Literature Review
Stigma against mentally ill individuals is inherent in society and must be eliminated in order to allow the mentally ill fair and equal treatment. George Rosen in his book, Madness in Society, presents instances of mental illness and their reception throughout human history. He touches upon ancient, medieval, Renaissance, premodern, and modern times. Rosen notes that although the mental illness in ancient times (Palestine, Greece, and Rome) was related to divine power and extraordinary abilities, it has had a mostly negative perception since the Middle Ages. One of the main reasons that inhumane treatment of mentally ill has perpetuated since then is due to the inability of people to regard mental illness in the same manner as physical diseases. Torrey and Miller point out the falsity of this concept in their appropriately named The Invisible Plague, “Insanity is an invisible plague. There are no body counts with which one can compare the present with the past. In most countries, there are remarkably few statistics that can be used to assess insanity’s prevalence over time. Professional textbooks assume that insanity has always been present in approximately the same numbers as now” (Torrey). The writers make a crucial comparison in this book; the parallel between mental and physical illness are real and necessary. Mental illness is a major factor that affects the public socially, politically, and economically. Torrey and Miller illustrate the last aspect particularly well with their analysis of the cost of insanity in the U.S. in the year 1991 alone (approximately $110 billion).
Reasons for the negative perception of mentally ill individuals have been explored extensively in various studies. The work of Crocetti, Herzl, and Iradj, compiled in their book Contemporary Attitudes toward Mental Illness, analyzed the nature of mental illness attitudes in different environments in an initial assessment of literature. They include studies on public and employer attitudes as well trends in acceptance. The results are inconsistent, and call for studies that will refine and ramify trends that were suggested by previous work, “Some two dozen studies have been reviewed here. The findings are quite disparate” (Crocetti). A common theme, however, was one of stigmatization, prejudice, and attitude, three factors that make up the authors’ “theory of rejection,” which they proceed to relate to numerous surveys. In her essay “Social Fears Influencing the Development and Containment of Psychiatric Symptoms,” presented in Thomas Scheff’s Mental Illness and Social Processes, Jules Coleman recognizes the influence of social groups in both stabilizing and irritating symptoms and behavior of the mentally ill. Contemporary Attitudes contains a relating study on social distance in which Crocetti & Co. acknowledge recognizes its potentially active role and the need for better empirical analysis of it. They answer this need in the form of surveys specifically addressing social distance and the mentally ill (an example question would be “I wouldn’t hesitate to work with someone who had been mentally ill; agree, diasgree, don’t know”), conducted multiple times with different groups of people (Crocetti 81). Howard Kaplan’s The Sociology of Mental Illness summarizes studies that exhibit current beliefs that the public possess about mental illness and how culture can affect and change them. He draws conclusions about what is and isn’t considered illness and how there is little to no consensus on what specifically defines mental illness. In Mind, Modernity, Madness: The Impact of Culture on Human Experience, Liah Greenfield focuses on three largely misperceived mental illness—schizophrenia, bipolar disorder, and major depressive disorder—and asserts that culture makes a direct impact on their effect and prevalence.
In terms of acceptance, multiple authors touch upon key points. David Mechanic notes the different levels of acceptance that characterize different people in society and that the degree of a “deviant act” is relative to the microsociety of the individual (Scheff). A 2014 study in the journal Social Psychiatry & Psychiatric Epidemiology weighs the risks of coming out about mental illness to family and friends, an important concept because family is the closest and most unconditional support mentally ill individuals can potentially receive. Results showed that a lesser perceived risk of stigma and discrimination lowered coming out anxiety, providing evidence that erasing initial stigma is the first step to awareness and acceptance (Rüsch). Another essay in Scheff tracks the recognition and acceptance of mental illness within a familial relationship, specifically a heterosexual marital relationship. The analysis makes obvious that family is the primary way in which patients can get treatment as they are the first to notice symptoms as well as first to accept their implications, despite initially seeing them as a threat or burden.
The literature summarized above were all initially published with the ultimate intent of eliminating stigma, whether by identifying its causes, influencing factors, or possible solutions. Most authors, however, in their call to action tend to target a very specific group of advocates—those who have Ph.Ds. Books such as Challenging the Stigma: Lessons for Therapists and Advocates, like the title suggests, are intentionally geared towards the professionally trained, who, though qualified, do not always produce visible and effective results. Additionally, it is difficult to professional therapists to differentiate stigma as an injustice rather than a phenomena, which the book’s author, Patrick Corrigan, identifies as an important mindset for dispelling stigma (many of his contemporaries in previously mentioned literature have referred to stigma as such). Decades of literature on mental illness has not made a huge impact in eliminating stigma and negative treatment of the mentally ill; it is time to mobilize a new advocating force—the family. The family, thought mentioned in research on mental illness in society, has not been analyzed as a unit capable of fighting for rights of the mentally ill, yet they are qualified in a manner different from professionals. They have firstly gone through stages leading to acceptance themselves, so they have experienced first-hand the fear that prevents public acceptance and perpetuates stigma. Families as an advocating force have the potential to be incredibly powerful in number as well, if they chose to assemble as a large group. More data, both quantitative and qualitative, is necessary to further explore this opportunity in fair and just treatment of mental illness in modern society.
