I was a third-year medical student when I discovered my calling to become a psychiatrist. To this day, I remember the gentleman who changed the trajectory of my life.
He was middle-aged and presented to the clinic due to difficulties with depression. As I entered the exam room, I remember feeling uneasy by his appearance. I could not make eye contact with him as he slumped over his chair resting his head in his hands. He spoke very slowly as he mustered the strength to answer my questions. His answers were brief, but his suffering was pervasive.
As I was about to exit the interview room, I remember telling him “You have battled and defeated this illness before. I believe you will defeat it again. We are here to help.” Then something amazing happened. I saw him break a faint smile. He had regained a flicker of hope. The feeling of earning his trust and witnessing the change in his facial expression was invigorating. I knew I had finally found my calling.
I remember being so convinced that I had to share the news. I decided to call a close family member that same day. They had played a pivotal role in my upbringing. My inner child was coming out as I was seeking the sound of validation in their voice.
Their response was quite unexpected. It left me feeling hallow and dismissed. In their words “I think you should become a cardiologist. You will make more money and not work with the insane.”
Though painful, I appreciate their response because it taught me a valuable lesson. I experienced firsthand the stigma against mental health. I was on the path of becoming a physician and experienced judgment from a close family member. I could only imagine what others who actually battle mental illness must go through.
Overcoming Stigma
The stigma against mental illness is real. If you have any doubt, consider there is a median delay of 11 years between the onset of mental health symptoms and receiving care. One reason for this delay is that people try to hide their mental illness due to the fear of being judged.
Look around society, and you will see that discrimination against mental illness is widespread. In the workforce, people with mental illness are less likely to be hired because they may be incorrectly labeled as unreliable or incompetent. In addition, employees may be reluctant to seek mental health treatment out of fear that revealing their mental illness may jeopardize their job security.
In a mental health crisis, people are more likely to encounter police than get medical help. About 15% of individuals in jails, compared to 4% in the general U.S. population, have a serious mental illness. Once in custody, people with serious mental illness tend to stay longer than their healthy counterparts.
Stigma is also present in subtle ways. Consider the language we use to describe mental illness. We often label people with their mental health diagnosis. For example, one may perpetuate the stigma by saying “he/she is bipolar.” A more appropriate statement would be “they have bipolar disorder.” Please recognize that one’s identity expands beyond any physical or mental health diagnosis.
Each one of us has an obligation to play a role in overcoming the stigma of mental illness. There are three ways to make an impact.
1. Education
It is important to educate people that mental illness is prevalent. In 2018, there were an estimated 47.6 million adults in the U.S. with mental illness. This number represents about 1 in 5 adults.
Evidence also shows that mental illness is on the rise. A new Lancet Commission report on mental health said that mental disorders are on the rise in every country in the world and will cost the global economy $16 trillion by 2030.
I share such statistics with my patients to convey the message that “You are not alone.” This statement does not intend to minimize the experience of suffering from mental illness, but to remove any shame associated with seeking help. People do not experience shame in seeing their family physician for a physical complaint. Why is there a double standard when it comes to mental health treatment?
2. Empathy
Empathy is the ability to emotionally understand another human being. You are standing side by side with them and seeing things from their point of view.
Please recognize that people suffer from mental illness. When someone has major depressive disorder, they struggle with a host of symptoms such as depressed mood, fatigue, a lack of pleasure or joy, insomnia, feelings of guilt or shame. People with an anxiety disorder may be tormented with worry thoughts, irritability, concentration difficulties and panic attacks.
The suffering from mental illness can become so unbearable that it affects one’s ability to function. Why worsen the suffering by being judgmental?
3. Advocacy
Be an advocate for raising mental health awareness. Contact your community leader to officially recognize national mental health awareness events such as Mental Health Awareness Month in May. Connect with local businesses and media outlets to spread the word.
You can also support organizations that advocate, educate and care for individuals and families affected by mental illness.
To this day, I think back fondly of that gentleman who changed the trajectory of my life. Through my clinical work, writing efforts and speaking engagements, I am trying to break down the barrier of stigma and make mental healthcare more accessible. Please join me in the fight against stigma