b'ing stigma-free

 

 

Caregiver loveComments from caregivers of people living with mental health conditions have been occupying my thoughts. Recently, I worked on two reports based on nationwide surveys of caregivers—On Pins and Needles: Caregivers of Adults with Mental Illness (with partners from the National Alliance on Caregiving and NAMI), and soon-to-be published on the Temple Collaborative website, Community Inclusion from the Perspectives of Caregivers of People with Psychiatric Disabilities.

In both of these reports, most of the caregiver respondents self-identified as close relatives—the vast majority as parents. They made it abundantly clear that they, as well as their loved-ones, face many challenges—including stigma.

Almost twenty years ago I was the primary caregiver of a rapid-cycling, suicidal teen, who I referred to as the “teenaged Morticia.” During those seemingly unending four years between my daughter’s 14th and 18th birthdays, life was chaotic and frightening for my entire family. Even though we experienced many of the same issues that caregivers report today, at the time I didn’t think of it as stigma. But I guess it was.

Financial Strain

I regarded the inequities that my family experienced as out-and-out discrimination. I was outraged that in that pre-parity era getting insurance reimbursement was a constant struggle. Claims were always being lost and denied—or lost, then denied. In fact, insurance coverage for my daughter’s treatment might have ended altogether—because she reached the lifetime limit by the time she was sixteen! To my relief along came the first iteration of the federal parity bill, and even though overt discrimination was still legal (albeit somewhat lessened), at least half of the cost for a limited number visits were covered—rather than nothing at all.

Were it not for having really good credit, my family would have drawn even closer to bankruptcy as we supported, financially and otherwise, my daughter’s recovery. Somehow we cobbled together treatment that made a difference, and won the battle to have the school district pay for an individualized education at a private school where, unlike the experience reported by so many caregivers in the surveys, the staff did understand and made a positive difference.

My daughter is no longer Morticia. She has grown up and left home. She has become an accomplished woman—a hospice nurse (maybe there’s some irony in that) who is happily married and expecting her first child.

Social Stigma

The financial burden impedes caregivers’ ability to afford to include their loved ones in all of their own social activities. In these surveys caregivers were emphatic that stigma must be addressed by educating school personnel, employers (and employees), clergy and other community leaders, and the public. They begged for compassion for themselves and their loved ones.

Caregivers said that because of stigma, their social life was compromised and invitations dwindled. One mother, speaking about her daughter reported: She’s fine . . . (but) I have no socialization!

Caregivers reported that their employment suffered too, as they try to make up for the deficiencies in mental health services and supports. Still they wanted to do more, as did this mother: The only way I could support her more is to quit my job and be with her 24/7.

When I think back to those difficult years when my daughter struggled, what sticks out most in my mind is the way that people looked at me. Unlike many of the survey respondents that reported people turned away, or pitied, or even blamed them, I remember people did look at me—with tears in their eyes. Maybe their tears represented the compassion that caregivers expressly called for, but it felt like the tears were just the outward expression of the cliché: there but for the grace of G-d….

 

 

Debbie PlotnickDebbie F. Plotnick, MSS, MLSP is the Vice President for Mental Health and Systems Advocacy at Mental Health America (MHA). Previously, she was the Director of Advocacy and Policy for the Mental Health Association of Southeastern Pennsylvania (MHASP), where she developed policy, organized grassroots advocacy activities, and designed recovery-oriented, community services. In her role at Mental Health America, Debbie provides leadership for mental health and systems advocacy initiatives within its affiliate network, with outside coalitions, industry/business, and policy makers. She provides technical assistance to policy makers, government officials and is frequently called up to speak to the press and the general public about what is needed to create a community-based continuum of mental health care, and to challenge entrenched mindsets and misinformation. She also coordinates the efforts of the Regional Policy Council (RPC), a six person council of MHA affiliate policy experts.

Debbie earned a degree in Political Science from Bryn Mawr College. And she holds dual master’s degrees in Social Service (MSS) and Law and Social Policy (MLSP) from the Bryn Mawr Graduate School of Social Work and Social Research. But her real understanding of mental health recovery and her passion comes from the people she works with and for, and her true expertise comes from her own lived experience, as a family member, and a mental health systems advocate.   


 

Musical notesIf you’ve ever listened to your favorite song to get you through a long day or drive away a bad mood, you know how helpful music can be for mental health. Studies have shown that music can alleviate feelings of depression, lower stress, and improve mental functioning. How about addressing stigma, and creating meaningful social change?

