In 1949, Congress designated May as National Mental Health Awareness Month, which has been marked annually since then. The intention was, and still is, to get people talking about mental illness and mental health and its prevalence in order to reduce the stigma. Stereotypes and myths about mental illness prevent people from getting treatment that can help them recover, or manage a chronic condition.
Mental Health Awareness Month 2014 Activities
The theme for the 2014 Mental Health Awareness Month is “Mind Your Health.” Sponsored by the advocacy organization Mental Health America (formerly the National Mental Health Association), Mental Health Awareness Month is meant to increase public recognition of the important role of mental health in terms of overall health and wellness. Other goals include informing people of the ways that the mind and body interact, and “providing tips and tools for taking positive actions to protect mental health and promote whole health.”
Activities during May, 2014 include the ninth annual Children’s Mental Health Awareness Day on May 8, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Other related mental health awareness campaigns during May include:
- National Anxiety and Depression Awareness Week, May 4-10, established in 1994 by Freedom from Fear, a national advocacy group. Every year, more than 40 million people in the U.S. suffer from an anxiety disorder and 20 million experience a depressive disorder;
- Older Americans’ Mental Health Week, May 15-21, organized by the Older Women’s League to reduce the stigma that keeps many older Americans from seeking help. The key message is that mental illness is not a normal, inevitable part of aging; and
- Schizophrenia Awareness Week, May 18-24, organized by the Schizophrenia and Related Disorders Alliance of America. One out of every 100 people has schizophrenia.
Stigma is Real
Psychiatric issues are understood today as conditions related to both the brain and the mind, with causes that may be a combination of heredity, neurochemistry and neurobiology, and personal experience. Diagnosis of mental health disorders has become more systematic, and treatment has become increasingly evidence-based. However, mental illness still carries a stigma, making people uncomfortable and even fearful because they don’t know or understand the conditions or symptoms.
There are two kinds of stigma associated with mental health disorders. The first is social stigma, characterized by prejudice, exclusion and discrimination directed at people who have been labeled as having a mental health problem. The other stigma is referred to as a perceived stigma or self-stigma, which occurs when a person’s self-esteem is damaged.
In a 2003 report to then-President George W. Bush, the New Freedom Commission said that the perceived stigma of mental illness, “leads others to avoid living, socializing or working with, renting to, or employing people with mental disorders.”
Surveys suggest that many people still believe that people with mental health disorders are dangerous, despite evidence that clearly shows that abuse of drugs and alcohol are far more likely than mental health status to result in violent behavior. People with mental health disorders are much more likely to be victims, rather than perpetrators, of crime. About 25 percent of people living with a mental illness are likely to be victims of violent crime, compared with three percent of the general population. In fact, it is estimated that half of police shootings involve people with a mental health disorder, mainly because they are not capable of understanding or complying with instructions during an acute episode.
Both mass media and the entertainment industry perpetuate and reinforce myths and stereotypes. The media is quick to raise the possibility of mental health problems in connection with crimes such as mass shootings. In books and films, serious mental illness such as schizophrenia or post-traumatic stress (PTSD) disorder is often a plot device used to explain violent behavior and murder.
Another source of stigma is that people with certain mental health disorders, such as substance abuse and eating disorders, are perceived as weak because they lack the willpower to control behavior that appears to be self-inflicted.
People with mental health disorders often suffer from self-stigma, or poor self-esteem. They become embarrassed or ashamed, and frequently conceal their symptoms from others. They may feel that they are weak, flawed or “broken.” They have difficulty separating their identities from their conditions, and as a result lack motivation to get treatment. Often, that is accompanied by fear of failure that robs them of hope and prevents them from striving for personal or professional achievement. They are also afraid of being labeled and subjected to mockery, bullying, violence or discrimination in their personal or professional lives.
Fighting the Stigma of Mental Illness
Efforts to reduce the stigma are a legacy of men and women who served in the armed forced during WWII, and those who wanted to but were rejected. One of the reasons Congress took action in 1949 was because more than 1.8 million men had been rejected for military service during WW II for mental health reasons. Others were discharged from the military for reasons including shell-shock or combat fatigue, which would later be recognized as post-traumatic stress disorder. Veterans and their families also demanded better treatment and services.
The message that had repeatedly been delivered to soldiers was that there was nothing wrong with seeking psychological help, and that doing so was in fact a sign of courage. As a result, the Veterans’ Administration (VA) was overwhelmed. By 1946, roughly 60 percent of all patients in VA hospitals (44,000 of 74,000) were suffering from mental health problems. In fact, by the mid-1950s, 10 percent of the nation’s psychiatrists were employed at the VA’s 35 psychiatric hospitals, 75 general hospitals with psychiatric services, and 62 mental health clinics.
Mental health had traditionally been a state or local responsibility, but rapid advances in biomedical research as well as psychiatric and psychological therapy were occurring. In 1946, then-President Harry Truman signed the National Mental Health Act, authorizing the creation of the National Institute of Mental Health (NIMH) to support the research, prevention and treatment of mental illness, although the institute was not formally established until 1949. The focus shifted from mental illness to mental health.
