Imagine you’ve just walked into the home of friends for their 25th wedding anniversary celebration. At this party there are a couple of people you’ve known for years, several you know pretty well and many more you’ve only just met. There are 40 people at the party, let’s say, a sizable group for any home-based occasion. Envision these people in your mind: laughing, sipping punch, chatting it up in the living room and kitchen—some spilling out onto the patio. Their faces are happy and engaged as they enjoy the company of friends and new acquaintances. As with any place people gather, some of the guests are gregarious, telling jokes and stories to the rapt attention and laughs of listeners. Others are quieter—several groups of two speaking in low tones. But every face you see appears like any face at any party, anywhere in the country: easy or pensive, delighted or humorous. Ordinary.
Mental Illness and Stigma
Now consider this: According to the NIMH, approximately one in four people struggles with a mental health challenge; 10 people at this party, perhaps. It’s hard to imagine that in any large group of people, so many individuals could be suffering, but the reality is that mental disorders are commonly occurring, if not ordinary, health challenges. Mental illness can happen to anyone, and it does occur all the time, to all demographics—rich and poor, black and white (and otherwise). The most fundamental challenge in assessing and treating these disorders—most of which can be greatly assisted with the aid of therapy, medication and/or some other combination of treatments—is not a matter of being able to detect who “looks” sick; mental health disorders are largely diagnosed on the basis of behavioral factors and the self-reports of individuals (how they feel, what they experience, etc.). Instead, the greatest barrier to accurate diagnosis, and thus, sufficient treatment for often painful and life-interrupting disorders is one of social misunderstanding. The general population is simply uninformed about mental health challenges, and this lack of education creates fear and ignorance through which tremendous stigma exists and has existed for centuries. This stigma prevents individuals from seeking the help they need.
Story of Mental Health Stigma in the Workplace
Shasta was a 32-year-old supervising accountant for the corporate headquarters of a national franchise. She’d been something of a math wizard since she was a child, and had a good head for managing groups. All in all, she was an excellent employee, and a top-ranked manager within her company. As a teenager, Shasta had been diagnosed with type 1 diabetes, and later, at age 26, she was diagnosed with bipolar 1 disorder. Shasta had excellent health insurance, so getting to the doctor, filling insulin and other prescriptions and buying insulin injection kits had never been a problem for her. Later, when she required the help of a therapist and psychiatrist, she was extremely fortunate as well. Her company’s insurance provider was ahead of the game, though she’d discover that her workplace culture was not.
Shasta required hospitalization in 2012 after a troubling mixed state episode that left her with serious suicidal thoughts. When she was released to work again, Shasta confided in a close friend from work—or someone she’d thought of as a close friend. This particular colleague had not known about Shasta’s diagnosis, nor did she understand much about bipolar illness. She assumed that “bipolar” equated with “completely crazy”—as if mental illness were all encompassing and somehow elective—and decided that Shasta should no longer be her supervisor or anyone else’s. This co-worker began a character assassination campaign against Shasta. Before long, everyone in the office was talking badly about her, sometimes where she could hear them. The stress of the situation impacted Shasta’s mood states negatively and undermined her work, only verifying the negative views of her co-workers. She was brought before HR to explain herself and was eventually fired, her sudden poor performance being cited.
No one had batted an eye when Shasta’s diabetes had created brief interruptions in her work, causing her to have to run to the cafeteria in order to adjust her blood sugar, and even once careening into the file cabinets, her face pale and sweaty. When she spoke, her speech had been slurred and it took several moments for nearby co-workers to determine that Shasta was in hypoglycemic shock. She’d been working overtime and had let the day get away from her without eating well. But diabetes was similar to bipolar disorder in that it had been an illness she had not planned to experience, nor could it be cured. Shasta’s mental illness was as much biological as it was experiential, and she simply had to live through it, treating it as best she could. One disorder took place in her blood and metabolic system (diabetes), the other in her brain. And she knew by the statistics that there were others in her company who shared these disorders, though to her knowledge, only she had lost her job as a result.
Eliminating the Stigma
Dismantling the stigma created by misunderstanding and ignorance begins with a willingness to understand, which may then become the seed for compassion to grow. Without understanding and compassion, individuals continue to suffer in silence, and many face direct hostility and discrimination. Times have certainly changed in a positive direction for sufferers, and treatments for mental illness are far more successful than they have ever been. But without cultural and familial support, these advancements do too little.
May is Mental Health Awareness Month. Let’s celebrate by honoring friends, loved ones and ordinary party guests everywhere by taking a stand against oppressive judgments and misunderstanding. We can all do our part to eradicate the stigma.