Reducing the stigma of mental illness

Abstract

The days of telling your patients to “pull themselves together” should be over. Jim Bolton discusses the various ways in which health professionals can help to reduce the stigma of mental illness at a professional, service, and individual level Mental health problems are treated as if our thoughts and feelings are separate from our physical bodies. This artificial distinction is reflected in our thinking and language as well as in the provision of health services. This separation of mind and body contributes to the stigma of mental illness. The description of mental health problems as being “all in the mind” is often followed by the instruction to the patient to “pull yourself together.” As a liaison psychiatrist who works in the divide between mental and physical health services, I have many reasons to consider the stigma of mental illness and how it should be tackled. The artificial divide between physical and mental health services is shown by the high rates of psychological morbidity in general hospitals. Medical and surgical patients have higher rates of anxiety and depression than patients in the wider community, and one third of adult male inpatients drink alcohol in amounts that are hazardous to their health.1 Up to 5% of patients presenting at emergency departments have primary psychiatric problems.2 Having separated the organisation, location, and funding of mental and physical health services in the United Kingdom, we are now struggling to bring them together to meet the psychological needs of general hospital patients. This need is met by liaison psychiatry, which provides psychological care for such patients.3 It also provides important opportunities for combating the stigma of mental illness. Stigma marks an individual out as being different and evokes some form of sanction. Illnesses can often be the stigmatising characteristic. However, whereas the …