From Billie Holiday’s song Strange Fruit, a powerful song protesting racism and the horrific practice of lynching in 1939, or U2’s One in 1992 which dedicated profits to AIDS research and was rumored to be about a conversation of acceptance between someone living with AIDS and his father, to Lady Gaga’s 2011 anthem of self-acceptance and LGBTQ pride Born this Way, music has long been a powerful tool against stigma and helpful in breaking the taboos of the time.

Today, mental illness continues to be a forbidden topic in our society. While it’s socially acceptable to talk about a physical illness or ailment, mental illness is often regarded with skepticism, fear, and embarrassment. It can be difficult to talk about mental health without experiencing feelings of shame and stigma, which prevent many people from speaking out and receiving the support they need to get well or stay well.

Music can alleviate feelings of depression, lower stress, and improve mental functioning

We can change this, once again, by using music to break stigma and get people more comfortable talking about mental health. Better yet, the power of music doesn’t lie only with famous artists. Musical expression is open to everyone. Writing and performing your own music or spoken word piece about your experiences at youth organizations, with friends and family, an open mic night, or on social media can be healing — not only for you, but it can also help start important conversations in your community.

Through the power of music, you can create change and share positive messages about mental health. Let’s come together to remove the barriers and #breakthestigma once and for all!

 

Lisa SmuszLisa Smusz, MS, LPCC, is a consultant for Each Mind Matters as well as a Licensed Professional Clinical Counselor with more than 17 years of experience operating large-scale mental health projects. Ms. Smusz has internationally published works on stigma reduction and interventions for at-risk youth. Currently, she heads her own consulting company and is an instructor at California State University, East Bay.

Each Mind Matters is California’s Mental Health Movement. We are millions of individuals and thousands of organizations working to advance mental health. Each Mind Matters wants to end the stigma around mental health, so we started the Music for Mental Health project.

#MillionsLikeMe Music for Mental Health is a compilation of original music created by young adults who are participating in music programs run by non-profit youth organizations all across California. The goal of the album is to get young people to think and talk about the issue of mental health, to showcase the work of talented youth in California, and to support organizations who are using music to promote mental health in their communities.

Want to hear what these talented young artists have to say about mental health? You can download the album free of charge! Not ready to write your own song? Do your part by listening to the album, and sharing it with your friends.

Editor’s note: These tunes are great! Radio-worthy, we highly recommend them. So much so that we’ve created an additional link to the album on our Pinterest board, Songs that b Stigma-Free!


 

3D bodies Facts

 

Eating disorders are complex illnesses with biological, genetic, cultural and environmental components. They have the highest mortality rate of any mental disorder, yet they are consistently trivialized as being about vanity and lifestyle. The fallacies and stereotypes about eating disorders go on and on. “That’s only for white girls.” “You don’t look like you have an eating disorder.” “You’re fine, just eat something.”

Eating disorders are not choices, but serious biologically influenced illnesses.

The truth is that eating disorders affect everyone, regardless of age, ethnicity, gender, sexuality, size or economic status. They are life-threatening illnesses that can lead to bone loss, electrolyte imbalance, organ failure and death. Stigma, misconceptions and myths about eating disorders prevent people from getting the potentially life-saving treatment they need and deserve.

The stigma surrounding eating disorders is a problem in many ways. People too often suffer in silence because they are too ashamed to admit they have a problem and ask for help. Or they may not even realize that they have an eating disorder because they don’t fit the stereotype of a young, white, severely underweight teenage girl. Men, people of color and older adults have problems getting the treatment they need because those around them miss the signs. And even if the warning signs are recognized, individuals do not want to initiate the discussion because they think having an eating disorder is a sign of weakness, femininity or childishness.

Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses.

Even medical professionals contribute to the stigma surrounding eating disorders because of a lack of training and the many prevalent myths. Doctors may perform test after test to determine why their male patient keeps losing weight, when he clearly has an eating disorder. They may suggest that their patient loses weight, when that individual is actually struggling with a binge eating disorder. In fact, research has documented that physicians are the #2 source of weight stigma, and stigma has also been demonstrated in nurses and medical students, psychologists, dietitians and fitness professionals[1].

To fight the stigma, the largest eating disorders organizations in the country have banned together with a list of Nine Truths about Eating Disorders:

Truth #1: Many people with eating disorders look healthy, yet may be extremely ill.

Truth #2: Families are not to blame, and can be the patients’ and providers’ best allies in treatment.

Truth #3: An eating disorder diagnosis is a health crisis that disrupts personal and family functioning.

Truth #4: Eating disorders are not choices, but serious biologically influenced illnesses.

Truth #5: Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights,
sexual orientations, and socioeconomic statuses.

