What was the most likely outcome for a person who was mentally ill
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Learn about the early warning signs of mental illness, symptoms, and how to take action at Psychiatry.org. Show
Major mental illnesses such as schizophrenia or bipolar disorder rarely appear “out of the blue.” Most often family, friends, teachers or individuals themselves begin to recognize small changes or a feeling that “something is not quite right” about their thinking, feelings or behavior before a illness appears in its full-blown form. Learning about developing symptoms, or early warning signs, and taking action can helptoe ensure prompt treatment. Early intervention CAN help reduce the severity of an illness and interruptions in quality of life and functions. It may even be possible to delay or prevent a major mental illness altogether. Signs & SymptomsIf several of the following are occurring, it may useful to follow up with a mental health professional.
One or two of these symptoms alone can’t predict a mental illness but may indicate a need for further evaluation. If a person is experiencing several at one time and the symptoms are causing serious problems in the ability to study, work or relate to others, he/she should be seen by a physician or mental health professional. People with suicidal thoughts or intent, or thoughts of harming others, need immediate attention. Taking Action, Getting HelpMore than a decade of research around the world has shown that early intervention can often minimize or delay symptoms, prevent hospitalization and improve prognosis. Even if a person does not yet show clear signs of a diagnosable mental illness, these “red flag” early warning symptoms can be frightening and disruptive. Just as with other medical illnesses, early intervention can make a crucial difference in preventing what could become a serious illness. Encourage the person to:
Recognize that stigma may pose a significant barrier to seeking help. Each individual’s situation must be assessed carefully and treatment should be individualized. Comprehensive treatment to prevent early symptoms from progressing into serious illness can include ongoing individual and family counseling, vocational and educational support, participation in a multi-family problem-solving group, and medication when appropriate. Family members are valued partners and should be involved whenever possible. Learning about mental illness and what is happening in the brain can help individuals and families understand the significance of symptoms, how an illness might develop and what can be done to help. More than half of people with mental illness don't receive help for their disorders. Often, people avoid or delay seeking treatment due to concerns about being treated differently or fears of losing their jobs and livelihood. That's because stigma, prejudice and discrimination against people with mental illness is still very much a problem. Stigma, prejudice and discrimination against people with mental illness can be subtle or it can be obvious—but no matter the magnitude, it can lead to harm. People with mental illness are marginalized and discriminated against in various ways, but understanding what that looks like and how to address and eradicate it can help. The Facts on Stigma, Prejudice and DiscriminationStigma often comes from lack of understanding or fear. Inaccurate or misleading media representations of mental illness contribute to both those factors. A review of studies on stigma shows that while the public may accept the medical or genetic nature of a mental health disorder and the need for treatment, many people still have a negative view of those with mental illness. Researchers identify different types of stigma: (See chart below.)
Stigma not only directly affects individuals with mental illness but also the loved ones who support them, often including their family members. Stigma around mental illness especially an issue in some diverse racial and ethnic communities and it can be a major barrier to people from those cultures accessing mental health services. For example, in some Asian cultures, seeking professional help for mental illness may be counter to cultural values of strong family, emotional restraint and avoiding shame. Among some groups, including the African American community's, distrust of the mental healthcare system can also be a barrier to seeking help. (See more on mental health in Diverse Populations.) Types of StigmaPublicSelfInstitutionalStereotypes & PrejudicesPeople with mental illness are dangerous, incompetent, to blame for their disorder, unpredictableI am dangerous, incompetent, to blameStereotypes are embodied in laws and other institutionsDiscriminationTherefore, employers may not hire them, landlords may not rent to them, the health care system may offer a lower standard of careThese thoughts lead to lowered self-esteem and self-efficacy: "Why try? Someone like me is not worthy of good health."Intended and unintended loss of opportunity Source: Adapted from Corrigan, et al. Media representations of people with mental illness can influence perceptions and stigma, and they have often been negative, inaccurate or violent representations. A study published in April 2020 looked at a recent example, the popular film Joker (2019), which portrays the lead character as a person with mental illness who becomes extremely violent. The study found that viewing the film "was associated with higher levels of prejudice toward those with mental illness." Additionally, the authors suggest, "Joker may exacerbate self-stigma for those with a mental illness, leading to delays in help seeking." The stigma of mental illness is universal. A 2016 study on stigma concluded "there is no country, society or culture where people with mental illness have the same societal value as people without mental illness." Harmful Effects of Stigma and DiscriminationStigma and discrimination can contribute to worsening symptoms and reduced likelihood of getting treatment. A recent extensive review of research found that self-stigma leads to negative effects on recovery among people diagnosed with severe mental illnesses. Effects can include:
