Having a chronic illness or condition and being different from the general population subjects a person to possible stigmatization by those who do not have the illness (Joachim & Acron, 2000). Stigma is a negative stereotype. For persons with mental illness, stigma is one of the greatest barrier to complete and satisfying life. Mentally ill individuals are seen as being dangerous, violent and unpredictable.
As a result of this view, the mentally ill are stereotyped, discriminated against, refused health insurance, jobs and independent living in pursuit of goals, difficulty keeping friends and even family members which also result in their low-self esteem. For this reason as well persons who may suspect that they may be experiencing a mental illness example that of Depression, may refuse to seek medical help because if fear of what others may think of them. This sigma can be minimized by educating the public, community at large.
Being diagnosed with a mental illness can be detrimental to any individual as they struggle to accept or continue to denying their condition. It gets even more complicated when family members, society and friends reject them, leaving them to flight the challenges of life being discriminated and stigmatized for a condition they didn’t ask for. During my work experience, I met a highly qualified Accountant diagnosed with having Bipolar disorder for 45 years. He remained in constant denial which resulted in his non- compliance with his medication and having to be hospitalized for his several relapses.
Despite, doing extremely well at his job when he was well, employees got frustrated, and with any signs of a possible relapse, sometimes work stress related, was eager to dismiss him in fear of him exhibiting any aggressive or violent behaviour. He complained on several occasions that workers would not talk to him outside work related conditions. Fortunately for him, he eventually found a understanding employer who also had personal closeness with a friend who was also mentally Ill. With her understanding and sympathy to the situation, she decided to work with the patient, aiming for positive mental health.
He was given conditions under which he had to maintain in order to keep his job. Some of these condition meant showing prove of hospital clinic or Doctors appointment. He battled his condition with the help of family members who neglected him, yes because of his mental condition but also because of his confident “cocky attitude” that he tried to portray as his means of self defence to mask his internalized low self esteem. He would however express to the hospital team who became his family, a feeling of being lonely and the lack there of understanding the struggles of trying to be accepted and to live a normal quality life.
Although being stigmatized of having a mental illness, the issue of discrimination and internalized low self-esteem significantly affected him to the point where life later became meaningless resulting in suicide. Why the need to focus on Mental illness? As a student nurse, I rotated through the Psychiatric unit of The University Hospital of the West Indies, Ward 21 and the Caribbean Psychiatric hospital, Bellevue Hospital. Back then i can recall being fearful of these patients who were referred to as being capable of having aggressive, violent and unpredictable behaviour.
I was told to walk in groups while on the ward floors or unit, and not to allow patients to detect our fear. It was even after my final rotation at the Bellevue Hospital that i felt the need to spend more time, even to pursue the possibility of specializing in this area. Even after being told that staff who spend significant time in this area of speciality usually becomes mentally ill. However this area became fascinated and gave me the opportunity to meet various persons with varying diagnosis, conditions and personality, the “special persons” who are discriminated against and stigmatized.
With this in mind my main aim is to make a difference to society by getting a better understanding of the area of mental health prevention and treatment of the mentally ill in order to impact my knowledge on the public at large. Consequences of Mental Illness Discrimination Stigma is a significant challenge for persons with Mental illness. Social psychological models describe stigma as comprising stereotype, prejudice and discrimination (Corrigan, Rafacz, & Rusch, 2011). Stereotypes are harmful beliefs about groups of people and are unavoidably learned from maturing in a culture.
According to Corrigan et. al, stereotype is usually associated with persons with mental illness, including dangerousness, blame and social incompetence. He went on to state that “Discrimination is the behaviour response to prejudice. The mentally ill feels alienated and feels less than a full member of society resulting in social withdrawal. During socialization we are thought to look on persons that appear to be different from us as outcast, unique, or not fitting for our society. Based on our morals, values and beliefs, persons who are mentally ill as seen as being processed with evil spirits.
They are often time taken to the ‘obeah’ man or woman for spiritual healing. These spiritual healers would provide the patient and or family members with oils, potions and other apparatus, in an attempt to heal the sick. When these methods have failed, the second option of a medical physician is sort. Being discriminated against and having to deal with a medical illness can be very challenging for the mentally ill, and this situation is compounded even more without the support from family members and friends ,employee, neighbour or an intimate partner.
These individual are devalued and viewed as being less trustworthy, less intelligent and less competent (Link, Struening, Neese-Todd, Asmussen, & Phelan, 2001). Whether employment has a positive or negative effects likely depends on the workplace environment as finding employment is often associated with quality of life (Rusch, et al. , 2014). Fortunately for some of these individual, they are able to receive and maintain jobs but for the majority they remain unemployed or deemed unemployable with may result in low self-esteem.
Self-Esteem Who is to be blame for having low self-esteem? Internalized stigma has been associated with a number of negative outcomes, including increased depression, avoidant coping, social avoidance, decreased hope and self-esteem. This leads persons to wonder if because of these negative self-concept and ineffective coping, the mentally challenged in advertently, internalize stigma.
In an article entitled, ‘A model of Internalized Stigma and Its effect on People with Mental illness’ by Drapalski et. al. publish in the Psychiatric Services March 2013 volume 64, issue 3, it aimed to examine the prevalence of internalized stigma among individuals with serious mental illness. This article revealed that of the 100 participants’ age ranging between 18 -80 years, and being diagnosed with some form of mental condition as a inclusion criteria to the study, thirty-five percent (35%)of the participants reported moderate to severe levels of internalized stigma, whilst forty-six percent (46%) reported mild levels of internalized stigma.
However internalized stigma was significantly associated with greater symptom severity, representing a p-value of 0. 01 and lower self-esteem with identical p-value representing that of statistical significant. It has been theorized that sigma is harmful to the self-esteem of persons with mental illness as these individuals are continuously being stigmatized leaving the mentally ill to have negative feeling of self.