Mental illness stigma lingers through “it’s a brain disease”

Recently a review of an article published in the Journal of Psychiatry concluded that public perceptions regarding mental illness and addiction had improved but still had a long way to go. The two survey periods compared were 1996 and 2006. In the LA times review of the same article, Shari Roan elegantly summarized the study as follows:

The study compared people’s responses to vignettes involving mental illness and addiction to gauge public understanding of the illness and feelings toward those who are ill or addicted. The surveys took place in 1996 and 2006. The idea, the researchers said, was to assess whether major efforts to improve the treatment of mental conditions and eliminate stigma in the United States is working. Several sweeping efforts have been made in the past two decades to educate Americans on mental illness. A major theme of these campaigns is that mental illnesses and addiction are biological, brain-based, sometimes-genetic illnesses that are each “a disease like any other.”

The research revealed people would be more likely to recommend a psychiatrist for alcohol treatment (80%, up from 60%) and that awareness of the biological basis for depression had improved too (67% up from 54% in 1996). It also showed that the public is still reluctant to “work closely” with a depressed person and the perception of those with schizophrenia being a danger to others has actually risen to 60% from 54% in 1996.

This is all good insofar as people are not regarded as sinners or morally weak regarding mental difficulties or addictive behavior. On the other hand, there is precious little pragmatic difference in stating an individual is possesed by an evil spirit versus saying he has a “brain disease.” Even the paper’s lead author, Dr. Link, offers this caution in the section on Policy Implications:

However, clinicians need to be aware that focusing on genetics or brain dysfunction in order to decrease feelings of blame in the clinical encounter may have the unintended effect of increasing client and family feelings of hopelessness and permanence.

Saying everyone with addiction has a “disease” is for practical purposes no better than saying they are of weak moral character and they are shunned no less because of it. To the outside observer, the behavior of the addict certainly appears “crazy” or diseased. In the person who is addicted, the perception of specific reward is skewed toward immediate pleasure instead of pleasure postponed. The way to healthy choice is not through disempowerment and medical stigmatization. To behave better, the “addict” must be educated, brought into the community, and held accountable for his actions. Don’t you agree?

via Mental illness stigma lingers even though people understand it’s a brain disease – latimes.com.

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Category: Current Events, Neuroscience, You Don't Need Rehab

About the Author: Dr. Jason Giles is certified by the American Board of Addiction Medicine and the American Board of Anesthesiology. He is a physician specializing in the treatment of drug, alcohol, and behavioral addictions. He is the founder of Haywire.


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