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More PsychNotes: Policies and Issues in Mental Health

October 30, 2018       
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People with Mental Illness are Essential to Our World
by Monica A. Frank, PhD

People with Mental Illness are Essential to Our World

Even though our society gives lip service to supporting those with mental illness, the stigma still exists. Sometimes I think the stigma is worse because as awareness of mental illness has increased, the pressure for compassion has caused the stigmatization to be more subtle and hidden.

Recently, I became acutely aware of this when I heard someone dismiss a well-known celebrity's opinions because he has a mental illness. When will we begin to understand that a mental illness is not the person? A person can still love, laugh, work and form coherent opinions even though they have a mental illness.

Maybe it is because in trying to remove the stigma society has made certain words unacceptable. It is no longer okay to say someone is “crazy.” So, instead, people say the person has a “mental illness” which can be factual but is not necessarily the cause of their behavior or of the formation of their opinions.

What happens as a result, though, is the term “mental illness” becomes a substitute for “crazy” so that all those who have a mental illness become further stigmatized by virtue of being in that category. When one person's opinions are dismissed or their accomplishments are ignored because they have a mental illness, everyone with a mental illness is stigmatized. Yet, a mental illness often has little to do with their behavior or opinions.

At least when we called people “crazy” we reserved it for those whose behavior or opinions were outside the norm. But now we are replacing it with a term—mental illness—that describes about 20% of our population at any particular time and almost 50% at some point in their lives (Kessler, et al, 2007). Most people with mental illness are not “crazy.” In fact, I would go so far as to say that “crazy” as it is commonly used is not related to mental illness. Instead, it means someone who is different or odd. Yet, most people who have mental illness are not different or odd at all!

When we see depictions of mental illness in TV shows or movies it is usually in the guise of severely affecting someone's life or causing harm to others. And, sure, there are those with debilitating mental illness that encompasses a person's entire life and prevents normal functioning.

Yet, most people with mental illness function well in our society everyday. They are our doctors and our hairdressers, our teachers and our co-workers, our friends and our family. Most of them function so well that we would never know they struggle with mental illness. Even more, some of them are successful because of their mental illness. It has taught them not just survival skills but how to thrive when faced with obstacles.

People with mental illness are not the fringe of our society but are often the backbone of our society. In the course of my career I have been privileged to see the inside of people's lives--the side they don't show to everyone. And I've seen that most people with mental illness support us in many ways everyday. They make decisions that enhance our lives. They make discoveries that can save our lives. They create beauty that delights us. They often have more empathy for others because of their personal experiences with mental illness. Consequently, they help us throughout each day to make our lives more livable.

We do not need compassion to take care of those with mental illness because they are often taking care of us. We need compassion and understanding to realize that mental illness is only one aspect of them. We need to recognize that when people do really “crazy” things we shouldn't link it with mental illness because most people with mental illness never do anything “crazy.”

For instance, although most people equate mental illness with violence, it is only a tiny subset of those with mental illness who are violent. Even severe mental illness is not the sole cause of violence. Research following over 34,000 people for an average of three years concluded that “the current results show that if a person has severe mental illness without substance abuse and history of violence, he or she has the same chances of being violent during the next 3 years as any other person in the general population (Elbogen and Johnson, 2009).”

Mental illness is not something to be ashamed of but to be celebrated. Because most people with mental illness do everything everyone else does but with one hand tied behind their back—and frequently they do it better. We don't see their wheelchair but they live their lives while also struggling with the illness.

Without people with mental illness, our world would not function. Because they are us.

Elbogen EB, Johnson SC. The Intricate Link Between Violence and Mental DisorderResults From the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2009;66(2):152–161. doi:10.1001/archgenpsychiatry.2008.537

Kessler, R. C., Angermeyer, M., Anthony, J. C., DE Graaf, R., Demyttenaere, K., Gasquet, I., DE Girolamo, G., Gluzman, S., Gureje, O., Haro, J. M., Kawakami, N., Karam, A., Levinson, D., Medina Mora, M. E., Oakley Browne, M. A., Posada-Villa, J., Stein, D. J., Adley Tsang, C. H., Aguilar-Gaxiola, S., Alonso, J., Lee, S., Heeringa, S., Pennell, B. E., Berglund, P., Gruber, M. J., Petukhova, M., Chatterji, S., … Ustün, T. B. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World psychiatry : official journal of the World Psychiatric Association (WPA), 6(3), 168-76.

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