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The social stigma associated with mental disorders is a widespread problem. The US Surgeon General stated in 1999 that: "Powerful and pervasive, stigma prevents people from acknowledging their own mental health problems, much less disclosing them to others."[198] Employment discrimination is reported to play a significant part in the high rate of unemployment among those with a diagnosis of mental illness.[199] An Australian study found that having a mental illness is a bigger barrier to employment than a physical disability.[200] Efforts are being undertaken worldwide to eliminate the stigma of mental illness,[201] although the methods and outcomes used have sometimes been criticized.[202] A 2008 study by Baylor University researchers found that clergy in the US often deny or dismiss the existence of a mental illness. Of 293 Christian church members, more than 32 percent were told by their church pastor that they or their loved one did not really have a mental illness, and that the cause of their problem was solely spiritual in nature, such as a personal sin, lack of faith or demonic involvement. The researchers also found that women were more likely than men to get this response. All participants in both studies were previously diagnosed by a licensed mental health provider as having a serious mental illness.[203] However, there is also research suggesting that people are often helped by extended families and supportive religious leaders who listen with kindness and respect, which can often contrast with usual practice in psychiatric diagnosis and medication.[204] Mental health I O C The mentally ill are stigmatized in Chinese society and can not legally marry.[205] Recently more studies are being conducted to show how being stigmatized effects the care and treatment mental health patients receive. Participatory action research is a method now being used to help understand how young people in particular are being effected by their diagnosis. One study conducted by, School of Health and Human Sciences, University of Essex showed that males and females had a hard time telling their friends about their recent diagnosis and felt alienated. Most of them, however felt that the experience allowed them to open their minds to the idea of needing mental help[206] Doctors and therapist also play a role in helping patients to learn to cope with the possibility of being stigmatized. In order to improve their quality of life the people involved in the patient's care must make them aware that stigmas may arise and prepare them for the reality of being diagnosed with a serious mental illness. Yet another study was conducted in which 101 participants diagnosed with a serious mental illness were monitored for a year, some patients were socialized with the intent to teach them about stigmas and how to cope and others were not. The results showed that those participants that were socialized fared better in daily activities such as work and school and they also responded to treatment better than those who were not exposed to the socialization[207] Based on the most recent research from 2012–2013, children and adolescents have been widely reporting to face problems with peer relationships due to the diagnosis of a mental illness. They face isolation and ridicule from peers. Stereotypes that are associated with their diagnosis also do not go unnoticed, many of them face bullying simply due to the fact that they have ADHD or Depression. This hinders their chance for a fast recovery and may even prevent them from seeking further treatment[208] Media and general public Main article: Mental disorders in art and literature Media coverage of mental illness comprises predominantly negative and pejorative depictions, for example, of incompetence, violence or criminality, with far less coverage of positive issues such as accomplishments or human rights issues.[209][210][211] Such negative depictions, including in children's cartoons, are thought to contribute to stigma and negative attitudes in the public and in those with mental health problems themselves, although more sensitive or serious cinematic portrayals have increased in prevalence.[212][213] In the United States, the Carter Center has created fellowships for journalists in South Africa, the U.S., and Romania, to enable reporters to research and write stories on mental health topics.[214] Former US First Lady Rosalynn Carter began the fellowships not only to train reporters in how to sensitively and accurately discuss mental health and mental illness, but also to increase the number of stories on these topics in the news media.[215][216] There is also a World Mental Health Day, which in the US and Canada falls within a Mental Illness Awareness Week. The general public have been found to hold a strong stereotype of dangerousness and desire for social distance from individuals described as mentally ill.[217] A US national survey found that a higher percentage of people rate individuals described as displaying the characteristics of a mental disorder as "likely to do something violent to others", compared to the percentage of people who are rating individuals described as being "troubled".[218] Recent depictions in media have included leading characters successfully living with and managing a mental illness, including in Bipolar disorder in Homeland (2011) and Posttraumatic stress disorder in Iron Man 3 (2013).[original research?] Violence Despite public or media opinion, national studies have indicated that severe mental illness does not independently predict future violent behavior, on average, and is not a leading cause of violence in society. There is a statistical association with various factors that do relate to violence (in anyone), such as substance abuse and various personal, social and economic factors.