The following is an excerpt from….

“Stigma Of Mental Illness Continues To Impede Early Diagnosis And Treatment Of Affective Illness In The United States”

written by Landino, Roy and Buckley

(Read the entire article here)

The Oxford-Unabridged Dictionary defines “stigma” as a mark of “infamy, disgrace, or reproach”; in Middle English — a “brand”; derived from Latin — “tattoo, indicating slave or criminal status”; originating ultimately from stizein, the Greek word for “a recognizable sign made by burning or cutting a part of the skin of a less valued member of society with an aim of distinguishing him/her from the rest of the members” (14).
With the advancement of Christianity, the word stigmata, through a most ironic derivation (i.e. the physical disfigurement of one who was to be emulated rather than shunned, someone in the Biblical account who shunned no one), nonetheless came to reference a physical condition, an overt recognizable mark or disfigurement, as the blisters on the palms of the hands and feet — the “Christ’s spot” (15,16).
Nathaniel Hawthorne’s The Scarlet Letter (17) is a cautionary tale for modern readers of society’s lingering propensity, perhaps indeed an inalienable compulsion to “mark” the social pariah, in the case of Hester Prinn quite literally a scarlet insignia inviting scorn for her divorce from normative morality:


But Hester Prynne, with a mind of native courage and activity, and for so long a period not merely estranged, but outlawed, from society, had habituated herself to such latitude of speculation as was altogether foreign to the clergyman. She had wandered, without rule or guidance, in a moral wilderness. . . . The scarlet letter was her passport into regions where other women dared not tread. Shame, Despair, Solitude! These had been her teachers,—stern and wild ones,—and they had made her strong, but taught her much amiss.

Second World War Jews not only were tattooed with serial numbers, but also were made to wear yellow armbands to identify their devalued heritage and social status (18). Within the Nazi concentration camps, homosexual Jews additionally were marked with pink armbands to signify their undesirable sexual identity (19). Countless similar examples litter the historical record of human existence from the seqer-ankh of ancient Egypt (20), to punishments for adultery and other challenges to Sharia law that still are observed in parts of the Arab world (21).
Stigmatization of the mentally ill continues a long history of selective isolation of persons whom society considers flawed by a discernable characteristic of physical appearance or behavior, characteristics curiously that may be celebrated in other social settings (22,23). Stigmatization deprives victims of mental illness their full measure of human dignity and participation in wider society (13,24) by undermining social support and compromising opportunity for treatment. And it does so by individual and institutional discrimination resulting from misconceptions (25), prejudicial stereotypes (26) and negative public and professional attitudes about mental illness (27).
Widely shared prejudicial attitudes about schizophrenia, alcoholism and other substance dependence disorders continue to stigmatize victims of those illnesses (28). And though such negative attitudes may be somewhat less widely held by psychiatric care providers, studies indicate significant negativism among health care professionals, including many with advanced training in the care of psychiatric illness (29-32).
Many among the general public assume that persons with psychotic disorders are unpredictable and incapable of being managed, even by the best efforts of the health care system, and therefore are considered a threat to the social order and to public safety (33). Persons suffering from substance abuse/dependence disorders suffer the additional widely held presumption, shared as well by many who provide treatment to this client population, that patients with these diagnoses, in whole or in part, whether for lack of character, or willpower, or basic social skills to cope with the routine challenges of adult life have brought affliction upon themselves (2,13,34).
Society encourages and reinforces stigmatization through a host of mechanisms. The film media, whether unwitting, or knowingly feeding, and profiting from the societal compulsion to stereotype and ostracize selected groups, encourages stigmatization by the dramatization of psychiatric illness through distorted and exaggerated (35) and thereby presumably more “interesting” and salable depictions of mental illness (36). Print media similarly select as featured coverage psychiatric incidents that reinforce the most egregious, the most titillating, and ultimately, the most marketable product for their business (35), yet also the most damaging to the image and overall understanding of psychiatric illness. Public judgment is thereby directed subjectively at the symptoms of mental illness, magnifying and overemphasizing the disparity between normative behavior and the aberrant actions of the mentally ill, inciting the very fear and prejudice that reinforces stigmatization of persons who have scant opportunity to challenge neither the veracity of the depictions nor the morality of the process (37). Entertainment television exerts a pernicious influence on children, who develop an understanding of the world unthinkingly from their social context, which increasingly includes passive participation in confabulated realities transmitted through television and computer screens that portray stigmatizing constructs of mental illness (16,24,38-40).


Stigmatization of mental illness may be understood to confound care of the mentally ill by two distinct processes. First and foremost, the stigma of mental illness prevents care seeking among the psychiatric population; and secondly, it interferes with the rational treatment of mental illness when mental illness when it presents to the medical community, often resulting in prejudicial treatment and ineffectual care.

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