Roots of the Stigma of Mental Illness
The stigma of mental illness in most ancient cultures was linked to belief in magic and supernatural phenomenon, and sometimes the conviction that it was a sign of divine punishment or demonic possession. For example, the Salem Witch Trials in 1692-93, may have been triggered by mental illness on the part of one or more young girls, who were reported to scream hysterically, bark like dogs and experience convulsions
Family members with a mental illness were generally confined, concealed, abused, or abandoned. By the 16th and 17th centuries, mental illness often meant being placed in the workhouse or poorhouse, or an asylum, called a madhouse. Residents were generally either neglected or abused in any of those settings.
In 1792, Philippe Pinel improved living conditions at an asylum in France, and found that the condition of many patients improved. This launched a movement call “moral management,” focusing on the individual’s spiritual, moral and occupational rehabilitation. That was followed by the Mental Hygiene movement, spearheaded by Dorothea Dix, an educator who became a reformer in 1841, when she began teaching Sunday School at a women’s prison in Massachusetts. Appalled by conditions in prisons, poorhouses and asylums, she researched and lobbied for the federal and state governments for more humane conditions. Over the course of 40 years, she devoted her efforts to the creation of large state hospitals for humane treatment of people with mental illness. By 1880, there were 75 large state hospitals in the U.S. for the treatment of people with mental illness in a country of 50 million people; Dix was directly responsible for the creation of almost 40 of the facilities.
Modern Treatments are Effective
The emergence of psychotherapy created a foundation for treatment of mental health disorders by talking with a psychiatrist, psychologist or other mental health provider. Through therapy, people learn to understand themselves and their mental states and behaviors, and how to respond to challenging situations by using healthy, appropriate healthy coping skills. Knowledge of psychology and neurology, and discovery of pyschotropic drugs such as lithium all contributed to improved treatment for mental illness and better outcomes in the 20th century.
For example, the American Psychiatric Association (APA) reports that the current treatment success rate for depression is 85 percent, for bipolar disorder it is 80 percent, and for schizophrenia it is 60 percent.
Changing social values including concerns over civil rights and the discovery and popularization of anti-psychotic and anti-depressant medications, in the 1960s a “deinstitutionalization” movement began, aimed at closing large institutions that housed people with mental illness. However, the development of community support that was expected to accompany this shift never materialized, leaving large numbers of people with mental illness living on the streets, and others in prisons and jails or shuffling between the two.
Mental Illness: on the Streets and Behind Bars
The state psychiatric hospital system was intended to protect and treat people with serious mental illness. Peak occupancy occurred in the mid-1950s, when public psychiatric hospitals housed 558,922 out of a population of 164 million. Buoyed by advances in therapy and new medications such as the first effective antipsychotic chlorpromazine (Thorazine), which offered the promise of effective treatment and control of mental health disorders, the U.S. embarked on a program of deinstitutionalization in the 1960s. By 1994, when the population was 260 million, there were 71,619 patients in public psychiatric hospitals, and today there are only 35,000 patients in state facilities. About 75 percent of those discharged were people with schizophrenia, bipolar disorder or severe depression.
Those with milder disorders benefited. However, the necessary community support – including affordable housing – for people with serious mental disorders was not implemented as envisioned. Patients were discharged from hospitals to nursing homes, and board-and-care homes, group homes, transitional living facilities and residential care facilities. By the 1980s, there was recognition that deinstitutionalization was a well-intended reform that had gone wrong. By the mid-1980s, the connection between deinstitutionalization and the growing number of homeless people was recognized. Today, about one-third of the 750,000 homeless people in the U.S., or about 250,000, are people with serious untreated mental health disorders such as schizophrenia or bipolar disorder.
Some mental health advocates, such as the Treatment Advocacy Center, argue that the U.S. is returning to the “asylum” model of care for people with mental illness, except that prisons and jails have become the “new asylums.” A 2014 report, The Treatment of Persons With Mental Illness in Prisons and Jails: A State Survey, estimates that there are 356,268 inmates with severe mental illness in prisons and jails across the country, 10 times the number of people in state psychiatric hospitals.
There are significant differences between mental health disorders and serious mental health problems, Despite progress treating and managing both, new stereotypes and stigmas have developed about mental illness, replacing old ones.
Sovereign Health Group Treats Mental Illness
Medication and therapy can help those who have mental disorders to recover or manage their conditions and lead healthy, productive lives. Knowledge and understanding is critical for recovery; so is understanding and acceptance from family and friends.
Sovereign Health Group offers state-of-the-art, evidence-based treatment for a variety of mental health conditions, including anxiety disorders, depression, PTSD, and bipolar disorder. We use a biopyschosocial approach that treats the individual, not the disorder. You can learn more about our program here. We also offer treatment services for addiction and dual diagnosis. Call our Admissions team today at 866-264-9778.