[219] In fact, findings consistently indicate that it is many times more likely that people diagnosed with a serious mental illness living in the community will be the victims rather than the perpetrators of violence.[220][221] In a study of individuals diagnosed with "severe mental illness" living in a US inner-city area, a quarter were found to have been victims of at least one violent crime over the course of a year, a proportion eleven times higher than the inner-city average, and higher in every category of crime including violent assaults and theft.[222] People with a diagnosis may find it more difficult to secure prosecutions, however, due in part to prejudice and being seen as less credible.[223] However, there are some specific diagnoses, such as childhood conduct disorder or adult antisocial personality disorder or psychopathy, which are defined by, or are inherently associated with, conduct problems and violence. There are conflicting findings about the extent to which certain specific symptoms, notably some kinds of psychosis (hallucinations or delusions) that can occur in disorders such as schizophrenia, delusional disorder or mood disorder, are linked to an increased risk of serious violence on average. The mediating factors of violent acts, however, are most consistently found to be mainly socio-demographic and socio-economic factors such as being young, male, of lower socioeconomic status and, in particular, substance abuse (including alcoholism) to which some people may be particularly vulnerable.[25][220][224][225] High-profile cases have led to fears that serious crimes, such as homicide, have increased due to deinstitutionalization, but the evidence does not support this conclusion.[225][226] Violence that does occur in relation to mental disorder (against the mentally ill or by the mentally ill) typically occurs in the context of complex social interactions, often in a family setting rather than between strangers.[227] It is also an issue in health care settings[228] and the wider community.[229] Mental health The recognition and understanding of mental health conditions have changed over time and across cultures and there are still variations in definition, assessment and classification, although standard guideline criteria are widely used. In many cases, there appears to be a continuum between mental health and mental illness, making diagnosis complex.[230] According to the World Health Organisation (WHO), over a third of people in most countries report problems at some time in their life which meet criteria for diagnosis of one or more of the common types of mental disorder.[156] Mental health can be defined as an absence of mental disorder. Other animals Main article: Animal psychopathology Psychopathology in non-human primates has been studied since the mid-20th century. Over 20 behavioral patterns in captive chimpanzees have been documented as (statistically) abnormal for frequency, severity or oddness—some of which have also been observed in the wild. Captive great apes show gross behavioral abnormalities such as stereotypy of movements, self-mutilation, disturbed emotional reactions (mainly fear or aggression) towards companions, lack of species-typical communications, and generalized learned helplessness. In some cases such behaviors are hypothesized to be equivalent to symptoms associated with psychiatric disorders in humans such as depression, anxiety disorders, eating disorders and post-traumatic stress disorder. Concepts of antisocial, borderline and schizoid personality disorders have also been applied to non-human great apes.[231][232] The risk of anthropomorphism is often raised with regard to such comparisons, and assessment of non-human animals cannot incorporate evidence from linguistic communication. However, available evidence may range from nonverbal behaviors—including physiological responses and homologous facial displays and acoustic utterances—to neurochemical studies. It is pointed out that human psychiatric classification is often based on statistical description and judgment of behaviors (especially when speech or language is impaired) and that the use of verbal self-report is itself problematic and unreliable.[231][233] Psychopathology has generally been traced, at least in captivity, to adverse rearing conditions such as early separation of infants from mothers; early sensory deprivation; and extended periods of social isolation. Studies have also indicated individual variation in temperament, such as sociability or impulsiveness. Particular causes of problems in captivity have included integration of strangers into existing groups and a lack of individual space, in which context some pathological behaviors have also been seen as coping mechanisms. Remedial interventions have included careful individually tailored re-socialization programs, behavior therapy, environment enrichment, and on rare occasions psychiatric drugs. Socialization has been found to work 90% of the time in disturbed chimpanzees, although restoration of functional sexuality and care-giving is often not achieved.[231][234] Laboratory researchers sometimes try to develop animal models of human mental disorders, including by inducing or treating symptoms in animals through genetic, neurological, chemical or behavioral manipulation,[235][236] but this has been criticized on empirical grounds[237] and opposed on animal rights grounds. |
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