Truth #6: Eating disorders carry an increased risk for both suicide and medical complications.

Truth #7: Genes and environment play important roles in the development of eating disorders.

Truth #8: Genes alone do not predict who will develop eating disorders.

Truth #9: Full recovery from an eating disorder is possible.

It’s important that everyone affected seeks professional help. Early detection and intervention greatly increase the chances of successful recovery, so let’s end the stigma and get the facts straight. Everyone knows someone with an eating disorder, whether they realize it or not. So, if you are concerned about yourself or a loved one, take this online screening to see if it’s time to seek help. It’s quick and confidential – remember, 3 minutes can save a life.

 

Claire Mysko_2013Claire Mysko, MA is the CEO of the National Eating Disorders Association (NEDA). To raise awareness and combat stigma, the NEDA is coordinating National Eating Disorders Awareness Week (#NEDAwareness). The goal of NEDAwareness is to put the spotlight on eating disorders and improve public understanding of their causes, dangers and treatments. Millions of people across the country suffer from eating disorders, but by increasing awareness and access to resources, we can encourage early detection and intervention. Learn more at www.nedawareness.org or call the NEDA Helpline for information and resources about eating disorders – 800.931.2237.

 

[1] Puhl, RM and Heuer, CA 2009. The stigma of obesituy: A review and update. Obesity; 17(5): 941-964. Links to this and other research about weight bias here.

Links to research about eating disorder stigma here.


At first it was like I was sick again. I wouldn’t tell many people about my struggles. This3D bodies love especially occurred around dating, as all the women would eventually ask, “What are those scars on your arm about?”

I remember how ashamed I used to be of my illness, and how confusing it was to not know what precisely my diagnosis was. Initially I was classified as bipolar II with hypomania, but today I’m packed in there beside schizoaffective with a general mood disorder.

The Dating Scene

When you’re male and you’re depressed, there’s a definite stigma, and that’s definitely true for male self-injury as well. I feel much of it grows out of how society discourages males from showing their emotions or wounds. It also grows of one’s own perceptions and assumptions. I finally left my nearly two-decade long struggle with self-injury behind, and learned to cope better with the ups and downs of life. I moved out of a group home after ten long years.

I tried full disclosure and openness with a few dates, saying, “I used to cut myself.” I found the ladies would almost uniformly pull back, skew their heads a little to the side, and find a way to disentangle themselves and disengage from the relationship. This happened maybe three or four times in a row. I was right around forty-one years of age, and I felt great. The world seemed brand new to me again, but I felt personally and romantically quite stuck.

Finding Love

The next woman I dated was different – unique. Not only did she wear Batman Band-Aids on her finger, she was Pagan, worked in a corporate office, and was moving up in the company. She wanted to take it slow between us, so we only communicated by emails on e-Harmony for two weeks. We didn’t talk on the phone at all, until we came face to face. Amy Holmes had both a BA in Liberal Arts, and also a BS in Animal Science from UConn. While I loved dramas and artsy films, she preferred sci-fi and shoot-em-up movies and liked to read fantasy and write novels – yes, she wrote novels, too – about princesses saving dashing young princes on white horses, and sorcery and magic.

After our first date, which we spent at the local zoo, Amy pointed to the scars on my forearms and wrists and asked, “What are those?”

The rest is history. Amy was accepting when I told her I used to cut myself. She did check with a psychiatrist to better understand my illness, but by then we were pretty enthralled with one another. Still, though, I was cautious. I had her promise not too tell her family or co-workers what exactly I struggled with, for fear they would talk her out of being with me. Even as I pursued a master’s degree, I was still afraid. Then I got a book contract by Harper Collins to write my memoir, Sharp: My Story of Madness, Cutting and How I Reclaimed My Life. and I’ve been flapping my mouth about it ever since.

 

David Fitzpatrick_sDavid Fitzpatrick grew up in Guilford, Connecticut and, graduated from Skidmore College with an English degree, and got his MFA from Fairfield University in 2011. His memoir, Sharp: My Story of Madness, Cutting and How I Reclaimed My Life was published in 2012 by Harper Collins. His essays have appeared in New Haven Review and The Perch. He lives in Middlefield, Connecticut with his wife, Amy, a writer, photographer, and real estate investment analyst. David is currently coming down the homestretch on a novel.

Nowadays, Amy and David travel throughout New England, and as a couple they give talks about mental illness and stigma. Amy typically does the introduction, but also talks about her angle. David reads two or three portions from his memoir, and then gives a talk entitled, “Hope, Faith and the Power of the Broken.”

