MHM Magazine

34 | MENTAL HEALTH MATTERS | Issu3 2 | 2022 MHM Medical writer, Naveed Saleh says, “The media teaches us about people with whom we don’t routinely interact. This constant flow of data gives us incessant social cues about the nature of other groups of people—including which groups of people should be praised or scorned.” Stigmatisation of mental illness in media is abundant. Media representations of people with mental illness influence perceptions and stigma. Media portrayals too often skew toward the negative, inaccurate, overgeneralised, or trivialised. Emma Frankham (National Alliance on Mental Illness) found many examples of stigmatising language in media accounts from journalists, family members, community members, and officials. • Using mental illness as the defining characteristic of an individual: “paranoid schizophrenic,” “alcoholic” or “drug addict.” • Describing people with mental illness as helpless with little chance of recovery. • Using derogatory language: “crazy,” “insane,” “mental,” “crazed,” “deranged,” “nut.” • Implying that suicide is caused by a single event rather than mental illness. • Portraying violence as the norm for people with mental illness. (Research has indicated that on average individuals with mental illness are not violent and that individuals with mental illness are more likely be victims of violence.) • Describing individuals with mental illness as “not normal” and “not mentally there.” Stigmatising language indicates how society reacts, judges, and thinks about issues like mental illness. And what we see is concerning. Focussing on the individual with mental illness rather than framing mental illness as a societal issue leads society as a whole “more likely to blame an individual for their illness.” South Africa need not look further than the Life Esidimeni Tragedy as proof. STIGMA IN THE WORKPLACE Employee Assistance Programmes are in place to help employees deal with a variety of issues that affect mental and emotional well- being. According to the Centre for Workplace Mental Health, only about 3-5% of employees use available EAP services. There should be more compassion towards leave regardless of what the type of compassionate needs. “We all need to be more aware of mental wellness and we all need to take care of our mental health daily.” There should be more focus on prevention and management of our mental health before we reach the point of needing sick leave for a mental illness. Stigma and discrimination are still prevalent in the workplace. The APA Foundation's Centre for Workplace Mental Health suggests organisations strive to "create a culture in which mention of depression, anxiety, post-trauma, and other common illnesses become as mentionable as diabetes, hypertension, and migraines." Programmes and services need to be tailored to company culture and leaders must be trained to identify emotional distress and make referrals and respond promptly and constructively to behavioural performance issues. Stigma in health facilities undermines diagnosis, treatment, and successful health outcomes. STIGMA AND THE IMPAIRED PRACTITIONER Acknowledgement of the impaired physician as a distinct problem in medicine has been the subject of attention for over 35 years. It is estimated that anxiety, depression and mental illness occur commonly among health practitioners. Depression is seen in 10 - 20% of doctors and the suicide rate among doctors is reportedly 50% higher than that of the general population. Chemical dependency has a lifetime prevalence approaching 10 - 15%, alcohol dependence varies from 8% to 15%, and the abuse of opiates and benzodiazepines has been shown to be enabled by self-prescribing. The awareness, compassion, and attention to ensure ‘impaired practitioners’ obtain the services that they themselves provide for others is scant. Stigma of mental illness thrives in the medical profession due to “the culture of medicine, medical training, perceptions of physicians, and the expectations and responses of health care systems”. (Jean E. Wallace) In their paper, The Impaired Practitioner - Scope of the Problem and Ethical Challenges , published in October 2006 in the South African Medical Journal, Professors Ames Dhai, Christopher P. Szabo, and David Jan McQuoid-Mason write that “physicians as a group deviate from the norm when seeking treatment when they fall ill. Physicians have a tendency to diagnose and treat themselves, and if they do seek care they often do not use the usual programmes of the health service, choosing instead to seek the advice of colleagues.” Establishing a therapeutic relationship and reversing roles from practitioner to patient is a complex one. Questions for mental healthcare practitioners to ask themselves: 1. Do we label and isolate or do we diagnose and include and empower patients? 2. Do we recognise and address cultural stereotypes and labels? 3. Do we explain conditions and diagnoses? 4. Do we actively address stigma in the media? Do we contact the HPCSA, phone and complain? Do we raise awareness? 5. Do we separate us and them – psychiatrists vs patients? Individuals, Professionals, and Organisations Have a Duty to Help Reduce the Stigma of Mental Illness: • Talk openly about mental health. • Respond to misperceptions or negative comments by sharing facts and experiences. • Be conscious of language – remind people that words matter. • Encourage equality between physical and mental illness – draw comparisons to how they would treat someone with cancer or diabetes. • Show compassion for those with mental illness. • Be honest about treatment – normalise mental health treatment, just like other health care treatment. References available upon request