Stigma and Mental Health
Introduction
When it comes to psychiatry and mental health, stigma starts right away when you even mention anything around it. For me, I felt it when I informed my parents that I want to pursue Psychiatry as my post-graduation speciality. My mother supported me wholeheartedly but my father would occasionally voice his dissent with comments like ‘Medicine has better options’, ‘Pediatrics is a lucrative branch’ which I would politely counter with affirmative remarks without going into any further arguments.
However, the harshest comments and opinions were made by some so-called well-wishers who would lash out their disappointments with ridiculous notions like if you treat mad people, you will become mad too or right way calling me mad people’s doctor or even mad doctor (because in their understanding I was mad to take psychiatry).
Nevertheless, I
did persevere and it’s been more than a decade for me in psychiatry, interacting with and treating hundreds
of patients, listening to their minds, their stories, their sufferings and all
I can say is that it has only improved my understanding of myself among other
things.
A Major Hurdle
Stigma is one of the major reasons which prevent people, and sometimes even educated, urban and affluent ones from seeking help with regards to mental illnesses. This arises from centuries of discrimination which people with mental illnesses have faced irrespective of their class, country, race and society in general.
Many early literatures depicted the cause of mental illnesses as being possessed by demons or evil spirits, some were even hunted down as witches, some theorized that the afflicted were getting punishment for their sins done in previous lives; some were simply outcast due to their odd behaviours, shabby and unhygienic states.
Many had been subjected to violent and cruel treatment because of random acts of violence done by one patient. When there was no cure for tuberculosis, patients were kept in sanatorium with all facilities, whereas people with mental illnesses were kept shackled in chains or in asylums across the world, sometimes denying even the basic human needs and dignity.
Today, we have developed many medications for
treatment of psychiatric illnesses and many have been treated successfully and
have been reintegrated with their families. We can gauge the success of
treatment from the fact that asylums have closed down or have been converted to
open settings (like a general hospital where patients get admitted with their
attendants) and yet stigma remains prevalent as ever.
Stigma and Shame
Stigma is directly related to the feelings of shame which instinctively causes people to hide whatever is causing them to feel embarrassed about, it could be a scar mark or deformity or mental illnesses. So people suffering from mental illnesses or their families try to hide their illnesses till it becomes unbearable and then seek help and most of the time, it’s not mental health professionals that are their first choice. .
Most people still prefer going to local quacks and when they can’t get any relief, finally reach to psychiatrists. However, it does not end there. Many are very skeptical about medications because of wrong perceptions like all psychiatric medications are addictive and habit-forming. This notion is more prevalent among the well-read, internet educated section.
It is true that there
are some medications which can lead to dependence forming but those who have any idea
about addiction will surely know that there are multiple factors involved in
making a person dependent on a substance.
Speak before you Break
Some are worried about being ridiculed by relatives or
neighbours for seeking treatment; others are worried about potential loss of
employment opportunities if their employer or colleague comes to know about
their mental health conditions. It must clear by now that people suffering from
mental illnesses have to cross many stigmatized hurdles to seek treatment;
hence many choose to suffer in silence till they reach a breaking point.
I must mention here the Mental Health Care Act, 2017 which is a landmark legislature which has protected many rights of people with mental illnesses and they are adequately protected by Indian laws and courts.
There are many reasons and causes which we are just beginning to understand, but it’s definitely not one’s fault if one suffers from mental illnesses. Just consider this situation. You may eat healthy food, exercise regularly, sleep well and yet may have an occasional bout of fever, cold and cough, stomach problems which are normal part of living and so are mental illnesses.
Dr. Suhasini Das
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