As with other groups that are likely to be seen as separate and different from the “mainstream”, members of the general public often make certain assumptions about older people — without taking the time to look at each person as unique and individual. Older people who suffer with mental disabilities may, as a result, be “twice branded”. We are grateful to Otto F. Wahl, Ph.D., a leading expert, advocate and educator in the field of mental illness awareness, for contributing the following information to this year’s World Mental Health Day Planning Kit:
Stigma is defined in the dictionary as “a mark of shame or infamy.” It comes from the ancient Greek practice of physically branding slaves, marking them with a clear sign by which others would know such individuals were inferior to and less valued than ordinary citizens. Today, stigma does not involve physical marking, but instead is attached through social labels. One such stigmatizing label is “mental illness.”
Mental illness has long been a label that leads to negative judgments and mistreatment of those given that designation. Early civilizations viewed mental disorder as a sign of demon possession, thereby marking the person as undesirable and even dangerous to be around. Medieval Europeans saw those who displayed mental disorder as evil and sinful and as having brought their afflictions upon themselves through weak character and lack of faith.
Later, European views “evolved” to conceptualize those with mental illnesses as bestial rather than sinful, ruled by uncontrollable animal passions and not sensitive to cold or heat or pain or embarrassment the way other civilized persons might be. Still later, Nazis proclaimed psychiatric hospital patients as possessing “life unworthy of life” and began their experiments with efficient extermination using these populations.
Current Manifestations of Mental Illness Stigma
Mental illness stigma shows up, first of all, in the attitudes and behaviors of the public toward those with psychiatric disorders. Research has repeatedly demonstrated that the vast majority of those with psychiatric disorders, including more severe illness such as schizophrenia and bipolar disorder, are neither violent nor dangerous. Nevertheless, the common image conjured up by the labels “mentally ill,” “mental patient,” “ex-mental patient,” and the like are of a violent, unpredictable predator who can explode at any moment to harm innocent bystanders. Although those with psychiatric disorders are more likely to be victims of violence than perpetrators, exaggerated fears persist.
There is evidence also that many people respond to the label of mental illness as a verdict of incompetence and even hopelessness. People with mental illnesses are seen as incurable and unlikely ever to be productive members of society. Their impaired judgment, it is believed, renders them incapable of making responsible decisions, contributing to their own treatment planning, or helping others.
Although improvements in medical and community treatment and the efforts of the consumer/survivor movement worldwide — in which those with mental illnesses have organized to help one another and to educate the rest of society about their capabilities — has demonstrated the inaccuracy of such pessimistic appraisals, they persist even within the healthcare field.
There remain also residuals of the belief that mental illness is the person’s own fault. Despite increasing evidence that severe mental illnesses have primarily biological and genetic roots, many still believe that mental illness reflects weakness of character and moral flaws. Those with mental illnesses, some would say, are getting what they deserve as a result of their own personal inadequacies. They are perceived, for example, as lacking the motivational resolve to overcome their problems, as lazy, as self-indulgent in their emotions; they have simply given in to stress and failed to pull themselves up by their bootstraps as would a person of stronger character.
Negative attitudes toward mental illness are shown also in — and perpetuated by — the images offered by our mass media. The entertainment industry — films and television in particular — rely heavily on depictions of mentally ill killers to generate fear and excitement in their audiences. Indeed, the most common role for a mentally ill character on television is that of a violent villain. News and entertainment media focus on the most impaired individuals, often referring to those with psychiatric disorders with slang terms like “lunatic” and “psycho” and “nutter,” demonstrating and encouraging a lack of respect that would not be tolerated for people with other serious diseases.
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