Breaking Silence: How Stigma Is a Barrier To Mental Health?

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    Mental health
    Source: Scientific American Blogs

    Trapped within the fortified confines of my brain, I see no light. I breathe heavy as pain and fear cloud my existence. I sit in the shadows to avoid carping stares. I would prefer wearing out in silence instead. For me, eyes cut deeper than a knife. But I can only drag this suffering too much. So, am I strong or would chewing out “HELP” brand me as WEAK?

    This question troubles every other mind in suffering and while it stems from objective standards of strength set by the society, its answer is far from being an objective yes or no. People like the strong and despise the weak. So, it is natural for those who suffer, especially men, to steer through the storms on their own. But is it bad? Most of the times, yes. People who suffer from mental health issues often do not buy help because they consider it a stain on their personal dignity and their family’s reputation. The fear of rejection and the stigma associated with carrying a mental health disorder bothers them more than the issue itself. This prevents them from seeking treatment and makes their prognosis worse. According to Substance Abuse and Mental Health Services Admission’s (SAMHSA) data of 2014, out of 21.2 million individuals suffering from mental health illnesses, only 2.5 million stepped forward for treatment, proving that stigma is a serious barrier to mental health care.

    The stigma we talk about encompasses a multitude of attitudes and malpractices towards sufferers of mental illnesses. From instilling a sense of shame in them for developing a mental illness to blaming them for their outcomes, the greater part of this stigma clocks in due to various stereotypes associated with mental disorders and the patients suffering from them. All such patients are deemed crazy and labelled freaks. They are even considered dangerous and thus face unhinged abandonment from friends and family. This fear of isolation and a sense of embarrassment for not having one’s mental health intact, plays a major role in pulling the patients away from an appropriate treatment. Even if they somehow put all these villains behind and decide to come out of the closet, many a times their parents put them down. The reason all the same, irrational judgement by the society and a lack of awareness on the etiology of such illnesses. The result, deterioration of the sufferer and heartrending outcomes.

    Awareness on mental health illnesses such as anxiety and depression may have increased during recent times. Yet, stigmatization and social sanctions on people with mental disorders have not changed an inch, not in the third world countries at least. In fact, baseless orthodox conjectures such as, “things like depression confront only those who are flawed in their religious affiliations or have lack of piety”, are still mainframes in small towns and villages where the overall literacy is below average. This form of stigma fuels the illness even further as it breeds guilt and self-reproach. The patient makes futile attempts to reestablish his presumably lost connection with his Lord, where in actual it only delays access to treatment and worsens disease prognosis.

    The stigma associated with visiting a mental health facility which in most developing and underdeveloped countries is a mental hospital only, needs paramount consideration as well. Health systems in most such countries lack psychiatric consults and evaluations at primary care level by general practitioners. Thus, all patients whether those of mania or depression are dealt with in a mental asylum. They all face a similar social upheaval. This lack of stratification in terms of disease severity and proportionate treatment makes all mental health patients equally vulnerable to social abuse even if they have a mild condition that requires moderate psychotherapy. So yes, being called out a maniac for merely stopping off at a mental hospital is a stigma that significantly affects access to treatment.

    But how to pull the breaks then? The first step which is perhaps the most important step too is to raise awareness among population at risk. We need to empower the people who suffer from mental health issues using a self-seeking approach. Patients need to be taught that asking for help is not a sign of weakness and that they should sustain nobodies but themselves. Still, if they somehow feel flustered in going to a special mental health facility for treatment, arrange in-home psych consults for such patients.

    The second step is to try to change the attitude of the society . Although it should be placed top of the list, we have barely seen fruitful outcomes despite employing it for years. Anyhow, if done using the right approach, it can do wonders. People need to understand that mental illnesses involve pathologies in the brain (such as an imbalance of certain neurotransmitters) and just like any other disease, these require appropriate treatments too. We need to teach people to develop acceptance and instead of looking down upon mental health sufferers, translate their attitudes into supportive and comforting gestures. People can only reiterate what they are taught repeatedly. Thus, medical professionals especially psychiatrists have a major role to play here, to normalize the talk on mental health disorders among general people and to normalize seeking psychological consult every once in a while.

    They say it’s better to let the pain sting you for a change than to rot away in a bubble of self-nurtured monotony. Thus after trying for years and years to shift the paradigm and still failing, it’s time we shift our focus of attention from general society to high risk populations (such as adolescents of high schools and colleges), change our approaches and mobilize all our medical workforce instead of putting it on the shoulders of mental health providers alone and then hope for a change. For only CHANGE can father a CHANGE.

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