Ben Maudlin

Registered Nurse, Prince of Wales Hospital

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How do we break down the Stigma attached to those people who have mental health or psychiatric issue?

Current research suggests that one in three people will develop a mental illness in their lives (WHO 2011). Psychiatry and psychological treatment is moving away from treating the disease and towards treatment of the patient as a person. Instead of a person being a "schizophrenic" they are now someone with schizophrenia. However this subtle adjustment hasn't translated into the general public. People still shy away from or are scared by people who are mentally unwell. This causes further isolation to a person and can remove some important social supports.

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    Dec 27 2011: Lots of great points on this thread. I'm glad that Johanna mentioned that more people who recover need to come forward. By not talking about our mental health struggles, we feed stigma by suggesting there's something to stigmatize. Avoiding fear and anxiety, creates more of it.

    My recovery began with a six month course of Exposure & Response Prevention therapy, and I only wish I'd known about it sooner. There are so many evidence-based, effective treatments for proactively preventing mental illnesses and, yet, we have this illness-first approach to mental health, so we don't discuss it until it's too late.

    A project myself and some designers are currently working on and will launch later in the new year is a brand of clothes, books, and a website that involves products to create dialogue around mental health. The reason for this is that objects are easier to talk about than ourselves. I used to work with TEDster Tom Wujec, who has a great talk on how we make meaning: http://www.ted.com/talks/tom_wujec_on_3_ways_the_brain_creates_meaning.html
    and in workshops, we would use tangible visualization techniques to help companies overcome anxiety in the boardroom. Objects and visuals allow people to discuss tough topics. With our anti-stigma brand, we're taking the same approach.

    People don't like sickness. But they do like their best friends, their mothers, sisters, brothers, etc. To get over stigma, I think we need to highlight emotional connections between people who are dealing with mental illness. To do that, we need to give those people a means to start the conversation about mental health.

    I just saw this conversation now and it's almost closed, but if you'd like to check out my YouTube videos where I talk about my own mental health stories as well as mental health research, and the books and other projects I have on the go about mental health, I'd love to hear what you think. You can find it all at www.markfreeman.ca

    Thanks for bringing up this topic, Ben!
  • Dec 17 2011: It's simple really. Talk about the afflictions and diseases openly, create understanding and acceptance. Bring it into the mainstream, because people are kidding themselves if they say their lives aren't or haven't been touched by some form of mental illness. By raising awareness in the community of the existence of mental illness, we pave the way for understanding the challenges faced by the afflicted, and ease some of their burden in life.
  • Dec 7 2011: I think we begin but not differenciating between diseases of the mind and of the body. Very few people would fault someone that is stricken with a brain tumor or a genetic disease. We must educate people to understand that illnesses of the brain are just as much under or out of our control as those of the body.
    • Dec 16 2011: I agree that this is a critical area (i.e. no differentiation between diseases of the mind and diseases of the body) to educate people about. Current research shows that there is can be physical causes for depression. I used to tell my son, who suffered from depression, that I believe we all have elements of depression: some of us suffer greatly and some not so much, and everything in between. I like to use the analogy to eye sight: some people have very good, nearly perfect, eye sight. Some people have good eye sight and don't need glasses, but their eye sight is not as good as those with near perfect vision. And so it goes along a continuum ... and somewhere along this continuum, we cross the boundary into people who need glasses, and then people who need stronger glasses, and then finally, people who have no eye sight at all - they are blind.

      And so it is with mental illness - everybody "has it" to some extent, but in some of us it is so weak that it really doesn't affect our daily lives.

      I also wonder if the terms we use need to change: "mental illness" - there is a LOT of negative baggage associated with that term. If someone needs glasses, we don't say that they have a "vision illness" - we don't even say they have a "vision disorder" but perhaps we could.