Neither is doing trigonometry or highly sophisticated surgery. They’re just two peers offering welcome doses of hope. Being real is what clicks and feels so right with a lot of the audiences they address – whether NAMI groups, mental health conferences, or Grand Rounds at leading psychiatric hospitals in the area.

Reach David on Twitter at @davidfitzbooks, or check out his website, www.DavidFitzpatrickBooks.com.


I call depression in men a hidden epidemic. Epidemic in that depression afflicts millions of men in the U.S. alone. Hidden in that too many of those men will not get treated for depression. They may not even recognize that they have depression! That’s a great shame because depression is one of psychiatry’s great success stories.

Ninety percent of people who get treated for depression report substantial relief, but fewerBarbells than three out of five get the help they need. It seems that a man is as likely to ask for help with depression, than he is to ask for directions. And for much the same reasons: Men don’t ask for help. Period. That’s because it goes against the traditional male code – the code of invulnerability. What it means to be a man is to be invulnerable. The more invulnerable you are, the more manly you are. The more vulnerable you are – and particularly emotionally vulnerable – the less manly you are; you’re weak, a sissy.

Compound Shame

Depression carries a double stigma when it comes to men. There is the stigma of having an emotional disorder that might challenge anyone. Beyond that, there is the stigma of unmanliness. It is not unwomanly for a woman to be depressed, but men aren’t supposed to get overwhelmed, particularly not by emotions, which is exactly what happens with depression. This double stigma sets off in many men what I call compound shame. These men are depressed about being depressed, ashamed of feeling ashamed. They’ve been set up to hide how they feel – and many do: to others certainly, but even to themselves.

Research shows that girls and women tend to internalize distress, ruminate about it and blame themselves. Boys and men, by contrast, tend to externalize distress – blaming others, or acting out their feelings through self-medication with substances or with processes, like gambling or sexual infidelity.

Covert Depression

Depression is usually seen as a woman’s disease. Supposedly, depressed women outnumber men two or even three times over. I think that figure is off – for two reasons. The first is simple under reporting; men minimize their depression. The second reason is a little more complicated and a lot more impactful. As I mentioned earlier, some men do such a good job of hiding their depression that they hide it from themselves. These men have what I’ve called hidden or covert depression. In covert depression you don’t see signs of the depression per se, but rather signs of what the man is doing to escape his depression – drinking, drugging, taking high intensity risks, womanizing, workaholism. You see the depression’s footprints in the man’s life. I speak of an unholy triad in male depression:

  • – Self medication
  • – Acting out – either sexual or aggressive
  • – Radical isolation.

If either you or a man you love has exhibited any one of these symptoms, then that may indicate an underlying depression. Am I saying that every alcoholic, every rager, has a core of unresolved depression? I am not. But I am saying that many do.

Signs of covert depression, like anger, often respond well to antidepressant medication.

Get Help

Listen, you have the right to health in your family. If you are the depressed man, reach out and get help. Have the spine to move beyond the male code. And if you are the spouse or family of such a man, so long as it’s physically safe, stand up and insist on health for you and your children. “Hey look, if you wanted to live alone in a cave you could suffer like this. But you chose to have a family. We need you to do something about this. Even if you don’t, we do.”

Many of the depressed men I treat are what I call wife-mandated referrals. This is not a time to stand on ceremony and wait until he wants to do it for himself. If you need to, you book the appointment. If he won’t go to individual therapy drag him to a couple’s therapist. But one way or another get him in front of a mental health professional who can diagnose, talk to him about, and ultimately treat his condition. You all deserve that. It might also help to enlist the help of your partner’s general physician, other family members, or friends. You decide what’s best. But please do something. Depression, both overt and covert, can be treated and improved, and even cured – if the man gets help.

Terry RealTerrence Real is a nationally recognized family therapist, author, and teacher. He is particularly known for his groundbreaking work on men and male psychology as well as his work on gender and couples; he has been in private practice for over twenty-five years. Terry has appeared often as the relationship expert for Good Morning America and ABC News. His work has been featured in numerous academic articles as well as media venues such as Oprah, 20/20, The Today Show, CNN, The New York Times, The Wall Street Journal, Psychology Today and many others.

In 1997 he published the national bestseller: I Don’t Want To Talk About It, the first book ever written on the topic of male depression. That was followed by How Can I Get Through To You? an exploration of the role of patriarchy in relationships and most recently, The New Rules of Marriage: What You Need to Know to Make Love Work, a practical guide for couples and couples therapists.

Terry founded The Relational Life Institute, in Arlington, Massachusetts, dedicated to working with the general population to help women reclaim their voices and men open their hearts. The Institute offers a training program which begins with an introductory level practicum as well as workshops and trainings throughout the US and Canada.

