. As Thomas G. Plante tells us in his book The Cost of Mental Illness, many employer health programs restricted therapy sessions to around 20 per year until the Mental Health Parity and Addiction Equity Act eliminated the restriction in 2010. Unfortunately, there still isn’t much of a difference since many health insurances continue to cover just a small part of a therapy session. Because of this, many of these patients that chose to seek help for their illnesses usually opt for the most affordable option: medication. Although measuring the effectiveness of psychotherapy is a difficult task that varies from person to person, psychiatrists and psychologists believe that the best way to overcome or reduce symptoms of mental illnesses is through a combination of psychotherapy and medication(Yang) Thus, patients who opt for just medication might have a harder time dealing with their illnesses as they might show improvement short-term but they are more prone to relapse, ultimately continuing to affect their work performance and even costing them their jobs. Although many of those who suffer from illnesses such as depression and anxiety are able to carry out their daily activities, in comparison to those who suffer from chronic illnesses such as schizophrenia, for example, it has been proven that they function at lower levels of productivity, a phenomenon that has been called presenteeism by social scientists(Rampell). Not only does this affect their employers, it also affects their chances of maintaining their jobs and their quality of life.
Now, although the workplace is a noticeable place to see the negative consequences stigma has had on the mentally ill, it is definitely not the first they encounter them in their lives. According to Plante, it is estimated that about four million children and adolescents suffer from a severe mental disorder or illness, yet only 20% are identified and treated for such. We see that even from a young age, a great number of people begin to experience symptoms of illnesses that often go untreated in the future due to stigma. Children and adolescents suffering from mental illnesses often go through many hardships in school or wherever they are surrounded by others their age since, from their early stages, children already begin to view these illnesses with negative beliefs and ideas(Plante). This has negative effects on an individual short-term, and even worse long-term as it can ultimately lead to a decreased quality of life in the future since many end up dropping out of school, earning lower grades, becoming isolated from society, or losing their jobs.
Letting mental illnesses go untreated from an early age, as mentioned above, can also lead these individuals to prison, which is another place where the lack of treatment for mental disorders has had a terribly negative effect, so much for youth and for adults. In youth, for example, many of those who have a severe mental illness begin to show signs of aggressive and/or reckless behavior from a young age, which can lead to a life of constant incarceration if left untreated. It also causes the victim to not have access to effective mental health treatments as the majority of these facilities are not equipped with the proper services. For adults it also has similar effect as many of them have had little to no access to treatments throughout their lives, have disregarded their symptoms, and/or have engaged in violent behavior as a result of their disorders. Although these effects have a negative impact on the ones who are mentally ill, it also poses a threat to those around them as these individuals might not be able to control their thoughts or behaviors, causing them to do harm to others. According to the National Center for Mental Health and Juvenile Justice, as much as 70% of youth in the juvenile system have at least one psychiatric disorder. This high percentage is a concerning one as it goes to show the often misunderstood relationship between the mentally ill and their aggressive and/or careless behavior. Another report done by the Public Citizen’s Health Research Group and The Treatment Advocacy Center found that, among 39 states, 95.7% of jails reported having inmates with serious mental illnesses, especially on larger facilities.
Many of the false beliefs about mental illnesses that are common nowadays in our society have come from society itself through the media. Studies have proven that mass media is one of the main sources where people acquire information about mental disorders such as bipolar, depression, and schizophrenia. Meanwhile, studies also suggest that the portrayal of the mentally ill in the media is one of the most flawed as they often view them negatively and based on unrealistic stereotypes(Fawcett). The media often portrays the mentally ill with an inaccurate picture, inducing fear and discrimination against them and even shame and embarrassment on the mentally ill themselves. Some of the common myths conveyed through the mass media are that people with mental disorders are violent, they have a poor appearance, and that they do not get better(Fawcett). For example, according to professor Don Diefenbach from the University of North Carolina, who researches media portrayal of mental health issues, found that those characters who were labeled as mentally ill were 10 times more likely to commit a violent crime compared to other characters, and about 10 to 20 times more likely to commit a violent crime compared to someone who is mentally ill in real life. When it comes to the myth that the mentally ill do not get better, movies and TV shows often show characters that suffer from mental disorders and engage in self destructive behaviors or suffer from the consequences of them, yet they rarely show they seeking help. And if they do, they do not rarely show them genuinely getting better and living a normal life. These false ideas spread by the media further intensify the stigma of these illnesses and diminishes the actual severity of them, causing society to continue to view these diseases as, in a way, something that is not worth investing money in or something that is to be ashamed of.
