Social perception of mental disease

Abstract

The social perception of mental illness cannot be correctly evaluated on the basis of superficial investigations and questionnaires alone: a parallel study on social pattern of behaviour towards the mentally ill is required. Those who are handicapped mentally are usually identified as such in all types of societies. The initial reaction to pronounced evidence of mental illness is a sense of uneasiness within the group for it would appear that it is the social group which is in danger rather than the insane man who is dangerous. The institutionalized reaction which follows varies from culture to culture. In all societies, however, it is characterized by a basic ambivalence where rejection and protection alternate in a strange way. The ambiguity of this attitude is in relation to the maintenance of an acceptable social conscience. The family, for instance, will take every possible precaution to conceal the presence of a mentally handicapped member from the neighbours. When he can no longer be controlled, he is driven away, he is ostracized outside the city walls. Studies have shown a stable correlation between racial prejudices and intolerance towards the mentally ill. Even the Bible (Leviticus 20: 27) shows a rejection of the latter. And this had a disastrous repercussion in the Middle-Ages at the time of the Inquisition. Even nowadays, the difficulties encountered by a former inmate in his readjustement to community living are well known. On the other hand, instances of protection are found in all cultures. From taboos which prevent primitive societies from putting the mentally ill to death, the institution of asylums in the Middle-Ages, Pinel's reforms and the open door policy in the last century, to the recent integration of psychiatry into the general hospitals and the discovery of new therapies, a slow but constant progress has been taking place including the integration of mental health services into community life. This succession of reforms and progress may lead one to believe that a final victory over secular prejudices has been won. However, recent studies show that only limited results have been achieved through intensive propaganda aimed at convincing the public that mental illness is a disease like any other disease. Therefore, it would appear that our goals should rather be: 1) To stimulate by every possible means the identification process of the average citizen to the mentally ill by the publication of expatients' personal experiences as for example Clifford Beers' and J. Charles Pagés. 2) To neutralize as much as possible the projection of aggressive affects and thus help free the mentally ill from the role of a scapegoat so often imposed upon him.