By Dr. Chua Sook Ning
In ancient Greece, the word stigma referred to a mark that was cut or burned into the skin of a slave or criminal. This brand served to visibly identify this individual to society as unworthy or a risk to society. It was to warn the people this individual was to be avoided or shunned.
Although we no longer physically brand individuals anymore, we continue to socially shun certain classes of individuals. We avoid those we don’t understand or those who are not like us, even when they have done nothing wrong. In particular, one of the most discriminated against are individuals who have a mental health condition. They are labelled as different and associated with negative stereotypes. This leads to the stigmatized individual to suffer status loss and be actively discriminated against.
Discrimination could happen on a system/societal level such as the refusal to hire someone suffering from a mental illness, or refusing to provide insurance coverage to someone with a mental illness, to personal discrimination such as name-calling individuals suffering from a mental illness derogatory names like “crazy”, “gila”, “nuts”, “psycho” and “cacat”.
In Malaysia, a recent study found that the people most likely to discriminate against those who are mentally ill are in fact are family and friends. The very people who are suppose to care and support those who are ill, reject them instead. This could be due to ignorance (knowledge), prejudice (attitudes), or discrimination (behaviour).
“There have been cases when a patient is discharged (from hospital), no family members came to pick them up. So, we get the ambulance to send them back. But when they (family) see the patient coming home, they lock the doors and windows. Pretending like they are not home”.
“They believe that if something is wrong with the patient, there’s something wrong with their genes so that is why they feel the need to ‘expel’ the patient from the family. So who is to care for them when their own family won’t?”
The consequences of social stigma are costly. The negative attitudes of society are internalized such that people with mental illness themselves start to advocate and believe these negative views. They start to see themselves as undeserving of care, responsible for their illness and unable to recover. The belief that they are unable to recover debilitates them and decreases help-seeking behaviour, which further worsens their mental illness. In Malaysia, social stigma is compounded by the systemic discrimination against people with mental illness leading them to deny or hide their problems. Untreated mental illness ends up costing the society in billions in lost earning potential, homelessness, increased physical health problems. There are no winners in social stigma, only escalating cost on individuals, families and society.
Dr. Chua Sook Ning is a Clinical Psychologist and a lecturer at the National Institute of Education at Nanyang Technological University, Singapore. She believes in raising public awareness of mental health by encouraging open and public conversations of mental health. She also is also working on early identification of mental health conditions by promoting mental health screenings and. training communities to recognize mental health conditions. Finally, she is working with a team of international researchers to develop accessible and affordable mental health interventions.