Charles* had worked on the mines for over 10 years. He was known as a good worker and he enjoyed his job. Every now and again, though, he became severely depressed and anxious. During these periods he often heard his colleagues say things like: “that man is mad” or “that man is taking substances.” He felt completely misunderstood. At the time of his employment, the mine did not even have a resident health worker. Finally Charles consulted a medical doctor off the mines who gave him a variety of different medications – none of which seemed to work effectively. In April ’89 matters came to a head when Charles went through a bad depression and missed 13 days of work as a result. The management did not consult a mental health professional to verify Charles’ claim of ill mental health. Instead Charles was promptly fires for being a “poor performer.”
Charles’ true story clearly illustrates the kind of discriminatory practices and ignorant attitudes that mental health sufferers still have to endure in South African society. Even in these progressive times, mental ill health is still shrouded in misconceptions and fallacies.
The stigma that is linked so strongly to mental illness is primarily born of ignorance. As with other groups that are likely to be seen as separate and different from the “mainstream”, members of the general public make certain assumptions about people with mental illnesses – without taking the time to look at each person as unique and individual. “My personal view“ says psychiatrist Dr Potgieter, “is that the large majority of people still tend to discriminate against psychiatric patients regardless of whether the patient is functioning properly or not. Sufferers who are doing the responsible thing by going for treatment are stigmatised as a result. They find themselves in a catch twenty-two scenario.”
There is a common image conjured up by the label 'mentally ill’ of violent, unstable individuals. Ironically enough, research has repeatedly demonstrated that the vast majority of psychiatric patients, including more severe illnesses such as schizophrenia and bipolar disorder, are more likely to be victims of violence themselves than perpetrators of violence. The mass media is also to blame for the misconceptions surrounding the mentally ill. The entertainment industry repeatedly depicts psychiatric patients as villains or killers, whilst news reports tend to sensationalise incidents involving people with psychiatric illnesses.
It is also common for the public to view someone with a mental disorder as incompetent and incurable. Often, it is thought that people with mental illnesses have impaired judgement and are incapable of making responsible decisions. In the workplace, sufferers are still heavily discriminated against because of these kinds of faulty assumptions.
There also remains the faulty assumption that mental illness is a person’s own fault, and is a sign of weakness of character. People suffering from mental illnesses are perceived, for example, as lacking motivation to overcome their problems or as lazy and self-indulgent in their emotions.
The truth is that biological and genetic factors play a large role in the development of mental disorders and there is only so much a sufferer can do to help him/herself without the aid of correct treatment or medication
The consequences of inaccurate images can make recovery for someone with a psychiatric disorder doubly as difficult. Some psychiatric patients may find themselves isolated or rejected by the “mainstream”, whilst other sufferers may battle to find a job because employers see them as high risk. Sufferers may even be reluctant to seek help because they know the kind of attitudes they will encounter as a result. Sufferers often experience difficulties finding a place to live insuring themselves or their property and even keeping custody of their children. Finally, when people with mental illnesses are continually rejected and devalued, they begin to doubt and devalue themselves. This is known as “internal stigma” and it can be particularly devastating for an individual’s self-esteem and life view.
Charles’ turning point came when he contacted the Depression and Anxiety Support Group – a non-profit, privately funded support group, which offers free counselling, referrals and information about anxiety and depressive disorders. The Support Group, which can be contacted on (011) 783 1474/6 also oversees the running of over 100 regional support groups countrywide. For the first time, Charles understood what was really wrong with him and was referred to a competent doctor who diagnosed him with major depression and anxiety, and put him on the correct antidepressant. Charles has been so empowered that he is in the process of lodging a case the mine for unfair dismissal. ‘I want my job back and compensation for my time off work,” he says. “They fired me before they had even got the psychologist’s results which stated that I was suffering from major depression and anxiety.”
So what can the average person do to help fight the stigma of mental illness? Firstly, you should examine your own attitudes and behaviour and behaviour towards people with mental illnesses. Listen and talk to people with mental illnesses so that you can better understand their behaviour and feelings. You could also take action to educate the public about mental illness and stigma. The more informed people are about the true facts of mental illness, the less likely they are to adhere to misconceptions. You could also challenge the stigmatizing media portrayals of mental illness, and work with your local media to present the correct information.
Finally, if you are battling with a mental disorder yourself, speak out and let others know about your illness. You can be a living example that challenges the stereotypes linked to mental patients. Don’t be afraid to stand up for your rights. Negative labels and myths need to be banished so that people who are battling with, or have battled with, a mental illness can be given the chance they deserve to prove themselves as functional and productive individuals. As Charles courageously says “I am not only fighting for myself but for all people with depression.”
*Not his real name
The author would like to acknowledge information from “The stigma of mental illness” prepared by Dr Wahl, George Madison University, USA and distributed as a press release by the World Federation for Mental Health