Sloan: The stigma behind ‘schizo’

Yesterday, on this page, Soeren Palumbo and Tim Shriver ’11 wrote a thoughtful column about the campaign against the word “retarded” (“Spread the word to end the word”). Though I applaud their effort and support the movement, the problem is bigger and scarier than they suggest and not limitted to those with intellectual disabilities. Words like “emo,” “schizo,” “sped” and “psycho” also reflect the widespread stigma against people with mental disabilities and disorders. While those who use these terms casually should reconsider, launching a campaign against such usage fails to target the root of the problem. Until the stigma itself is targeted, people will continue to appropriate accepted terms for use as insults. Such attitudes harm both individuals and society at large in a way that goes beyond making someone feel insulted — they prevent those with disorders from getting adequate care.

According to a report by the surgeon general, one in four adult Americans has a diagnosable mental disorder, but less than a third of them will receive treatment. There are many reasons for this, and stigma is behind all of them. First, fear of judgment may deter people with symptoms of a disorder from seeking help. Moreover, shame often prevents families from ensuring that proper treatment is obtained. This summer saw a worst case scenario in which Otty Sanchez, a 33-year-old under-treated schizophrenic, became psychotic and murdered her newborn son. While the impact is not always as explicit, it is often quite detrimental. Employers are often reluctant to provide support for employees with mental disorders, even though lost productivity due to mental disorders costs society nearly a hundred billion dollars every year.

Moreover, even those who do receive care usually don’t receive treatments that have been empirically supported. General practitioners, from whom most people seek treatment, tend to be poorly trained in assessing psychological risk. They treat disorders with medication alone if they treat them at all, contrary to research that recommends combining medication with psychotherapy. In fact, according to data collected by the NIH, less than 15 percent of those who seek mental health care from their general practitioner receive minimally adequate care. Even those who seek care through therapy are often limited in their choice of therapists, and the more affordable therapists are less likely to be trained in the most carefully studied psychotherapeutic methods. As a result, less than half the people who seek therapy receive minimally adequate treatment.

Until stigma is reduced, mental health will continue to fall by the wayside in discussions of health-care reform.

To be clear, I don’t mean to minimize the harm that using words like retarded can cause. As someone who has struggled with depression and self-injury, I personally feel the hurtful implications of the word emo. The other effects of stigma, however, are far worse. As such, there must be efforts to reduce stigma through education, to eradicate the ignorance that perpetuates it.

Incorporating information on mental health issues into the standard public school health curriculum would be a way to start. Alongside rolling condoms onto bananas, students can learn about what it means to have a mental disorder or disability. Understanding the terms they throw around would help them realize that even those with intellectual disabilities can have happy lives, with a job, friends and even children. They would learn that a disorder is not part of who you are, and that saying so is offensive. Eventually, attitudes toward mental health would begin to resemble those toward physical health. People would know how to take care of themselves and others, and would feel no qualms about doing so. In an adolescent population, where suicide is the fourth leading cause of death, this could save lives.

Another important source of information is the media, and holding them accountable for their reporting on mental health issues would improve awareness. The most recent media debacle regarding mental health concerned a study conducted on antidepressants. Most media outlets claimed that the study found that a certain kind of antidepressant was no better than the placebo. What the study actually reported was far more subtle, and drew careful distinctions about the kinds of patients who would likely benefit from these medications. Misinformation like this only serves to worsen the confusion with which our society approaches issues of mental health, and ultimately this confusion exacerbates the existing stigma.

The impact of stigma on all levels of society is too big to ignore, from the young intellectually disabled woman who is openly taunted in the shopping mall to the middle-aged man who begs to stay in prison because that’s the only place he can get treatment for his schizophrenia. Casual use of the word retarded should certainly end — but simply telling people not to say it will never be enough.

Emma Sloan is a senior in Branford College.

Comments

  • PK

    A thought-provoking, courageous article. This week or last, the New Yorker had an extensive article on mental health drugs addressing the placebo issue.
    PK

  • anonymous

    There is a whole bunch of issues that this piece touches on, including on the one hand the fact that this country sends psychotic people to prison, a practice unheard of in the civilized world. Nevertheless, I am not at all persuaded that most of the issues addressed have much to do with stigmatization and the casual use of psychiatric terms.
    There are other problematic claims in the article, such as the one that “a disorder is not part of who you are, and that saying so is offensive.” Quite to the contrary, the disorder IS a fundamental part of who you are (I speak from experience). And I actually find it kind of therapeutic to call myself “crazy”…

  • Yale 08

    Disorder is not an ideal to be sought.

  • y10

    Ever consider that this thing is wildly, wildly overdiagnosed? If you’re mentally handicapped (in the case of the “r-word”), it’s quite obvious a number of levels. On the other hand, lots of disruptive, destructive people who still fall on the extreme end of natural behavioral variance get off the hook because of their “disorder” or “condition.”

  • Barney the Purple Dinosaur

    Insults are mean!

  • anon

    You’re dumb.