Practical Strategies for Research and Social Change
Reprinted from "Stigma & Discrimination" issue of Visions Journal, 2005, 2 (6), p. 39
According to the book, public stigma is “the result of a naïve public endorsing the stereotypes of men- tal illness” (p. 12). Labels and stereotypes lead to prejudice and discrimination, which can affect a person’s opportunities, such as obtaining competitive employment and living independently in a safe, decent home. The impact of stigma also affects family members, friends and mental health service providers. Self stigma is deﬁned as “the consequences of people with mental illness applying stigma to themselves” (p. 12). By internalizing the stigma endorsed by the ‘public,’ people with mental illness believe they are less valued because of their psychiatric disorder. Self-stigma may result in lowered self-esteem and a lack of conﬁdence which, again, can signiﬁcantly interfere with life goals and quality of life.
The book does point out that stigma’s effects are not uniform. Many people with mental illness, for example, are aware of the negative stereotypes, but do not buy into them. Not everyone with a mental illness experiences low self-esteem. Some individuals become energized by prejudice, expressing “righteous anger” (p. 26). Others are indifferent and ignore the effects of public stigma altogether.
Stigmas are also not the same across disorder groups. For example, Chapter 10 outlines how substance use disorders are even more stigmatized than mental illness, due to the public’s blaming of people with addictions and perceptions of a lack of self-control, as well as associations with crime and violence. The authors note that changes are needed at the public policy level emphasizing treatment and de-emphasizing punishment.
The “practical strategies” promised in the book’s title include personal empowerment, public disclosure, protest, education, contact, and the role of media and marketing.
In Chapter 11, Corrigan and Calabrese discuss overcoming self-stigma by increasing self-empowerment. People with a strong sense of personal power can have high self-esteem and the conﬁdence to be active decision-makers in their own care. Empowerment may be considered one of the best ways to deal with the adverse effects of self-stigma and psychiatric labels. It can be fostered by giving mental health consumers greater control over their treatment and their reintegration into the community. This also provides inspiring stories of recovery to counter some prevailing stereotypes.
In another chapter, the authors talk about disclosure of one’s psychiatric history to others as being a powerful tool for change. Parallel lessons are drawn from disclosure of sexual orientation which can be a normalizing, liberating strategy. Of course, public disclosure of mental illness is a decision left to the individual, who must weigh the costs and beneﬁts.
In Chapter 13, protest, education and contact are presented as processes for changing public stigma. Protest strategies are directed against speciﬁc stigmas, using a moral appeal to stop behaviours and inﬂuences. Education attempts to challenge and replace inaccurate stereotypes with more factual information. Contact involves interpersonal contact between the public and members of the stigmatized group.
The book states that protest may have limited impact on changing overall public attitudes, but can change some behaviours signiﬁcantly. For example, organized protest may be useful to stop media outlets from running stigmatizing programs, advertisements and articles.
The beneﬁts of education may be limited, as evidence from education studies that target racial and other minority group stereotypes is mixed, according to the book. Short term improvements may be seen; further research is needed, however, to determine the long-term effects of such interventions
The book holds the greatest hope for the contact strategy to change mental illness stigma. Studies show that contact with a person with mental illness improves attitudes better than either protest or education interventions.
I strongly recommend this book as an up-to-date primer into a very complex ﬁeld. The book’s contributors maintain a wide view of the subject and its relevance to systems outside of the traditional mental health ﬁeld, such as criminal justice and addictions. The book would be of interest to academics, consumers, family members, mental health and addictions professionals, as well as law enforcement or criminal justice personnel, human rights and disability advocates, members of the legal profession—and educated lay readers. It’s academic in its approach and therefore most accessible to those with a college education— or who have interest and appetite enough.
About the Review Writer and Book Editor
Mailis is a freelance researcher and writer. She just completed a work practicum at CMHA from Gastown Vocational Services in Vancouver
Patrick Corrigan, associate professor of psychiatry at the University of Chicago and director of its Center for Psychiatric Rehabilitation, is an acknowledged leading expert in stigma and mental illness. Corrigan worked on this anthology with contributors from the Chicago Consortium for Stigma Research, a multidisciplinary team of experts from psychology, psychiatry, social work, law, sociology, and human development