For more information on his work, please visit his website, www.terryreal.com.


Barcode image - Labels in the WorkplaceA few years ago I worked in an office with several forensic psychiatrists. They didn’t meet with patients as my own life-saving psychiatrist did; rather, they reviewed disability files to help determine whether the claimant was capable of re-entering the workforce.

Every week we’d all meet to go over difficult cases and get feedback from each other. The sole layperson in these meetings, I attended as a learning experience, and I was often shocked and offended by what the psychiatrists said about the claimants. “I wish I could have time off work because of stress,” they’d say, or “Oh, boo-hoo. She had a panic attack once and hasn’t been back to work since.”

While not every claimant needed extended time off, and it’s often therapeutic to get back into the swing of things, I didn’t appreciate how even the psychiatrists’ valid opinions were expressed—with judgmental bitterness. These attitudes made me feel really uncomfortable; I worried what they meant for the claimants who had legitimate reasons for needing extra care. The review team labeled the claimants, and then surmised the validity based on that label. How could these reviewers assess the situation and then offer a fair, professional opinion when they couldn’t contain their personal biases?

So I spoke up.

I met with both the owner of the company and the woman who ran the meeting and was disappointed to realize they didn’t take any of my concerns seriously. When I told them I have obsessive-compulsive disorder (OCD), their tough demeanor changed. With a sympathetic look on his face, the owner said, “You shouldn’t feel bad about that. We all have quirks.”

“I don’t feel bad,” I said. “The point in me telling you I have OCD is to illustrate that you can never know who might have a mental illness. If I have OCD and no one realized it, who else here is going through something and may feel alienated? What if someone makes a joke about schizophrenia, not knowing someone three chairs down has a relative with schizophrenia?”

“You know, those are closed meetings, and our reviewers need to feel comfortable to let loose. This can be a very stressful job,” he told me. “The meetings aren’t going to change. But you can develop a thicker skin and be less sensitive.”

Blood rushed to my face. “No,” I said. “I won’t be less sensitive. I like having a thin skin. It’s a huge part of who I am.”

I didn’t realize I’d be so assertive, but I also hadn’t realized he’d refuse to meet me halfway. Everyone else—those who were making rude comments in meetings and joking about alcoholism and “being OCD” in the break room—they were okay. They had permission to continue being insensitive. On the other hand, the powers-that-be said that if I was going to be so upset by the meetings, I should just stop attending them. Even when faced with the effect of the stigmatizing language, they dismissed me. By labeling me, and others, as having a mental illness, they seemed to feel their actions were justified.

I knew I had to quit this job. It was eating away at me. I sat down and had heart-to-hearts with the highest-ranking people in the company, and they told me to toughen up. They defended what was happening; they were okay that misconceptions were being perpetuated. And they didn’t care that one of their own employees felt uncomfortable in the workplace. I’ve wondered if they’d taken me more seriously if I hadn’t outed myself as having OCD. What I considered a strong point in my argument could have been the weakest link—I was just another squeaky wheel with a mental illness, not unlike the people who needed some time off from work.

A few days after I’d been told nothing would change, one of the psychiatrists joined me for lunch. “I want to thank you for reminding me what it means to be a good psychiatrist,” he said. “I work in forensics. I don’t have patients, and that makes it easy to forget that these claimants are people, too.”

I left the company knowing it hadn’t all been for naught. My frustration turned to empowerment, and within a year I’d signed a deal to write a book for teens and young adults with OCD. I may have had a positive impact on only one person at that office, but now I’m spreading my message of acceptance and sensitivity as far as I can, to anyone who will listen.

 

Image of author Alison DotsonAlison Dotson is a writer, copyeditor, and proofreader who was diagnosed with OCD at age 26, after suffering from “taboo” obsessions for more than a decade. Today, she still has occasional bad thoughts, but she now knows how to deal with them in healthy ways. Alison is the president of OCD Twin Cities, an affiliate of the International OCD Foundation, and has been featured as an OCD advocate on the International OCD Foundation Blog, the Huffington Post, and in Glamour magazine. She lives in Minneapolis, Minnesota, with her husband and two rescue dogs.

Alison is the author of Being Me with OCD: How I Learned to Obsess Less and Live My Life. You can find her book, along with other books about b‘ing stigma-free, in our bookstore.


iFred Sunflowers

 

Stigma…simply writing the word and reflecting on it brings many other descriptive words to mind: isolation, discrimination, shame, fear, to name just a few. It silences people during times when they need the most care, the most love, and treatment for their health. In relationship to suicide, it is life threatening.

