Google “stereotype stigma discrimination” and what do you find? The entire first page of hits is for mental health and mental illness. We had Mental Health Awareness Month in May. We had Mental Health Awareness week Oct 2-8. Then World Mental Health Day on Oct 10th. Maybe we need so many awareness events to get mental illness off the first page of hits for this combination of phrases.
Let’s consider the dictionary definitions,
Stereotype: to believe unfairly that all people or things with a particular characteristic are the same
Stigma: a set of negative and often unfair beliefs that a society or group of people have about something
Discrimination: the practice of unfairly treating a person or group of people differently from other people or groups of people
So how do they fit together? Stereotype is the grain of truth that reinforces stigma and enables discrimination.
Stereotypes are tricky things. There’s usually a grain of truth hidden in them. An observation that <insert group of people here> typically have <insert characteristic here>. The stereotype comes into play when asserting that a specific member of that group personally has a characteristic without any evidence and most likely not even knowing the individual. Stereotypes have another thing going for them. That grain of truth? Well it’s usually something negative. Take for instance the stereotype that people with severe mental illness (SMI) are violent. Reading the Boston Globe Spotlight article, it’s clear that happens. They report that in a ten year period, 116 people with severe mental illness were accused of killing 139 individuals, mostly family members. Without question this is tragic in its own right, but the reporting reinforces a stereotype. Consider this. Right in the middle of that time period, NAMI published these figures for Massachusetts:
Massachusetts had 6.5 million residents. Of those, 211,000 were living with SMI.
Let’s do the math: Approximately 3% of the population in Massachusetts at that time was suffering with SMI. Making the assumption that the SMI population between 2005 and 2015 was essentially a stable number, that works out to .0005% (yes that is three zeros before the percent!!) of people in Massachusetts with a severe mental illness who were involved in a homicide.
The stereotype reinforced by the article is that those with severe mental illness are likely to be violent. That seems like a pretty small percentage for labeling a large group. Wouldn’t you call that unfair? It’s certainly a stereotype to be afraid of being killed by any individual person you meet with severe mental illness. And yes, that does include the homeless person talking to themselves on the street.
Which brings us to stigma. If this population is likely to be violent, why wouldn’t you be afraid to be around them? You certainly would want to distinguish yourself from them. Look for all the ways in which you are not like them. Avoid identifying any commonality; keep yourself safe. Safe from worrying about something like that happening to you, your family, or others you care about. Justified in keeping yourself safe by avoiding eye contact, acknowledging them or giving them any other sense of belonging to the community.
So now, through the “validity” of a stereotype, we’ve applied stigma which has (unfairly) identified those stigmatized as “other.” And to be clear, that other-ness is in a negative context. This is not – XYZ group is better. It’s most certainly that this group is worse than you. Moving us to that place where we don’t practice acts of human kindness. These feelings allow us to not help a family in the neighborhood by driving carpool or dropping off a casserole while they deal with the burdens of finding treatment for mental illness. The types of neighborly things we would normally do. In fact, we are more likely to avoid those friends and neighbors brave enough to share a mental illness and crisis.
And this is how we get to discrimination. Throughout history, when horrible injustices are perpetrated, it’s preceded with a campaign to identify and denigrate the “other.” That includes everything from the Crusades, slavery, the Holocaust, and the genocide in Rwanda to name just a few. And in our modern society, this identification of “other” which is actually “less than,” even sometimes “less than human” leads to not just discrimination, but our ability to turn a blind eye to that discrimination.
For example, read the story of the Seattle Tree Man. This is an incident where for 25 hours a man clearly in the throes of a psychotic episode, was refusing to come down from a giant sequoia. All concern and outrage was focused on the tree. The discussion was around the cost of the damage to the tree and whether or how to charge him with a crime and get him to pay for the damage. No one was concerned for his wellbeing. No one even brought up the failure of the mental healthcare system to provide him with treatment. We would not treat our animals this way. That is the face of discrimination. It’s a hop, skip and a jump from “benign” stereotypes to full blown discrimination.
It’s past time to reform our attitudes and our mental healthcare system and treat our fellow human beings as exactly that – human beings. Start with yourself. Make eye contact. Recognize the human being. Raise your voice every chance you get to denounce discrimination. You can start by calling out stereotypes and stigma; demanding treatment not prosecution for those in need. Don’t wait for the awareness month, week or day, to raise your voice, to speak out.
Because it’s the right thing to do. And because you too could be stereotyped, stigmatized and discriminated against. It’s a hop, skip and a jump to being considered “less than.”