Breaking The Stigma

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

The author of The Presentation of Self in Everyday Life analyzes a person’s feelings about himself and his relationship to people society calls “normal.” Stigma is an illuminating excursion into the situation of persons who are unable to conform to standards that society calls normal. Disqualified from full social acceptance, they are stigmatized individuals. Physically deformed people, ex-mental patients, drug addicts, prostitutes, or those ostracized for other reasons must constantly strive to adjust to their precarious social identities. Their image of themselves must daily confront, and be affronted by, the image others reflect back to them. Drawing extensively on autobiographies and case studies, sociologist Erving Goffman analyzes the stigmatized person’s feelings about himself and his relationship to “normals” He explores the variety of strategies stigmatized individuals employ to deal with the rejection of others, and the complex sorts of information about themselves they project. In Stigma, the interplay of alternatives the stigmatized individual must face every day is brilliantly examined by one of America’s leading social analysts. “This short book established the conceptual understanding of stigma that continues to buttress contemporary sociological thinking.” —Sociological Review

Details the results of the Open Doors Programme, set up to fight the stigma/discrimination attached to schizophrenia.

This book makes a highly innovative contribution to overcoming the stigma and discrimination associated with mental illness – still the heaviest burden both for those afflicted and those caring for them. The scene is set by the presentation of different fundamental perspectives on the problem of stigma and discrimination by researchers, consumers, families, and human rights experts. Current knowledge and practice used in reducing stigma are then described, with information on the programmes adopted across the world and their utility, feasibility, and effectiveness. The core of the volume comprises descriptions of new approaches and innovative programmes specifically designed to overcome stigma and discrimination. In the closing part of the book, the editors – all respected experts in the field – summarize some of the most important evidence- and experience-based recommendations for future action to successfully rewrite the long and burdensome ‘story’ of mental illness stigma and discrimination.

This book is a collection of writings on how society has stigmatized mentally ill persons, their families, and their caregivers. First-hand accounts poignantly portray what it is like to be the victim of stigma and mental illness. Stigma and Mental Illness also presents historical, societal, and institutional viewpoints that underscore the devastating effects of stigma.

A compassionate and captivating examination of evolving attitudes toward mental illness throughout history and the fight to end the stigma. For centuries, scientists and society cast moral judgments on anyone deemed mentally ill, confining many to asylums. In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy. Nobody’s Normal argues that stigma is a social process that can be explained through cultural history, a process that began the moment we defined mental illness, that we learn from within our communities, and that we ultimately have the power to change. Though the legacies of shame and secrecy are still with us today, Grinker writes that we are at the cusp of ending the marginalization of the mentally ill. In the twenty-first century, mental illnesses are fast becoming a more accepted and visible part of human diversity. Grinker infuses the book with the personal history of his family’s four generations of involvement in psychiatry, including his grandfather’s analysis with Sigmund Freud, his own daughter’s experience with autism, and culminating in his research on neurodiversity. Drawing on cutting-edge science, historical archives, and cross-cultural research in Africa and Asia, Grinker takes readers on an international journey to discover the origins of, and variances in, our cultural response to neurodiversity. Urgent, eye-opening, and ultimately hopeful, Nobody’s Normal explains how we are transforming mental illness and offers a path to end the shadow of stigma.

This is the definitive textbook on global mental health, an emerging priority discipline within global health, which places priority on improving mental health and achieving equity in mental health for all people worldwide.

Paradigms Lost challenges key paradigms currently held about the prevention or reduction of stigma attached to mental illness using evidence and the experience the authors gathered during the many years of their work in this field. Each chapter examines one currently held paradigm and presents reasons why it should be replaced with a new perspective. The book argues for enlightened opportunism (using every opportunity to fight stigma), rather than more time consuming planning, and emphasizes that the best way to approach anti-stigma work is to select targets jointly with those who are most concerned. The most radical change of paradigms concerns the evaluation of outcome for anti-stigma activities. Previously, changes in stigmatizing attitudes were used as the best indicator of success. Paradigms Lost and its authors argue that it is now necessary to measure changes in behaviors (both from the perspective of those stigmatized and those who stigmatize) to obtain a more valid measure of a program's success. Other myths to be challenged: providing knowledge about mental illness will reduce stigma; community care will de-stigmatize mental illness and psychiatry; people with a mental illness are less discriminated against in developing countries. Paradigms Lost concludes by describing key elements in successful anti stigma work including the recommended duration of anti-stigma programmes, the involvement of those with mental illness in designing programmes, and the definition of programmes in accordance with local circumstances. A summary of weaknesses of currently held paradigms and corresponding lists of best practice principles to guide future anti-stigma action and research bring this insightful volume to an apt conclusion.