Suicides are happening across the world every 40 seconds and many individuals contemplating suicide experience anxiety, depression and hopelessness according to the World Health Organization’s report Preventing suicide: A global imperative. The stigma that surrounds mental illness, coupled with symptoms of hopelessness, only isolate people more. Individuals with suicidal ideation often see no other way out of their pain.

Most illnesses that affect the body are treated with care and compassion. And yet, when illness affects our brain, we cannot talk about it. Individuals are left with a sense of shame or guilt, and led to believe there is something wrong with them for not being able to simply “feel better.”

Depression is treatable. By destigmatizing mental illness, we encourage individuals to receive the necessary support and treatment, thus saving lives. As communities we can offer compassion, discussion, education, and research on best treatment practices. Prevention programs may be offered, follow-up care provided, and families who have lost loved ones by suicide may be given a safe outlet to share their grief.

One way to end stigma is by rebranding the disease. By only displaying negative images of a person in the midst of a depressive state, society does not get to see the success of treatment and recovery. Positive and hopeful images will help people talk openly, build awareness, and break down the stigma barrier. Breast cancer eradicated stigma by primarily doing three things: focusing on the biology of a woman’s body, involving celebrities and leaders, and using a universal symbol for the disease.

If people’s perception of depression and mental illness may be changed to reflect a positive and hopeful outlook, we will help millions of people, prevent suicide, and promote living a life of positive mental health and well-being.

 

Kathryn GoetzkeKathryn Goetzke is the entrepreneur and innovator behind Mood-lites™.  The product line was made available nationwide at Lowe’s Home Improvement stores and was associated with the first successful cause marketing campaign for depression. She runs a consulting business and is the CEO of The Mood Factory, which just launched a new sensory line of products based on how smells impact moods. Kathryn was a featured presenter at Scent World, 2014 and her work has been showcased in Entrepreneur Magazine, Home, Chicago Tribune, BBC, CBS Chicago, InStyle, and more.

In addition, Goetzke is the founder of iFred (the International Foundation for Research and Education on Depression), dedicated to encouraging research on depression and reducing the stigma associated with the disease. The organization advocates to rebrand depression by utilizing the sunflower and color yellow as a positive universal symbol for depression; educating the public on brain biology; and inviting other organizations around the world to join in their efforts by planting sunflowers. Hopelessness is the number one predictor[i] to suicide, so iFred’s Schools for Hope program teaches kids about hope; this is based on research that hope is a teachable skill that can prevent suicide and promotes the importance of mental health.    

Kathryn serves on the Global Mental Health Advisory Board, and has presented on the need to rebrand depression around the world for NGOs and nonprofits. She recently participated for the third time in the World Health Organization’s invitation-only event, working on implementation of the Global Mental Health Action Plan adopted by the UN’s 66th World Health Assembly.

Kathryn is also on the Steering Committee of FundamentalSDG, a group of diverse experts in the field of global mental health. When FundamentalSDG noticed that mental health was not a part of the Post Millennium Development Goals they called for the United Nations to take action and make mental health a post-2015 sustainable development target. #FundamentalSDG invites you to add your name or organization’s logo to the site, tweet your support, and write to the United Nations on the provided template so leaders include mental health in the Post Millennium Development Goals.

[i] Sher, L., Preventing Suicide, QJM (2004) 97 (10): 677-680


Fighting stigma is critical to suicide prevention efforts for two reasons.

Prevention Image Stigma's Impact on Suicide

Stigma discourages people suffering with a mental illness from seeking help. Of all those who live with a mental disorder, only 1 in 5 seeks help. To reduce suicide we must change how we respond to mental illness and thoughts of self-harm.

While misinformation might explain why stigma exists, it doesn’t excuse its persistence. Stigma is a form of prejudice, and it leads to discrimination. It is our responsibility as a community to stand against it. Fighting stigma will help us change our society from one where people are embarrassed to seek help for mental health problems, to one where taking care of your mental health is the smart thing to do.

The second reason why fighting stigma is important may be less obvious.

Bereavement

We tend to think of stigma as something that impedes progress. Towards suicide prevention, however, it also complicates the experience of losing a loved one to suicide. In the context of suicide bereavement, the ugliness of stigma is stark.

When a parent loses a child to suicide, they often feel shame in addition to grief. Silence greets their loss as friends and family often lack the words, unsure of what is “appropriate.” Their child lost a battle with mental illness, just like people lose battles with cancer or heart disease. If we overcome our fear of talking about the circumstances that led to suicide, we can give the surviving family members the same compassion that we extend to those who lose someone to other causes of death.

