Eradicating ‘Stigma’, The New Sales Pitch For ‘Mental Illness’

It takes some stretching to put it in something resembling transactional analysis terms, but I think will give it a whirl. “I’m not Okay, but now that we have anti-stigma campaigns, it’s Okay not to be Okay.”

I guess I’m old fashioned. I still prefer Okay over not Okay.

Now we’ve got this problem of dissent and the mental health orthodoxy that didn’t exist 2 or 3 decades ago. You get the kind of thinking that runs if you don’t believe what we are saying to be true, you “stigmatize” the “mentally ill”, or more properly put, people with “mental illnesses”.

There is no “stigma” attached to mental health. There is a “stigma” attached to “mental illness”. Is there any “stigma” attached to recovering from a “mental illness”?

“Stigma”, once a brand or a tattoo, now refers to a more metaphoric or symbolic mark of disgrace. We have a problem in that, given this definition; use of the word itself is “stigmatizing”, or prejudicial. You can’t wash off disgrace any more than you can wash off the mark of Cain. When it is a matter of perception, maybe another word would be preferable.

Both words, “stigma” and recovery, are words that some people in the mad peoples movement claim have been co-opted by people who are in opposition to their wishes, aims, and rights. In the case of both words there is much legitimate truth to this accusation.

Recovery is now being used by pharmaceutical companies to sell pharmaceuticals. Pharmaceuticals are one of the reasons why some people in treatment don’t recover. Recovery is now used by mental health professionals who feel most people who have been labeled with “serious mental illness” labels are incapable of recovering. Some of this recovery rhetoric has even degenerated into being applied to custodial care by another name. Custodial care, in some of these cases, has merely been transferred from a hospital setting to a community setting.

The idea is that there are all these “mentally ill” people out there who are not getting treatment they need because of “stigma”. The question here becomes who determines need, and where do we draw the line. The thing that is seldom being pointed out is that there are a lot of people who are being treated by force and against their wishes. Do we need more people in mental health treatment who don’t want to be treated? If so, you or your neighbor could be next. Is it not “stigmatizing” to force treatment on people who don’t want, for whatever reason, to be treated?

I see a big danger in using “stigma” to sell “mental illness”. I think this is precisely what is going on today. The numbers of people being fed, clothed, and sheltered by the taxpayers due to a “mental illness” label is increasing by leaps and bounds. Sooner or later, given the kind of growth that is taking place in the field, this burden is going to become too great for the state to carry. Once that point is reached, it will have become too late not to do something about the problem.

Recovery takes place where people leave the mental health system. They leave the mental health system precisely because they have recovered their mental health. Where people don’t leave the mental health system, the mental health system could be said to be ‘broken’. The idea is to get more people leaving the mental health system, and fewer people entering it. When you get fewer people entering the mental health system, you are being preventative. When you get more people entering the mental health system, you are being causative. I’d say it’s time to take a good long hard and honest look at what we’re doing.

10 Responses

  1. Both words, “stigma” & “recovery” are overused and abused. Its up to us – survivors of psychiatry – to define for ourselves what these and other terms mean. We define our own experience. We are the true experts.

    • I’d add misused in many cases. SAMHSA recently “redefined” “recovery”. Why do they need to “redefine” anything when the dictionary defines the word quite clearly enough. Oh, but, of course, because we’re actually talking about something besides “recovery”. Simplifying matters, you lose something, you recover it. Lifetime “recovery” is like lifetime “mental illness”, anybody has something better to be doing with his or her time.

      We’ve never been “voiceless”, and yet such is the illusion created by those who would speak for us.

      Bravo! With recognition of that expertise comes empowerment! The mental health experts have been abusing us for years in the name of treatment. When they start to recognize that expertiential expertise, chiefly because our tongues have not been removed, it’s time to train the trainers.

  2. I agree with you, and I like that word “causative” you use to describe it. Making it “Okay not to be Okay” is a way of trapping people in illness. Being trapped in illness is now labelled “recovery”. Pointing this out is now labelled “stigma”. The result is financial and political gain for those who control the labels.

    • A certain amount of blindness, too, to the way the inequality of power and wealth affect relationships. A psychiatrist is his or her career, a mental patient/consumer is his or her lack of a career. If those who control the labels gain, those who receive the labels lose. This kind of one way relationship has to be addressed before it can be changed. Consider, perhaps it is the power and wealth disparity between these two groups that is “sick”.

  3. If the eradication of “stigma” means it’s now okay to be not okay, then why do we need psychiatrists and psychopharmaceuticals. Sounds like in trying to get rid of the stigma, they’re accidently closing down their profession (none too soon).

    • *sigh* I wish.

      Psychiatrists put bacon on the table “treating” people who see themselves as “not okay”. Big Pharma spends millions of dollars, and makes billions of dollars, by trying to persuade people that they are “not okay” without a drug. Although it is not a monetary priority among politicians, the “mental health” business is booming.

      The “stigma” is attached to being “not okay”. There is still no “stigma” attached to being “okay”. When “not okay” becomes “okay”, we have a contradiction of terms where one term must cancel out the other. Either that, or a lie that persists. For example, you can call the color black “white” to your heart’s content, but doing so doesn’t make the color black the color white.

      We do have a parellel in literature though, and in this instance I’m referring to the Newspeak in George Orwell’s novel 1984. Where slogans like War is Peace, Love is Hate, and so forth work, a slogan like Okay is Not Okay could go over without batting an eyelash.

  4. Bit we’re growing up with a generation where OK is not OK is an identity.

    • Certainly a portion of the generation growing up now is good with the ‘OK is not OK’ identity. The old neurosis (hysteria) label has been supplanted by the “minor mental illness” label. This gives you a situation where 25 % of the population can claim a “mental illness” if they want to do so. Much of this “illness” so-called will clear up eventually like a mild case of acne. This leaves you with the 5 % “serious mental illness” population. Their troubles are probably as much systemic as they are anything else. If you warehouse people, for instance, you don’t put people to use. Many of these people are encouraged by the system to think of themselves as irrecoverable. You can lament not having a job to your heart’s content, but to the rest of the world it’s a permanent vacation. One thing to consider is that this leaves at best 75 % of the population outside of the mental health system altogether, that is, mentally healthy. I guess this means that a lot of people still feel fine with the ‘OK is OK’ identity. Time will gnaw, but they’re good for awhile. Fred Flintstone is still in his pre-psychiatry element apparently. The post-psychiatry world is a little more elusive, but my understanding is that some people manage to wander into that clearing as well.

  5. “It is all right that you are having some problems right now; we are going to help you get well, ” would be good to hear. It causes resentment when others define you and label you. Even when you label yourself, it can be taken and used against you. It is, as always, the underlying prejudices that are at fault. Fear and ignorance are the main drivers, so education is key. No faculty in any university can prepare any medical student for dealing with mental health issues without addressing these factors. It ought to be compulsory to attend a set amount of seminars and classes given by people who have been through the mental health system.

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