The Anti-‘Stigma’ Feint

The notion of “stigma” is one of the biggest piles of crock in the mental health literature world today. I can hear the gasps and strenuous objections coming from some of its most devoted adherents already, but that’s my learned opinion on the matter. Why do I see the notion of “stigma” in this fashion? Let me explain.

In the Niagara Falls Review under local news there is this report, COLUMN: Stigma prevents mental health sufferers from reaching for help.

One in five children, youth and adults will have a mental health illness in their lifetime. Seventy per cent of these individuals will begin having their mental health problems during childhood or adolescence. Yet, only about one-third of all these people will reach out for help with their mental illness, even though we know treatment works.

This article talks much about a Mend The Mind website all about this “stigma” and campaigning against it. I don’t think that website’s existence lessens the significance of anything I am going say on the subject.

First, this one in five, or 20 %, of the entire population includes a lot of people who are only marginally affected at best. The “illness” here, if that’s what you want to call it, is by no means long term. It’s going to evaporate anyway. Calling them “mentally ill” is something of a stretch to start out with. Then they say that 70 %, 7/10ths, almost 3/4ths, of this figure caught their “disease” as children or adolescents. It goes onto say that only 1/3, or around 33.3 %, of this 20 % group seek help.

Alright. I feel well off enough is well off enough if well off enough is left well alone. ADHD, oppositional defiant disorder, conduct disorder, social anxiety disorder, and childhood bipolar disorder are just ingenious ways that the psychiatric profession has found to make money pathologizing childhood. Pathologized children have a major tendency to grow into pathologized adults. Little wonder then that from psychiatrized kids we often wind up with psychiatrized families.

Much of the above 20 % figure deals with what amounts to little more than the mental health equivalent of the common cold. The numbers of people labeled seriously disturbed or “mentally ill” generally comprises about 5 % of the entire population. This is primarily people who have been labeled schizophrenic, bipolar, and clinically depressed. People labeled schizophrenic, for example, are calculated to make up about 1 % of the population.

This “stigma” complaint is actually about the selling of biological medical model psychiatry. The mental health treatment offered generally tends to be biological psychiatry, specifically the belief and theory that psychiatric disorders stem from biological conditions requiring drug maintenance. Such psychiatrists like to point to low recovery rates as their excuse for drugging people. This depressing recovery rate is due to their primary method of treatment, specifically drugging. Countering “stigma” is now offered as an explanation for the suppression of approaches other than, and any criticism of, biological psychiatry.

You mix a little bit of confusion about the very real and devastating prejudice and discrimination that people who have had their lives disrupted by psychiatric incarceration face, and you can imagine the outcome. This counter “stigma” movement actually endeavors to replace very real and legislative efforts to correct those deficits with facile and superficial measures that are doomed to failure. This is because the unstated aim of the counter “stigma” campaign is often not the ending of prejudice and discrimination. The real aim of the counter “stigma” campaign is to drum up more business for the psychiatric treatment and the drug making industries.

What’s Needed To Improve Mental Health Recovery Rates?

Psychiatrists have long emphasized low recovery rates for serious mental health issues resulting in a great number of what are called long-term or chronic cases. My feeling is that this low recovery rate has 2 major causes. The first is due to the fact that the primary form of treatment, drug treatment, is crippling in its own right, and it doesn’t really address the underlying circumstances behind whatever dilemma a person may be facing. The second is that we’ve got an expansive self-perpetuating mental health system that isn’t really interested in seeing people released from that system. If the rhetoric says one thing, the facts suggest another.

Biological psychiatry, which would blame these bad outcomes on heredity, is blinded by its own prejudices and presumptions. All research in this area of expertise can only be approximate, by no means is psychiatry an exact science. If you are saying that these people have bad genes, you still have to demonstrate that all of them have bad genes, and not just a fraction. Biological psychiatry is trying to say that that fraction includes a greater rather than lesser number of people it has labeled. This theory has been disproved by World Health Organization (WHO) research into recovery rates in developing countries. If recovery rates in some countries in the developing world were twice those in the more industrial nations, obviously the fraction suffering from bad genes, in this instance, becomes smaller rather than greater. Under the skin, people in the developing world are the same as the people in the developing world.

The real and only difference between a mental patient, and much of the rest of the world, is meaningful and paid employment. The mental health system, as it is now set up, being based upon insurance disability claims, can’t co-exist with meaningful employment. People receive disability when they are deemed unfit to work. There is no graduated system within the mental health system of getting people back into the working world. Loss of disability serves as a disincentive to working, especially when job insecurity and relapse fears abound. The idea of doing something innovative, like incorporating a small labor force, flounders when you reach the bureaucratic insurance company and governmental red tape involved.

Work has been described as conducive to recovery when it comes to mental upsets and life crises. The mental health system is hiring Peer Support Specialists at this time because it just doesn’t make sense to tend so many under and unemployed people when you can put a few to work. People in the mental health system often want to work. Simply sending them to college for more training is not always the best policy for them. It would help if the mental health system made finding people suitable employment outside of the mental health system a part of its business. I’m not saying work solves everything. I am saying that work can be fun, and that it doesn’t have to be conceived of as nothing but tedium and drudgery.

Both of these causes will have to be addressed if recovery rates are to be substantially improved. Non-drug alternative approaches to disabling and damaging chemical treatments need to be studied and applied. The question and nature of the worth of people in the job market will need to be reintroduced and explored. Special and novel ways of achieving that worth need to be looked at as well. This is a social matter, and as such, it involves groups of people seeking solutions to the problems that people have in common. In order to come up with these solutions, something of the insular and segregating nature of the mental health system will have to give way before the need to engage more people in the active life of their communities.