Last night I had the pleasure of attending a lecture on the Stigma of Mental Illness delivered by Dr. Norman Sartorius who, in addition to his achievements as a psychiatrist who has published 300+ peer-reviewed articles, is the former Director of the Division of Mental Health of the World Health Organisation (WHO). He spoke to a relatively small crowd of people at the University of Western Australia before the start of this weeks “Meeting of the Minds” mental health conference in Fremantle, Western Australia. At the end of the lecture the host spoke into the lectern and said,
‘I don’t think anyone will leave this room with quite the perspective on mental health as they arrived with.’
This was 100% true in my case! My views on the stigma of mental illness were completely flipped upside-down and examined from the inside-out. All the beliefs based on the best research available that I have been holding on to were thoroughly scrutinised, reminding me of something from Tim Minchin:
“Opinions are like arse-holes, in that everyone has one. There is great wisdom in this… but I would add that opinions differ significantly from arse-holes, in that yours should be constantly and thoroughly examined.”
So what made Sartorius’ speech so engaging? It was his experiences from decades of advocating for a reduction in the stigma that surrounds mental illness (especially with schizophrenia).
The following are 8 lessons I learned about the Stigma of Mental Illness from Dr. Norman Sartorius:
- Stigma spreads horizontally andvertically: That is, stigma spreads from the individual to their family, carers, and the community and is passed down generation-to-generation. Why? One reason is self-stigmatisation, the other is because of stigma from other people and health-care professionals themselves
- Stigma decreases health care: People with mental illness are less likely to seek health care for physical problems and health-care professionals are less willing to provide proper care to individuals who present with a mental illness. Self-neglect in combination with professional neglect increases mortality. Research supports this.
- It is possible to reduce stigma and prevent it: And campaigns that ask people themselves about their experience of stigma are the most effective. We need to ask people: What disturbs you? What bothers you the most? What do you need? Patients and their families have the best answers to these questions.
- Listening is the key: When people are listened to they feel good and begin to trust professionals and people who implement programs. By listening to other people we take the first steps in bringing people out of isolation and uniting them in the collective campaign against the stigma of mental illness.
- Teach people what to DO about an illness rather than just improve knowledge: Knowledge only seems to be useful if it increases competence in dealing with problems. I will be spending more time delivering strategies about resilience in my public speaking from now on.
- Anti-stigma campaigns that only focus on stigma for one week are not effective: Having one week for mental health, the next week for your left toe, the next week for your kidney… these campaigns leave little trace in attitudes and behaviours. What we need is campaigns that follow-up these initial traces over, say, a year. For example, a campaign that connects with carers and their families once-weekly for a year to examine stigma and deliver strategies to help their own mental health could be an effective initiative.
- Communities, school groups, judges, policemen, etc. need different types of anti-stigma messages: These groups differ in the prejudices they already hold and anti-stigma messages need to be tailored to these groups.
- People with a lived experience of mental illness are vital to reducing stigma associated with mental illness: By sharing their own recovery and showing that they can function and contribute to the community they show society that people with mental illness are not write-offs: they have value. If people with mental illness are valued by society then this provides a basis for generating funding from government bodies.
Norman Sartorius is a leading person in the fight against mental illness stigma. Above all he teaches us that the first place to start the fight against stigma is to examine and, if necessary, change our own opinions about people experiencing mental illness. Start with changing your own prejudices and the benefits will multiply.