Stigma’s effects conceal the depth of the problem in our society. Silence in the face of stigma makes suicide less urgent, and therefore more difficult to rally people to take action against it.

The reality is that suicide takes more lives than war, murder, and natural disasters combined. And yet too many people still don’t want to talk about it. Suicide is the last great health issue of our time. We have to talk about it. The lives of our families and friends and neighbors and colleagues depend on it.

 

Image Bob Gebbia, AFSPRobert Gebbia has been the Chief Executive Officer (CEO) of the American Foundation for Suicide Prevention since 1998. As CEO, Mr. Gebbia is responsible for the overall management of the organization and developing strategies to support its mission: expanding suicide prevention by funding scientific research, adding new educational programs, public awareness initiatives, national and local advocacy campaigns, and supportive services for individuals and families that have lost a loved one to suicide. 

Mr. Gebbia works closely with nationally recognized scientists in suicide research, business, civic and political leaders, professional associations and people personally impacted by suicide. He holds a BA in Sociology from Hofstra University, and an MA in Sociology from the New School for Social Research. 


 

“Hijita, eso es algo que no debería ser compartido fuera de la familia.”
“Daughter, that is something that should not be shared outside of the family.”

Image: Fighting the stigma of mental illness in the Latino communityGrowing up as a child of two Mexican immigrants, and later as a counselor working in the Latino community, I have heard this sentiment often. Deeply ingrained within the Latino culture one finds a great amount of stigma and discrimination against mental illness — even to the point where people are afraid to seek help because of fears they will be perceived by their community as being ‘loco,’ or ‘crazy.’

According to the U.S. Census Bureau (2011), by 2050 Hispanics will make up approximately 30 percent of the US population[1]. As this population increases, its need for mental health services and supports will likely grow. Unfortunately Latinos are not seeking these services. A study in Health Services Research (2013) by Benjamin Le Cook found that only 27 percent of Latinos in need of mental health care actually sought help[2]. This reluctance to seek care is due to a number of factors, including self-stigma and a fear of social perception.

Stigma against mental illness in the Latino community hits close to home for me. I actively fight myths and misperceptions about it through my work with journalists at The Carter Center, promoting accurate and sensitive depictions of mental illness in the media. In fact, one of the greatest misperceptions or misunderstandings within the Latino community revolves around the concept of asking for help in the form of talk therapy. During my time at a clinic for expectant or recently delivered Latina mothers, I found that many mothers did not realize they could benefit from therapy.

Sitting in front of me with a look of complete exhaustion on her face, I remember staring into Alejandra’s* beautiful brown eyes. She was a 23-year-old mother of newborn twin girls and had a rambunctious two-year-old in tow. Alejandra barely had enough energy to get through each day. She was depressed and exhausted. Alejandra came into the clinic for ‘free’ baby supplies, but she learned that she could also find some relief for herself through talk therapy with me. She had never realized that therapy was something she could benefit from, nor did she know it could re-energize her for the week. Eighty percent of the mothers with whom I worked were dealing with mild to severe depression; many felt like they had to figure out everything on their own, not wanting to be a burden to others.

Latinos don’t typically put a name to feelings like anxiety or discuss an emotional problem with others, even their closest relatives. My clients were dealing with a double dose of stress: being new mothers, as well as being in a new country. Once in a safe environment and given the opportunity to talk with a therapist, they could begin their road to recovery.

I urge all people, no matter what one’s ethnic background, to seek help if needed. It is NOT weak or needy to reach out for help and to speak about personal challenges when it is safe to do so. There is strength in vulnerability and a real courage found in someone who asks for the help he or she needs. Let’s break this cycle of cultural stigma together. We need to encourage a culture of recovery in all our interactions so that one day we can be a culture of wellness that promotes social inclusion, not only for Latinos, but for all.

I hope one day I will have a different conversation with my daughter.

“Hija, tu puedes compartir tus preocupaciones de salud mental fuera de la familia para obtener la ayuda que necesitas.” 
“Daughter, you can share your mental health concerns outside of the family to get the help you need.”

* Name has been changed to protect confidentiality.

 

[1]  U.S. Census Bureau, National Characteristics: Vintage 2011 (2011). http://www.census.gov/popest/data/national/asrh/2011/index.html. Accessed April 28, 2014.

[2] Center for Advancing Health, Blacks and Latinos Seek Mental Health Care Less Often (2013), http://www.cfah.org/hbns/2013/blacks-and-latinos-seek-mental-health-care-less-often. Accessed April 28, 2014.

