NZ Herald Column Kyle MacDonald

Where mental health stigmas are still rife

This is my column this week in the New Zealand Herald, which is published in the digital edition every Thursday…

“Do we still have a problem with stigma towards those with mental illness in NZ?”

I wonder what most of you think of now when I say “mental health”. Depression? Maybe anxiety? We’ve done a great job at making knowledge about the most common mental health struggles more public, and more okay to talk about.

But what about the more “severe” problems? What do people understand about psychosis, bipolar disorder, chronic and complex post-traumatic stress disorder, personality disorders or severe addictions?

Odds are you don’t hear or see much about people with these problems in the media, or even in your day to day life.

Schizophrenia, for instance, is still a very misunderstood and somewhat controversial diagnosis. And one that still provokes a lot of fear and ignorance.

Despite what some still think it doesn’t mean people have more than one personality. The word literally means “split mind” and refers to a collection of symptoms defined by visual and auditory hallucinations, odd ideas and beliefs, distorted or false perceptions and a struggle to function in the world. It’s also true that with the right medication and support people suffering schizophrenia can lead a satisfying life.

And while people with the disorder may act in ways that can seem odd or even scary, the facts is that people with any severe mental health disorder are less likely than the rest of the population to commit any violent crime. In fact they are at higher risk of being the victim of assaults and violence, as well as being homeless, unemployed, or in unstable living situations.

Some people have misunderstood the push for a review and appropriate funding of mental health services to mean a return to “asylums” and more coercive care.

Not true.

Sadly, in my recent experience, those who are chronically struggling with these kinds of issues can now more frequently end up – due to less support services being available – under the “care” of Work and Income.

And this is where the stigma bites hard. We are so quick to judge those who fall to the bottom of our society’s ladder, so quick to blame the homeless, the chronically mentally ill, the struggling single parent. We are so quick to demand responsibility from those who are below the poverty line. We look at those with less and ask: “What’s wrong with you?”

We should be asking: “What happened to you?”

The recent focus on getting people back to work as being the measure of people’s worth fuels stigma: The stigma that if, for reasons of mental health, you are unable to work or function in society in a “productive” manner, then you are worth less, you are written off.

And this stigma is driven by dogma, and by current policy. “Social Investment” sounds like a good idea but it also implies we invest in people because we expect a return.

The more old fashioned term “Social Welfare” says something different. We want people’s welfare to be taken care of, not because it’s a good investment, but because some people need looking after.

Whether it’s because of chronic physical disability, illness or long term serious mental health issues, what seems increasingly hard to accept is that some of our fellow humans do need state support, whether it’s for a short time, or the rest of their life.

And to treat people as good or bad “investments” is as stigmatising as calling them “crazy.”

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