When I was diagnosed with cancer, my dearest friend, Steve, flew across the country to be with me. I opened my apartment door, and he smiled and reached for a hug. Looking over my shoulder past our embrace, he remarked on the many bouquets I'd received since my diagnosis.
When you go to the hospital with a physical illness, people send flowers.
When you go to a mental hospital with a mental illness, they don't.
Stigma against mental illness is everywhere. One evening, I was walking to my car with a colleague, who was on a tirade over a violent crime committed by a mentally ill person, reported in the newspaper that day. I said that mentally ill people were, on average, no more dangerous than others and certainly less dangerous than people who abuse substances. Expressing disbelief, my colleague remarked, "Maybe I'm just prejudiced. I mean, I've never known anyone with mental illness." I responded, "You mean you never knew anyone you knew had a mental illness." With a twinkle in her eye, she replied mischievously, "Can you please take me to my own car now?"
Some forms of stigma go beyond hurt feelings. Around 20 years ago, I found myself experiencing severe headaches and short-term memory loss. Friends brought me to the emergency room, where disaster struck: The ER workers found out I had a psychiatric history and -- predictably -- decided I was having a psychotic episode and tried to send me home. My friends, who had seen me psychotic and knew this was different, implored them to keep me. Eventually, a spinal tap revealed a bleed in my brain, the kind that kills roughly half its victims.
Stigma against the mentally ill, especially those with schizophrenia, is perhaps the most profound of all stigmas today. I myself came forward only after achieving academic tenure -- and after many years of listening in silence as people, joking and otherwise, used words like "crazies," "lunatics," and "nutcases" to describe, well, people like me.
Why is stigma so destructive? It hurts to have others make fun of and even fear you, even if they don't know it's you they're deriding. And having a secret to hide never makes friendship easy. Perhaps worst of all, stigma is a terrible impediment to seeking treatment for an illness that can be treated effectively.
What can we do to reduce the stigma of mental illness? First, people with the illness must come forward. You'll see that we are your friends, your colleagues, your family members, and, yes, even your lovers. I am not unique. My colleagues and I are currently collaborating on a study that will explore how people with schizophrenia manage and do well. Among our subjects are a psychologist, a physician, a full-time parent, a full-time student, and consumer advocates.
A more responsible media would be helpful as well. To the media: When it comes to the mentally ill, please don?t sensationalize violence. Report our positive accomplishments, which far outnumber our violent crimes. In short, report how things really are for our community, not just what makes titillating press.
The best remedy for stigma is the most obvious: resources. Early on after being diagnosed as schizophrenic, I was given my prognosis: "grave" -- the psychiatric equivalent of a death sentence, the assumption that I'd never live or work on my own. Today, I am a chaired professor of law and serve on medical school faculties, too. I publish extensively. I give lectures in the U.S. and internationally. I am married to a wonderful man. I worked to get better but was able to do so because I received excellent treatment, in the form of intensive talk therapy and appropriate psychiatric medications. The more we make good care available for individuals with mental illness, the more likely they will reach their full potential. Understanding and acceptance will surely follow.
I close by finishing the story at the beginning about my colleague. After I had spoken publicly about my illness, she said she was glad not to have known I had schizophrenia when we started having dinner. I asked why. She said she never would have gone out with me had she known. Hearing those words didn't feel good, but I was glad my colleague -- now my good friend -- could say them to me. Well-meaning, kind, and intelligent people can have thoughts and feelings based on stigma and fear.
When you have a colleague or friend in a psychiatric hospital, call and offer to visit. And send flowers.