A 2017 study involving more than 200 individuals with mental illness over a period of two years found that greater self-stigma was associated with poorer recovery from mental illness after one and two years. An editorial in the Lancet notes that the impacts of stigma are pervasive, affecting political enthusiasm, charitable fundraising and availability, support for local services and underfunding of research for mental health relative to other health conditions. Some of the other harmful effects of stigma can include:
Source: Adapted from Mayo Clinic Stigma in the WorkplaceEmployee Assistance Programs (EAP), commonly available through employers, help employees deal with a variety of concerns such as work-life stressors, issues affecting mental and emotional well-being, family issues, financial concerns, relationship problems, or legal concerns. However, the services often go unused—only about 3-5% of employees use available EAP services, according to the Center for Workplace Mental Health. A 2019 national poll from the American Psychiatric Association (APA) found that mental health stigma is still a major challenge in the workplace. About half of workers were concerned about discussing mental health issues at their jobs. More than one in three were concerned about retaliation or being fired if they sought mental health care. Only about only about one in five workers were completely comfortable talking about mental health issues. The poll found a generational divide: millennials were almost twice as likely as baby boomers to be comfortable (62% vs. 32%) discussing their mental health. On a more positive note, about half of workers were at least somewhat comfortable talking about mental health and most workers said they would help guide a troubled co-worker to mental health resources. However, even among those willing to help, about one in four workers said they would not know where to turn for mental health help. Addressing StigmaResearch shows that knowing or having contact with someone with mental illness is one of the best ways to reduce stigma. Individuals speaking out and sharing their stories can have a positive impact. When we know someone with mental illness, it becomes less scary and more real and relatable. A 2016 review of research on addressing stigma concluded that efforts to reduce stigma and discrimination can work at the personal and population levels. The strongest evidence was for anti-stigma efforts involving contact with individuals with lived experience with mental illness and efforts with a long-term commitment. About 3 in 4 young teens seeking information online about depression said they were looking for personal anecdotes from people who had suffered in the past.Many celebrities, such as Demi Lovato, Dwayne "The Rock" Johnson, Michael Phelps, Taraji P. Henson and Lady Gaga have publicly shared their stories of mental health challenges and brought the discussion much more into the general media and everyday conversation. Young people are looking for information and for these personal stories online. A 2020 national survey of 14- to 22-year-olds found that 90 percent of teens and young adults experiencing symptoms of depression are researching mental health issues online and most are accessing other people's health stories through blogs, podcasts, and videos. About three in four young teens seeking information online about depression said they were looking for personal anecdotes from people who had suffered in the past. Social marketing campaigns can also be effective. For example, a research study looked at the effectiveness of an anti-stigma social marketing campaign in California and found that the campaign increased service use by helping people better understand symptoms of distress and increasing awareness that help is available. The researchers estimated that if all adults with probable mental illness were exposed to the California mental health campaign, 47% would receive mental health treatment. If the same adults were not exposed to the campaign, 36% would receive treatment. The National Alliance on Mental Illness (NAMI) offers some suggestions about what we can do as individuals to help reduce the stigma of mental illness:
While stigma and discrimination are still prevalent in the workplace, employers are increasingly addressing stigma against mental illness. The APA Foundation's Center for Workplace Mental Health emphasizes the importance of both robust health care services and specific efforts to break the silence that surrounds the topic of mental illness. The Center for Workplace Mental Health suggests organizations strive to "create a culture in which mention of depression, anxiety, post-trauma, and other common illnesses become as mentionable as diabetes, hypertension, and migraines."Employers who are leading efforts to address stigma offer some suggestions:
Source: Working Well Toolkit Organizations and CampaignsAcross the country numerous organizations and campaigns focus on addressing the issue of mental health stigma and discrimination. A few examples are highlighted below:
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