Tuesday, 17 January 2012

The Stigma of Mental Illness: The Myth of the Homicidal ‘Schizophrenic’ pt 1/2

The Misconception: Schizophrenia sufferers are ‘violent homicidal maniacs’.

The Truth:  The vast majority of schizophrenia sufferers are not violent or murderous. In fact, the schizophrenia ‘population’ in the UK is just as likely to commit homicide as the general population of the USA and slightly less likely than the general population of Russia.

The implications: People with schizophrenia (and other mental disorders) are discriminated against by society based on a stigma which is wildly inaccurate. This leads to a lower quality of life and further reductions in mental health.

What is stigma?

Art By John Cadigan.
People with a mental illness often suffer twice over. Like anyone with an illness, be it diabetes, a broken leg or cancer, those with a mental illness have to cope with the associated symptoms, which is tough enough. But they also have to cope with the social implications of being labelled with a mental illness, leading to discrimination and further reduced mental health and quality of life. 

This is stigma.

Stigma can take two forms; public stigma and self stigma. The former occurs when society adopts and acts upon a particular stereotyped view of certain people. The latter, when people who are stigmatized internalise these views and thus have low self esteem and low self efficacy.

Research using meta-analyses of film and print commonly site three common misconceptions or stigmas of people with mental illness:

  • They are violent, homicidal maniacs and should be feared

  • They are rebellious free spirits

  • They have child-like perceptions of the world  

The impact of stigma on the mentally ill is widespread and well documented. The mentally ill are less likely to get insurance, to be rented apartments, to be employed and more likely to have false press charges for violent crimes against them. Shrink Rap provides a nice example these kinds of effects.

Why does stigma arise?
Stigma of mental health arises for a variety of complex reasons. Interestingly, it is argued that humans may be hard-wired to create schema or stereotypes in order to quicken processing. This can be very useful since each time we come across a new situation we can check it with a current schema, in order to predict behaviour and anticipate our response. But it also leads to problems such as racism and stigma. People are often judged unfairly based on a stereotype. This causes two problems:

1) The stereotype may simply be wrong as in the case with stigma of mentally ill or skin colour.
2) The stereotype may be true as a generalisation, ‘men are generally physically stronger than women’ but cannot be applied to all men and women i.e. ‘not all men are stronger than women.’ 

Either way an individual can be judged inaccurately based on a pre-existing belief.

Stigma may also arise from the diagnostic labels given. Whatever your views on the upcoming DSM-5 and it’s utility, a categorical classification system does seem to separate sane from insane distinctly, creating an ‘us and them’ mentality. In fact the title of this blog is stigmatising (hence the quote marks), since to call someone a schizophrenic, diabetic or epileptic is to define them as an illness, not as a person with an illness. A dimensional approach would certainly provide a more acceptable and accurate description of the mentally ill as being the same as those who are mentally healthy, simply lying at different points on a spectrum. 

Take, for example, the work of Marius Romme, who argues psychotic experiences are common in most people at some points in their lives. Perhaps we should conceive of psychosis an extension of normal experience rather than disease that is distinct from mentally healthy individuals. This, of course, is not to deny that many people with psychosis can suffer a great deal as a result of their symptoms, nor that mental illnesses exist. Blood pressure clearly runs on a continuum but as it moves towards the ends of the distribution we run into clinical disorders.

Personally, I think a lot of stigmatization of the mentally ill arises because our mind is how we define the self. The mind is an inherent part of us, comprising our beliefs, attitudes, personality and therefore, how we appear to others. It can be difficult to understand people whose beliefs or behaviour have radically changed or are different to that of societal norms.

Another significant cause of stigma in society lies in the role of the media. The mentally ill are often portrayed in film and news as homicidal, violent and crazy. We so often see headlines such as ‘Girl killed by her psychotic mother…’, that we associate the mentally ill with being dangerous, even though the vast majority are not. This is known as confirmation bias and it occurs because we are only exposed to sensationalist stories representing the few. 

We consider what the truth is with regards to homicide and Schizophrenia in part two.


References and notes

(taken from bio) - An emerging artist whose work integrates mystical themes with ancient symbology. The National Endowment for the Arts recognized Cadigan’s talent in 2001 and helped underwrite his autobiographical documentary, People Say I’m Crazy, which aired on HBO/Cinemax in 2004 after winning over a dozen festival awards. He also has Schizophrenia.

1 comment:

  1. What keeps the stigma alive?

    Well biologically minded psychiatrists for a start. You left that one out for some reason.

    A review of the literature to date in 2006 found that overall, biogenetic causal theories, and labelling something as an “illness”, are both positively related to perceptions of dangerousness and unpredictability, and to fear and desire for social distance. They identified 19 studies addressing the question. 18 found that belief in a genetic or biological cause was associated with more negative attitudes to people with mental health problems. Just one found the opposite, that belief in a genetic or biological cause was associated with more positive attitudes.