Over the years, the discipline of sociology has been facing the controversial issue of stigma in the discourse on mental illness. The labeling theory and the stigmatization of individuals have created discrimination and prejudice to victims. The deinstitutionalization of mental healthcare reinforced by societal stigmatization has resulted into contradictory responses. There have been claims that social stigma on mental health is on a rapid decline. Other quarters were of the view that intervention measures need to be instituted to reduce mental illness stigma. However, these two views are not effective in addressing the issue. The reemergence of a multi-disciplinary approach that embraced the beliefs, attitudes, and behavioral disposition of a population targeted social stigma, intervention measures, and its implications.
The Sociological Perspective
The sociological perspective is that stigma on mental illness is on the increase, whereas that of psychiatry is that it is on the decrease. Policy makers in psychiatry have from time and again declared that no intervention measures are required to tackle stigma because it is not an issue. For example, the sociological viewpoint on stigma and mental health compelled the staff at National Institute of Mental Health to call for continued research in the development of clinical and evaluations intervention measures to deal with the trauma and stigma associated with mental illness. This was aimed to reduce discrimination and abuse against mentally ill persons. Sociological researchers engaged themselves in studies involving stigma in mental illness. These efforts by sociologists led to the culmination of The White House Conference on Mental Health in 1999 among others. Research was mainly centered on the cultural perspective on stigma at all levels and capturing all the population segments including adults and children with mental illness.
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A new thesis on mental illness emerged which dealt with identity, public reaction, and individual reaction in self presentation in everyday life. There was need for a centrality in face to face interactions in reducing mismatches between some individuals from others which could possibly lead to the discrediting of others. Issues of interaction and identity were the main focus of attention when dealing with mental illness. However, hospitalization was considered as an avenue through which mental health stigma was reduced. The healthcare provider was key in providing a good discharge to a mentally ill patient to reduce stigmatization and increase level of society acceptance (Pescosolido, 2013). There has been the notion that stigmatized persons are less human owing to their mental condition. This stems from social interactions which excludes certain individuals from full participation in social activities. In recent times the concept of mental illness has been broadened to include other aspects. Earlier on, mental illness was widely associated with depression, anxiety, and notions of psychosis.
However, these aspects have expanded to include a wide array of mental health problems such as developmental disorders, substance abuse, and other non-psychotic problems. Other mental illness health problems include chemical imbalance and schizophrenia. With increased knowledge about mental illness there have been significant changes to the issue of stigma due to the changing responses of adults in their self-reported mental health problems. This may be attributed to better problem recognition, more mental health knowledge, and a more willingness to disclose. More mental health patients are now seeking professional support from non-medical health providers such as counselors, social workers, and psychologists. However, stigmatization is largely influenced by social acceptance and rejection. The levels of social stigma are substantial and do not suggest any form of dissipation. Mental illness treatment in hospital is usually tied to some form of prejudice and discrimination which has a long term effect on the .patient. Social acceptance and rejection is also highly influenced by the source venue and the nature of the problem. Patients engaged in intimate relationships reported higher levels of social rejection as opposed to those in casual relationships.
The Psychiatric Perspective
In contrast, the discipline of psychiatry has developed diagnostic treatment models which have shaped the process of mental illness stigma perceptions that has led to dissipation. This is in sharp contrast to the modified labeling theory which argues that an individual that is diagnosed with mental illness acquires negative feelings due to cultural ideas associated with the condition. Psychiatric diagnosis provides ways and means that moderates stigma associated with mental illness and those that are related to self-identities and appraisals. Recent studies indicate that individuals who are diagnosed with mental illness are culturally judged as being mentally ill, a fact that affects their psychological, material, and social well-being. These negative effects bring about negative feelings which trigger defensive behaviors to mitigate against this rejection. Such behaviors include withdrawing from social interactions, concealing of mental health history, and sensitizing others about mental illness. These behaviors result into harmful outcomes such as higher unemployment rates, reduced social networks, and feelings of demoralization, among others.
However, when compared to psychiatry, the modified labeling theory only serves a historical perspective purpose. This is a sociological concept that has not fully advanced and does not take cognizant to the field of psychiatry which actually deals with mentally ill patients. There is a general ignorance, on the part of sociologists, on the therapeutic and scientific development in psychiatry in the last quarter a century. The symptoms of mental disorder also known as residual deviance are not correctly label at the societal level. Additionally, such act of violations has no intrinsic value to the individual (Link et al., 2010). This means that these acts do not conform to any form of stereotypes in society and, therefore, have no explanations or guidelines on how to respond to them. Mental illness disorders are stereotyped right from childhood and reaffirmed in adulthood. It is in this respect, that acts of rule breaking are associated with these stereotypes that compel the society to provide psychiatric treatment for such acts which are regarded as mental illness. However, the psychiatric concept which deals with identification, explanation, and treatment of mental illness should be considered. This explains why mental illness cannot be definitely classified.
The discipline of psychiatry is effective in the control of mental illness which largely affects an individual’s ability to function normally. Any treatment methodology is developed because of a good explanation on the treatment being adopted and how it is going to work. The psychiatric concept is not related to societal contingencies which can also have an influence on how the concept is practically implemented. However, societal contingencies are related to psychiatric treatment to the extent that the availability of social resources have a positive effect on the delivery of psychiatric treatment. It is in agreement that any form of treatment is dependent on the scientific understanding of the condition using various social contingencies which influence the way the treatment is carried out. Moreover, social scientists believe that the medical profession utilizes social factors to treat physical disorders by minimized them to attain effective treatment. In this respect, social scientists are alive to the fact that medical professionals use social interactions and medical factors to treat physical disorders, a fact that reinforces the medical perspective. However, with regards to mental illness, social scientists differ with the psychiatric perspective and conclude that social factors have a huge effect on the validity of the psychiatric perspective. At the individual level, most patients who receive psychiatric treatment in an effective manner. This, therefore, counters the notion advanced by the labeling theory with regards to an increase in stigmatization to mentally ill patients.