Reasons for the negative perception of mentally ill individuals have been explored extensively in various studies. The work of Crocetti, Herzl, and Iradj, compiled in their book Contemporary Attitudes toward Mental Illness, analyzed the nature of mental illness attitudes in different environments in an initial assessment of literature. They include studies on public and employer attitudes as well trends in acceptance. The results are inconsistent, and call for studies that will refine and ramify trends that were suggested by previous work, “Some two dozen studies have been reviewed here. The findings are quite disparate” (Crocetti). A common theme, however, was one of stigmatization, prejudice, and attitude, three factors that make up the authors’ “theory of rejection,” which they proceed to relate to numerous surveys. In her essay “Social Fears Influencing the Development and Containment of Psychiatric Symptoms,” presented in Thomas Scheff’s Mental Illness and Social Processes, Jules Coleman recognizes the influence of social groups in both stabilizing and irritating symptoms and behavior of the mentally ill. Contemporary Attitudes contains a relating study on social distance in which Crocetti & Co. acknowledge recognizes its potentially active role and the need for better empirical analysis of it. They answer this need in the form of surveys specifically addressing social distance and the mentally ill (an example question would be “I wouldn’t hesitate to work with someone who had been mentally ill; agree, diasgree, don’t know”), conducted multiple times with different groups of people (Crocetti 81). Howard Kaplan’s The Sociology of Mental Illness summarizes studies that exhibit current beliefs that the public possess about mental illness and how culture can affect and change them. He draws conclusions about what is and isn’t considered illness and how there is little to no consensus on what specifically defines mental illness. In Mind, Modernity, Madness: The Impact of Culture on Human Experience, Liah Greenfield focuses on three largely misperceived mental illness—schizophrenia, bipolar disorder, and major depressive disorder—and asserts that culture makes a direct impact on their effect and prevalence.
In terms of acceptance, multiple authors touch upon key points. David Mechanic notes the different levels of acceptance that characterize different people in society and that the degree of a “deviant act” is relative to the microsociety of the individual (Scheff). A 2014 study in the journal Social Psychiatry & Psychiatric Epidemiology weighs the risks of coming out about mental illness to family and friends, an important concept because family is the closest and most unconditional support mentally ill individuals can potentially receive. Results showed that a lesser perceived risk of stigma and discrimination lowered coming out anxiety, providing evidence that erasing initial stigma is the first step to awareness and acceptance (Rüsch). Another essay in Scheff tracks the recognition and acceptance of mental illness within a familial relationship, specifically a heterosexual marital relationship. The analysis makes obvious that family is the primary way in which patients can get treatment as they are the first to notice symptoms as well as first to accept their implications, despite initially seeing them as a threat or burden.
The literature summarized above were all initially published with the ultimate intent of eliminating stigma, whether by identifying its causes, influencing factors, or possible solutions. Most authors, however, in their call to action tend to target a very specific group of advocates—those who have Ph.Ds. Books such as Challenging the Stigma: Lessons for Therapists and Advocates, like the title suggests, are intentionally geared towards the professionally trained, who, though qualified, do not always produce visible and effective results. Additionally, it is difficult to professional therapists to differentiate stigma as an injustice rather than a phenomena, which the book’s author, Patrick Corrigan, identifies as an important mindset for dispelling stigma (many of his contemporaries in previously mentioned literature have referred to stigma as such). Decades of literature on mental illness has not made a huge impact in eliminating stigma and negative treatment of the mentally ill; it is time to mobilize a new advocating force—the family. The family, thought mentioned in research on mental illness in society, has not been analyzed as a unit capable of fighting for rights of the mentally ill, yet they are qualified in a manner different from professionals. They have firstly gone through stages leading to acceptance themselves, so they have experienced first-hand the fear that prevents public acceptance and perpetuates stigma. Families as an advocating force have the potential to be incredibly powerful in number as well, if they chose to assemble as a large group. More data, both quantitative and qualitative, is necessary to further explore this opportunity in fair and just treatment of mental illness in modern society.