A Psychiatrist Comments on stigma

By Dr David Laing Dawson

Marvin is right about the limitations of the anti-stigma endeavours. In fact I would add that much of the movement downplays the seriousness of some mental illness, and creates a mush of euphemisms. Historically (my experience in the 60’s) the word cancer was not used in hospitals, at least not outside the Doctors’ lounge, the seminar room and the cafeteria. Real progress did not occur until the word Cancer became acceptable, with acknowledgement of the suffering and death it caused. Terry Fox did not run across Canada to raise awareness and money for Bone Health.

Leprosy, the very disease that gave us the term leper, did not lose its stigma when it was renamed Hansen’s Disease, but when it became both understood and medically treatable.

One day we may be able to divide Schizophrenia into several specific forms, each linked to specific genes, as we can now do with several types of cancer, but for now lets just accept the name schizophrenia and use the effective treatments we have. But let’s not confuse this illness with work stress or remorse or insecurity.

And let’s accept that physicians and physician specialists comprise the only professional group that can actually employ a methodology and tools to investigate, diagnose, and treat serious mental illness, with the assistance of several other kinds of “mental health professionals”. I state this bluntly because the anti-stigma movements usually refer to “mental health professionals” as a somehow unified body of equally qualified and knowledgeable helpers.  As I think about this more I wonder if the anti-stigma movement is further stigmatizing mental illness and by extension psychiatry by using such terms as mental health and mental health professionals, making it, I’m sure, far more acceptable to be seeing a counselor for mental health than a psychiatrist for a mental illness.  Which might be contributing, ultimately, through similar prejudices within the medical community, to the diminution of medical graduates entering psychiatry.

And…

I know statistically people suffering from mental illness are more likely to be victims of violence than perpetrators of violence but it is also true that the most gruesome and apparently inexplicable of crimes making the headlines of our newspapers are usually committed by people suffering from severe and untreated mental illness. Emphasis here on the word ‘untreated’.

2 thoughts on “A Psychiatrist Comments on stigma

  1. Yes i agree with what you.

    I have believed for some time that by downgrading a serious diagnosis like schizophrenia and manic depression it eads to neglect It simply makes it seem as though it is the patient who must work harder to send the illness packing. It also puts even more burden on patient and family. We know it is medical treatment that stabilizes the illness. I have heard many patients with these illness say when they have been stabilized ” i am relieved that it is an illness that is giving me so much trouble and that I am now getting some proper help”

    But of course every time the illness gets the upper hand insight is lost fast and fighting treatment becomes the major problem. Put yourself in their shoes!Their mind has been highjacked by a malfunctioning brain. I feel like screaming every time i hear some say “Well they can choose or not to have treatment as with other illnesses.” The difference is that the organ doing the choosing is offline. Autonomy can resume when the illness is stabilized. Yes the patient does have some rights especially to become well.

    The latter problem (UNTREATED Mental ILLness)often puts the person in double jeopardy i.e a danger to self and the public. AND we have a very flawed Mental Health Act in Ontario to blame for many of the tragedies that ensue.

    The Medical and legal profession have locked horns on this dilemma for a few decades, and thus not adjusted the dial on reason for treatment Alas a few half trained councillors have aided and abetted a poor outcome. Time to think this one out again.

    The councillors go home at night free of responsibility , The families can’t and many psychiatrists rue the day when they can’t get on with timely treatment because there is interference from the so called rights people like followers of Thomas Szasz. Their are plenty of adjunct health care areas that still believe in this bunk.

    As for the Bell lets talk stuff ? More on that another time. Apologies in advance for my lecture , but it it stresses me beyond bearable.

    Like

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