      We need to talk in terms of "mental health." It is a term that can apply to us all, that some of us have more of it than others. But if we use a term that applies to everyone, perhaps the stigma can be lessened.
  • Nov 30 2011: I'm so glad you asked this question because stigma is the single most barrier to recovery. People with mental illness internalize what people think and say about them making them feel bad about themselves. I am a recovery coordinator for the mentally ill and do a lot of public speaking and trainings on recovery. I teach doctors, residents, med students and mental health agencies about recovery. I've had four articles published on the matter in the Pittsburgh Post-Gazzete and will continue to write on the subject. I've also done six videos on a recovery website and been published in two magazines. I hope you continue to do what you are doing in your community, it helps. I've had schizophrenia for over thirty years and have been symptom free for ten years, I spend all my time fighting stigma and teaching others about truth not hollywood. The media has done people like me a great diservice and should be helping to make it right but they are not. So we are left to educate society on our own and I have personally spoken to thousands over the last ten years and it will be my lifes work to continue. Keep up the good work.
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      Dec 1 2011: Thank you and if I do even manage to get a TEDxHealth conference together I will have to organise you to speak about the stigma that those with mental health issues have faced and continue to face.
      • Dec 1 2011: Thank you Ben for bringing awareness to the TED community.
  • Nov 29 2011: The unfortunate fact is that most people who do recover well and are high functioning people in society are too scared to tell people about their past of being ill exactly for the reasons you state. Also many wish to forget about it and pretend it never happened. Others usually are not so lucky at recover to a pre-morbid state again, so people would not view them in the way that would be beneficial. It is a difficult one for sure. I like your analogy about laughing about people with cancer, it is true. I think peer work is becoming more and more recognised helping staff like me in mental health sector to have some idea of the experiences people may have and insight into them being like you say just 'normal' people with an illness. I believe that more work like this should be done like in schools and University's to get people more aware, not just for professionals in the Health field.
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      Dec 1 2011: Couldn't agree more, this is something that needs to extend beyond the health profession but I see it as a good place to start. There are so many professionals that I meet on a daily basis who are legitimately scared of people with any kind of mental disorder, regardless of what their condition is or how well treated it is. I'm not saying that the idea shouldn't be spread further but those closest is a great place to start.

      Spreading the idea so that it reaches further I agree, teaching children in schools will have a huge impact. I remember in high school my teacher bringing in a man with HIV/AIDs into the class to talk to us about the disease and how it effects your life. Seeing how this man was a perfectly normal person, changed the way I perceived the disease and continues to, to this day. Likewise my parents had friends who were gay or lesbian growing up and I never thought anything of it until I got to school and saw how other people thought homosexuals were "strange" or "unnatural" and I could never get this because to me the people that I had grown up with weren't any different. I believe this would hold true for teaching children about mental health. If we learnt that it is just a disease then we wouldn't be scared. Instead we have been made to believe that it is the person that is "weird" or "strange". Rather than trying to help them we in fact hinder their recovery.
  • Nov 28 2011: This is something that I really wish to try to do something about. Currently I am working with people with mental illness supporting them in residential houses and on the wards...I think it is a case of educating people about mental illness and the forms it can take and what behaviours (bizzare or unusual) people will tend to do but also the reasons behind these behaviours should be explained as usually bizzare behviours will be caused by delusions that have some basis in truth or reality.

    I would suggest that peer workers (people who have had a diagnosis of mental illness in the past and have now recovered) should educate people of things like a) how to react and act around someone who is mentally ill and b) to educate people about their experience of mental illness to gain insight into it. Most people can not fathom what it may be to experience mental illness. It would be beneficial for everyone whether they think they may experience it or not to have an idea of what may happen to them in the case of a mental breakdown. It can happen to anyone, especially if there are an accumulation of factors stressing someone in their life.
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      Nov 29 2011: This is a fantastic idea. If people who have recovered from mental illness showed people that they are just "normal" functional people with an illness it would go a long way. I have been trying to raise awareness in my community about this issue by using the analogy of "laughing at someone with cancer", we simply wouldn't do it because it is cruel. So why then is it okay to laugh at someone who is "crazy", its an illness with equal provenance and devastating consequences.
      • Dec 9 2011: Hello. I only have a thought or two to share. I have an unusual perspective. I am one of 'the diagnosed'. I am not fully recovered, and because this has been a lifelong affliction, I am keenly aware that due to my symptoms or issues I can be, shall we say, not always socially acceptable? Even I can't stand myself sometimes (I say with a sly smile). Human nature is human nature, and those who do not understand, fear. Those who are afraid and act out in ways that are oftentimes perceived as cruel are just trying to protect themselves from the unknown or their known weaknesses such as ignorance, insecurities or shame. It's so lovely that you're concerned about stigma. I believe it has nothing to do with any label, (mentally ill, LGBT, black, etc.) I think it has more to do with every persons individual story, so although education is always a benefit, for me, I take every individual in whichever specific situation I encounter, and try to not educate them about my situation, but educated myself as to what I can learn about them in order to communicate with them effectively so that we connect. Once they are open to you, the possibilities, as they say...