A Realist’s Approach to Mental Health Stigma


Current campaigns around mental health stigma tend to focus too heavily on persuading the general public to be more accepting of people with diagnoses by tackling common myths via public campaigns, but there’s little in the way of strategies for managing how those of us who are diagnosed deal with a dominant culture which is often prejudicial and discriminatory while also acknowledging that it isn’t only the dominant culture, but also we ourselves, along with the systems intended to care for us, which contribute to the problem.

While the myths in society do need to be addressed in the interests of social inclusion – though the evidence is that such campaigns achieve little, if anything – this shouldn’t be at the expense of developing an awareness of a community’s shortcomings, along with strategies for addressing them, when it comes to understanding mental health, not least if that may result in improvements.

Likewise, health services, while their very existence is contested, offer solace to many people, while they also stigmatise those they purport to care for with merely theoretical notions of such things as incurable diseases, chemical imbalances in the brain and genetic deficiencies all pointing to some internal and inevitable fault the evidence of which is still to be discovered.

We need a strategy which brings about the best in the stigmatised and the stigmatisers. It isn’t enough to be casually and conveniently dismissive of anyone, sacrificing a comprehensive and constructive understanding. We need to think creatively around how society and psychiatry positions us to think, behave and interact in key ways about certain conditions.

We need to understand how culture works us in order to redress the balance of power at a micro and macro level between ourselves and the societies we’re part of, to recognise that stigma isn’t a deficiency on the part of the stigmatised, but one of the stigmatiser or, better still, of our society and culture, embracing a more empowered way of life accordingly.

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