 

Image: Stephanie Uribe, guest blogger from The Carter Center

Stephanie Uribe, M.Sc., M.Ed., is a program associate for the Rosalynn Carter Fellowships for Mental Health Journalism at The Carter Center where she works with journalists to increase accurate reporting about mental health issues. This program decreases incorrect, stereotypical information about mental illness that leads to stigma. In addition to her work there, she actively volunteers on the planning committee for the UNESCO Annual Bioethics Art Competition and is a planning committee member with the World Affairs Council of Atlanta Young Leaders.

Photo: The Carter Center/P. Rohe. 

 


When I told a friend that I’d been diagnosed with obsessive-compulsive disorder (OCD), he said, “Are you sure? I mean, I’ve been to your apartment — it doesn’t seem like you clean a lot.”

I couldn’t really blame him for thinking that’s what OCD is all about, but it didn’t make itImage: Intrusive Thoughts any less frustrating. I was in an early, vulnerable stage and while I had welcomed my diagnosis because it meant I could be treated, I wasn’t ready to share many details.

Saying “I have OCD” isn’t necessarily a big deal, but explaining the impact it had on my life for years and years—that is hard. I can’t nonchalantly tell a co-worker, “No, no, I’ve never washed my hands excessively, but I did have an irrational fear that I might be a child molester.” It’s usually not the right time or place to explain how much I suffered from horrible, intrusive thoughts that made me question who I was and think I was morally bankrupt. And it’s painful to talk about how my obsessions led me to consider suicide before I finally received professional help.

Initially I feared how people might react to my “confession,” and I didn’t talk about my diagnosis. People often picture an OCD sufferer as a super-organized person who keeps everything spotless. They don’t know how to reconcile that preconception with my reality. Let me tell you—I am not very organized, and my house is definitely not that clean. People figure that if I have OCD, then the disorder can’t be so bad. They think I must have a mild case, because have you seen my desk drawer? What a mess!

Steering people away from that relatively innocuous impression and toward my own taboo, intrusive thoughts sometimes feels like a bad idea, like I’m welcoming judgment. I’m aware that I’m sacrificing privacy and breaking the protective bubble around me in my efforts to combat stigma.

One day a co-worker approached me after she’d read an article I’d written about OCD and told me she thinks she might have OCD too, because she keeps her clothes really organized. Not up to the task of explanation, I nodded and smiled and joked that being neat is definitely not a “symptom” I have.

Another day, a different co-worker pointed to her neat row of pencils, thinking we had something in common. And I felt the blood rush to my face. I asked her if organizing her pencils like that had ever made her cry, or if she couldn’t stop thinking about the pencils if they weren’t straight. “Do you straighten your pencils because you think a family member will die if you don’t?” I asked, my voice shaking.

The more pervasive these misconceptions are, the harder it is for people to get help when they are suffering. That’s the biggest problem with people’s nonchalance about the disorder — thinking it’s a small set of symptoms and not realizing how terrible it can be. It took me years to get the help I needed because it never occurred to me that I had a problem that could be treated. My knowledge about OCD was limited to what I saw on TV and in movies; I didn’t see a connection between what the media portrayed and my own unwanted thoughts. I thought I was a bad person. I was afraid to tell friends or family members because I thought they’d judge me or stop loving me. I was even hesitant to tell a therapist, because my thoughts were so wrong I really believed they’d have a professional, moral, and legal obligation to report me to the authorities or have me checked into a psychiatric ward.

Instead I told a few people I was depressed, and I confided to one of my oldest friends that I tend to obsess about things. She mentioned OCD, and I started to research the disorder. I made an appointment with an OCD specialist. Sharing my darkest secrets with him was one of the hardest things I’ve ever had to do, but it saved my life.

So even though I don’t always feel up to the challenge of spreading awareness, and sometimes I get emotional about it, I won’t give up. If I can keep others from suffering for as long as I did, it will be worth it.

 

Image of Alison Dotson, guest bloggerAlison Dotson is a writer, copyeditor, and proofreader who was diagnosed with OCD at age 26, after suffering from “taboo” obsessions for more than a decade. Today, she still has occasional bad thoughts, but she now knows how to deal with them in healthy ways. Alison is the president of OCD Twin Cities, an affiliate of the International OCD Foundation, and has been featured as an OCD advocate on the International OCD Foundation Blog, the Huffington Post, and in Glamour magazine. She lives in Minneapolis, Minnesota, with her husband and two rescue dogs.

Alison is the author of Being Me with OCD: How I Learned to Obsess Less and Live My Life. You can find her book, along with other books about b‘ing stigma-free, in our bookstore.


 

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