by Megan Kennedy

​The mental health community is buzzing with talk about stigma. As a social work student, my mental health classrooms were filled with dialogue about the ongoing consequences of shaming individuals with mental health problems. As a professional, the effects of stigma are often detailed in the stories and everyday lives of my clients, and as an individual with a lengthy history of anxiety, I have personally felt the effects of stigma and witnessed stigma through others close to me. Considering roughly 18.6% of adults and 13.1% of children (ages 8-15) suffer from diagnosable mental health problems, chances are you have too. Most of us agree that stigma is harmful, but where does it come from and what can we do about it?

Researchers report two distinct types of mental health stigma - social stigma and self- stigma. Social stigma results from prejudice attitudes and discriminatory actions that target individuals with mental health issues due to the assignment of psychiatric labels. Self-stigma, on the other hand, is characterized by one’s internalization of perceptions of discrimination.

A number of factors contribute to stigma. Historically, individuals with mental health concerns have been treated differently, rejected and abused. Dr. Graham Davey, a British professor of Psychology, notes that this kind of treatment stems from mistaken views that mental health problems steer people to act in more violent or unpredictable ways than those without such problems, or somehow people with mental health concerns are abnormal or different. However, none of these views have any basis in fact. Dr. Davey also includes the medical model as an unintentional source of stigmatizing beliefs, as this model usually signifies diagnoses and diagnoses implies a label to a “patient.” Such labels are often associated with undesirable attributes, which perpetuate the idea that individuals with mental illness and/or diagnostic labels should be viewed with concern.
It’s no surprise that the most blatant perpetuation of mental illness stigma is at the hands of the media, as media portrayals often reinforce stigma with images of violence and homicide associated with mental health problems. Discussions concerning mass shootings and mental illness almost go hand in hand these days. Moreover, words used to represent mental illness are so common in our present-day vocabularies they almost always pass without comment or judgment. Psycho. Nut-job. Crazy. Insane. He’s lost his mind. She has some serious OCD. The list continues.

For some, the nastiest consequences of stigma aren’t social injustices but the effect stigma has on help seeking behavior of those affected by mental health problems. The Scattergood Foundation reports a mere 30% to 40% of people with mental health problems seek treatment in the U.S., and up to 70% of adults and youth worldwide do not receive services for mental and behavioral health problems. Public health researchers attribute stigma as a major causative factor driving these alarmingly low rates of treatment. Moreover, stigma hurts treatment outcomes and hinders effective recovery from mental health problems.
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The good news is, there are many simple actions we can all take to help challenge mental illness stigma which include:

• Be respectful. Use courteous and considerate language. Avoid using from derogatory language and correct people when you hear the use of such words and phrases. As mention earlier, unintentional yet derogatory words such as “crazy” or “insane” aid in the maintenance of stigma. I know I’m guilty of this one.    
• Talk about mental wellbeing and mental illness. Educate yourself and teach others when opportunities arise.
• Get to know people who have experienced mental health problems.
• Offer support to those who are experiencing mental health problems.
• Speak up about your own experiences. The more concealed mental illness remains, the more people continue to believe that it is shameful and should be hidden.

Stigma is personal. Stigma isn’t some kind of frivolous abstraction experienced by a highly sensitive and sparse few. It’s a social injustice that shames countless individuals with mental health concerns and damages them tremendously in the process. The consequences are deep and extensive. Public endorsement of prejudicial attitudes and discriminatory behavior towards individuals with mental health problems embrace stigma, and the social effects of this include exclusion and isolation, poor quality of life, a lack of social support and low self esteem. Adopting and internalizing the stigma of mental illness and targeting stereotypical, harmful attitudes towards one’s self leave people believing they are helpless and undeserving.  

In order from most restrictive to least:

1.      Medically Managed Inpatient

• Supervised detoxification and stabilization under the care of 24/7 medical staff
  
• Provides safety when detoxing from substances like alcohol, benzodiazepines, opioids
• Helpful when clients have complicated medical conditions and co-occurring substance abuse and mental health conditions

2.       Inpatient or Residential (IP)

• May or may not include 24/7 medical care
• Involves a stay at the facility or hospital while receiving treatment.
• Can last from overnight, a few days, weeks, or in rare cases a month or more.
• Usually receive medical care, individual counseling, group counseling, family counseling, recreation, all meals
  

3.       Partial Hospitalization (PHP)

• Involves spending most all of the day at the facility or hospital, but evenings and nights are spent at home
• Usually receive medical care, individual counseling, group counseling, family counseling, some meals
• Removes you from your everyday environment without the added cost and time of spending nights
• Must have a stable and healthy home environment
  

4.       Intensive Outpatient (IOP)

• Involves 3-6 hours per day at the facility or hospital
• Involves group, family, and individual counseling, might share a meal
• Appropriate for those who need a high level of care to support a change in everyday living but need to maintain their work or school schedule
• Must have a stable and healthy home environment
  

5.       Outpatient (this is what Flourish provides)

• Weekly counseling sessions for family, individual, or group
• May or may not involve collaboration with physicians for medication management
• Focus may be on abstaining from substance use or problematic behaviors, and preventing relapse 
• Focus may be on “harm reduction”, or decreasing the amount or frequency of substance used
  

6.       Prevention and Early Intervention

• Information is provided to the general public about mental health and substance abuse
• May be used with  individuals experiencing life stress that may lead to substance abuse or mental health diagnosis

Health care professionals can help you make the best decision for what level of care is most appropriate. The first step is reaching out and letting us know what you're going through. We are here to help.

Check out the video to learn more about how to enroll in health coverage, save money on premiums, what the plans cover, and what happens if you're not covered. All plans offered must include Mental Health and Substance Abuse treatment.

Helpful links:

Main Site: Healthcare.gov
1-800-318-2596

To find help in person: localhelp.healthcare.gov. Here are the nearest local help locations to my office in the 75218 zip code:

1.       Mission East Dallas Community Health Center

Phone: (972) 682-8917 (MAIN)

Email: lisa.pettitt@missioneastdallas.org

Address: 2914 Oates Drive Dallas, TX 75228

2.       Urban League Of Greater Dallas And North Central Texas (ULGDNCTX)

Phone: (214) 413-1760 (MAIN)

Email: rseban@ulgdnctx.com

Web: http://ulgdnctx.org

Location: Pleasant Grove Community Service Center

Address: 3312 N. Buckner, Suite 234 Dallas, TX 75228

3.       Metrocare Services

Phone:(214) 743-6117 (MAIN)

Email: metrocare@metrocareservices.org

Web: http://www.metrocareservices.org

Address: 4645 Samuell Blvd Dallas, TX 75228

4.       Southern United Neighborhoods (SUN)

Phone: (800) 239-7379 (TOLL-FREE)

Email: la@southernunitedneighborhoods.org

Address: 5200 East Grand #550 Dallas, TX 75223

5.       Mesquite Community Hospital

Phone: (214) 320-7146 (MAIN)

Email: 868eligibility@hma.com

Web: http://www.dallasregionalmedicalcenter.com

Location: Mesquite Community Hospital

Address: 3500 Interstate 30 At Motley Drive Mesquite, TX 75150


Happy healthcare hunting! Feel free to contact me if I can be of support along the way. Be well.