Arguments on Mental Illness and Stigmatization
Individuals who have been labeled as being mentally ill view themselves negatively due to the connotation given to the term. This terminology is accompanied by rejection, stereotyping, discrimination, prejudice, and loss of status. Many social theorists are of the view that stigmatization almost certainly leads to self-devaluation and low self-esteem (Vauth et al., 2007). However, there is also a contradictory view that assumes that a large number of individuals who are labeled as mentally ill resist stigmatization and stereotyping by not accepting or adapting to such labels. This argument states further that stigma resistance is highly likely to patients with mental illness.
Sociologists propagating the arguments of labeling theories and social interactionism are of the view that social devaluation leads to self-devaluation. Sociologists view society as being a reflection of the self where individuals appraise their worthiness, goodness, and competence based on the perceptions of significant others and the community at large. It follows, therefore, that a negative label applied by the community to the self becomes a negative self-identity which consequently results into self-devaluation or self-stigmatization. In the labeling theory, individuals who have been classified as deviant usually view themselves as such (Kroska & Harkness, 2008). This is because individuals takes the views and perspectives of others in the community to adopt an identity. Therefore, if an individual is categorized as being mentally ill, he develops stereotypical imaginations about mental illness. They then act according to the given labels and accept the fact that they are mentally ill and take on the mental patient identity and role. This process leads to subsequent stress which affects their ability to control their behavior and thus validating the views of others.
The counter argument against stigma of the mentally ill is common in psychiatric practice. It is possible for mentally ill patients to resist the stigma associated with their conditions in two distinct ways. Firstly, a patient can challenge or fight off any harmful influence or force associated with social stigma. Secondly, he can deflect, impede or refuse to yield to the harmful influence of stigmatization. The individual has the ability to push back or block an outside influence from penetrating his thought processes and behavior. These types of resistance protects the individual against self-devaluation and creates opportunities of changing the negative attitudes and actions of others (Thoits, 2011). It gives the individual a sense of power and personal control. This in turn raises his self-esteem.
The use of the resistance strategy requires, first and foremost, that the individual accept the fact that they have been to mental treatment. This is important to harden the individual against any form of stereotyping and devaluation. They must accept the label “mentally ill” as being applicable to them even though they do not accept this type of personal identity. Additionally, they should also understand that this label could be their public identity once their mental history has been discovered. Also, they should also possess knowledge of the social meaning attached to the mental illness label even though they do not like it. The meanings can involve a stereotyped type of behavior, character, and the possibility of being prejudiced and discriminated. These are the preconditions associated with mentally ill patients who fully utilize the resistance strategy to ward off stigma and devaluation. Challengers are persons who disagree with labels and stereotypes about mental illness and reject the images that characterizes them as mentally ill. Their main objective is to change the views of others and not blocking their offences on their self-esteem. They confront the situation of the biased actions and attitudes of others by not ignoring them.
Personal Opinion
My personal opinion on the matter of mental illness is that the society needs to be sensitized on the need to change their attitudes and behavior towards mentally ill patients. Individuals in society should be made to understand that their negative behaviors and actions towards mentally ill individual plays a big role in worsening the situation. Just like any other disease, mental illness is a condition which needs care and understanding. The stigmatization and stereotyping of mentally ill individuals is a product of ignorance on the part of society. Adequate measures needs to be taken not only in the treatment and management of mentally ill patients but also in educating the community about the condition and how they can support them to be integrated back into the society. Apart from the resistance strategy that is helping lots of mentally ill patients cope with their condition, the society needs to be taught how to act when confronted with such a patient. Since society is a reflection of the self, it is supposed to empower the mentally ill patient to have confidence in himself and his abilities to effect treatment. By refusing to label, to discriminate and segregate mentally ill individuals, the society can play an active role in empowering the individuals to take their roles in society.
The change in attitude, behavior, and actions of the community towards patients with mental illness can only be possible with the provision of adequate knowledge on the issue of mental illness. On the other hand, mentally ill patients need also to be equipped with knowledge of how they can employ effective resistance strategies to cope with the devaluation effects of stigmatization, prejudice, and discrimination from the society. By addressing the issues affecting both the community and mentally ill patients it is possible that the prevalence of stigma and discrimination against mentally ill patients will begin to dissipate.
References
Pescosolido, B. (2013). the public stigma of mental illness: What do we think? What do we know; what can we prove? Journal of Health and Social Behavior , 54, 1, 1-21
Kroska, A., & Harkness, S. (2008). Exploring the Role of Diagnosis in the Modified Labeling Theory of Mental Illness. Social Psychology Quarterly, 71 (2), 193-208. Retrieved from www.jstor.org/stable/20141830
Link, Bruce G. & Jo C. Phelan. (2010). Labeling and Stigma . In A Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems. 2nd Ed. (pp. 571-87). Eds. T. L. Scheid and T. N. Brown. New York: Cambridge University Press.
Thoits, P. (2011). Resisting the stigma of mental illness . Social Psychology Quarterly, 74, 1, 6-28.
Vauth, R., Kleim, B., Wirtz, M., & Corrigan, P.W. (2007). Self- efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia. Psychiatry Research, 150, 1, 71-80