It is not only in places such as work, school, and penal institutions that stigma plays such a big role, it is also experienced by the individuals themselves in a very personal way. Many of those suffering from mental disorders or illnesses will refuse to seek help; not necessarily due to the very high costs of treatments, but sometimes due to the false beliefs that are attached to the mentally ill, especially to those who openly seek treatment. These individuals often fear the rejection, prejudices, and discrimination that comes with letting others know they suffer from a mental health disorder, furthering the tendency of not seeking treatment at all. These pre conceived notions also have a serious effect on an individual’s quality of life as they might experience lower self-esteem, difficulty socializing with other and/or maintaining relationships, feelings of shame and embarrassment, they suffer from more health conditions, amongst other factors.
It is no doubt that funding mental health services has a very significant cost for the federal government, which might be the reason behind the limited funding available to treat mental illnesses. However, there is evidence suggesting that actually spending on those services now is an investment as it will save millions in the future. Untreated mental disorders and illnesses are costing approximately $113 billion to American business, taxpayers, and the government on an annual basis(Plante). People with untreated mental disorders are more likely to miss work due to their illness, to quit their job, and/or be less productive than their counterparts, which costs companies millions of dollars every year. According to the National Mental Health Association, mental illness costs as much as $105 billion in lost of productivity. Thus, why is it that funding for mental health services continues to be cut so often? A study published in 2007 in The Journal of the American Medical Association helps to demonstrate how investing in these services can have a positive long-term impact on employers as well as those who are mentally ill. In this study, a number of depressed employees were enrolled at 16 large companies, some of them receiving extra care for their disorders and others receiving the usual care. As a result, the employees that were receiving extra care not only worked more weeks than the other group, they also demonstrated greater job retention. Although this study might be of smaller scale, it shows the positive effects treating mental illnesses can have on employers, the government, and society as a whole.
Unfortunately, this investment does not seem to be close as funding for mental health services continues to be cutback and, for the most part, health insurances do not cover flexible and adequate treatments for those suffering of these illnesses. There is also evidence suggesting that, even if effective mental health services became more accessible to those who need it, many would not take advantage of them due to fear of being stigmatized(Rampell). In addition, many would not receive the appropriate treatment for their conditions as each person often has specific needs and symptoms, placing them in need of a more personalized form of treatment, meaning that it would more expensive. Professor Lieberman poses a good example of the latter; he mentions his own experience with a woman called Sara, who suffered from panic disorder. Sara’s disorder caused her to develop agoraphobia, preventing her from being able to leave her home. Lieberman began exposure therapy and other treatment methods in order to help her overcome her phobia, which ultimately had positive results. He then mentions his experience with a young girl who suffered from Borderline Personality Disorder, which was different from the one with Sara as he was not able to provide the appropriate treatment or find the right medication. An example that goes to show the difficulty encountered by those suffering from mental disorders and illnesses, difficulties that make it strenuous for them to seek help, often leading them to not seek help at all.
Nonetheless, through systems such as schools, the workforce, and prison, we see how stigma has slowly creeped through the cracks to settle itself amongst them. Perhaps there are other factors that have fallen into play when it comes to adequate treatment being readily available to the mentally ill. But, above all, it is safe to assume that stigma has had a significant impact on this matter. The fact that these illnesses have been, for decades, categorized as just mood swings, or as “crazy” or “weird”, portrayed inaccurately by the media, and treated lightly by the government and by employers has slowly determined the way they are treated by society as a whole. Many still view these behaviors as voluntarily or something that can be easily controlled, especially by those who do not suffer from them or have been conditioned to believe that due to the false beliefs behind these disorders. Therefore, these illnesses have been diminished for many years, even though there is clear evidence that they are very much real and threatening diseases if left untreated, just like, let us say, heart disease. As professor Lieberman mentions in his video, if there was no stigma, a public health initiative could be launched against mental illnesses just like it’s been done in the past for other diseases such as infectious ones. Consequently, why do we as a society continue to stigmatize these diseases and the ones who suffer from it when there is sufficient proof of them being just a serious as other diseases we treat regularly and without shame? Perhaps there is not one specific answer to this question, as it varies from person to person, and can be based on different factors, but stigma has had a detrimental impact on this matter and will continue to do so if greater awareness is not given to these illnesses and adequate mental health treatments are not given the importance they require.
BIBLIOGRAPHY
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