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We hear a great deal about the “stigma” associated with serious mental illness. We read that it’s a bad thing, something to combat. The stigma of serious mental illness leads to shame, economic disadvantage, bias in employment, housing and other necessary areas of life. The issue of stigma is so serious that the federal government funds a cadre of Disablity Rights Attorneys to search out, litigate and change laws wherever they find stigma against those with serious mental illness. This is certainly a good and laudable goal. But it doesn't seem to be working. And the reason is clear. We've got the whole concept of stigma backwards. We're doing things all wrong.
First a definition: What exactly is “stigma?” Stigma is a Greek word which means a "dot, puncture, brand or mark." A more general meaning would be "a sign." Stigma then is a physical mark (the Greek verb is "to puncture") that sets a person apart. In ancient Greece the stigma was a mark or tattoo burned or cut into the skin of criminals, slaves or traitors in order to physically identify them.
Modern research has identified three categories of persons who bear stigma. 1) Persons with physical deformities 2) Poor personal traits and 3) Tribal or group status. It's easy to think of examples for all three groups. But this misses the point.
The larger point is this: Stigma is a mark. Something physical. Something that sets a person - or group - apart from the rest. It is NOT the reaction of others to that mark. Society's often bad reaction to those with serious mental illness is simply the symptom of the problem, not the problem. The root of the problem is the mark, the stigma.
Then what is the true stigma of serious mental illness? The mark? It's the often bizarre, psychotic, violent behaviour of those so afflicted. This is what marks the serious mentally ill. This is what causes the public aversion. This is what we should be spending money to correct. People will never tolerate bizarre, violent, psychotic behaviour. Never have. Never will. To think otherwise is tragically naive.
Treating the effects of stigma is the classic mistake of treating the symptoms of a problem and not the root cause. It's the psychotic, dangerous behaviour that needs to be addressed. That's the stigma. That's the mark. And removing the mark will go a long way towards removing all the unfortunate consequences that follow from it .
If you want better conditions for persons with severe mental illness. If you want social and economic barriers to fall. Then you need less violent, dangerous, psychotic behviour. And if you want that, you need more treatment, voluntary or otherwise.
If the federally funded Disability Attorneys, mental health advocates, patients, friends and families of those afflicted, truly want less stigma, they must advocate, litigate and fund programs to eradicate the true problem: untreated mental illness. Remove the mark. More Treatment = Less Stigma.
