The Stigma of Difference: Empathy, Understanding, Dignity, and Justice for People with Mental Illness

Every day I wake up, I have a conversation with myself about whether or not to get out of bed. For most people, I would argue this conversation is more to do with needing a few more minutes of sleep. For me, while that might be the case sometimes, this internal conversation is a struggle to cope with life and stress. This feeling of struggle stems from a chemical imbalance that is truly out of my control. And, although I am hesitant to “out” myself as an academic and educator who suffers from mild to moderate depression due to the stigmas still related to this field, I think it is important that I do so. In fact, I think that part of the reason that mental illness is so stigmatized is that people are not brave enough to talk about these issues in public forums. Discussion about depression and other mental illness is considered awkward, uncomfortable, and people mostly just don’t get it. And things that make us uncomfortable are things that we tend to censor or ignore. For me, I consider talking about mental disorders like depression, schizophrenia, anxiety, etc. an issue of social justice.

Although social justice is an often bandied term that means different things to different people, I like to think of social justice as a concept regarding the creation of a society that is based on principles of equality and solidarity. This society not only understands the values of human rights but also recognizes the dignity of every human being. In addition, for me, social justice also carries with it the need for action, when one encounters injustice.

As I watched the news and listened to the details of Dylann Roof’s massacre of nine African American individuals at Emanuel AME Church in Charleston, North Carolina, and the voices of people on social media, I felt an instant ache at the events that were unfolding and just how far we have NOT come on issues of race in America. But, I would also argue that we have not come very far on understanding mental illness in the United States, either. Many people were quick to call Dylann Roof mentally ill.

However, to equate mass murder and racist actions to mental illness is not only inaccurate but it also is deeply hurtful to people who deal with mental illness on a daily basis. Of course, some acts of violence can be equated with mental illness, but it is not the majority. I wholeheartedly concur with Arthur Chu in his recent Salon article on equating mass murder sprees to mental illness; he wrote: “mentally ill are far more likely to be the targets of violence than the perpetrators.” And this can be corroborated by a study in 2001 that looked at 34 adolescent mass murderers. Out of that group, slightly less than 1 in 4 of those studied had a documented psychiatric history–meaning that the vast majority did not, and causality of murder to mental illness couldn’t be directly linked in the cases that did.

What is important to think about as an educator is how mental illness is constructed in our society as a stigma, a modern day Scarlet Letter, for those who deal with the effects of mental illness. In fact, approximately 1 in 4 American adults and 1 in 5 American youth suffer from a mental disorder. As a former middle and high school teacher, I think the fact that suicide is the third leading cause of death in students age 10-24 according to the Centers for Disease Control and Prevention is terrifying and needs to be addressed. Mental illness is widely considered to be the most stigmatized human condition in the world, and when we create these socially constructed stigmas, we push people to the margins of our society. People fear what they don’t know and the stigma of mental illness exacerbates the misconceptions people have about who the person really is. Those who are labeled with a mental illness face oppression.

In 1990, Iris Marion Young, a professor of political science and gender studies, wrote about the five faces of oppression, believing that the presence of even one of these types was adequate to consider a social group oppressed. These five faces include:

• Exploitation: using people’s labors to produce profit while not compensating them fairly, therefore creating a system that perpetuates class differences.
• Marginalization: relegating or confining a group of people to a lower social standing or outer limit or edge of society; a process of exclusion.
• Powerlessness: inhibiting a group of people’s development of one’s capacities, taking away decision making power, and exposing a group of people to disrespectful treatment because of lowered status, determined by the ruling class.
• Cultural imperialism: taking the culture of the ruling class and establishing it as the norm.
• Violence: subjecting members of a group to fear of random, unprovoked attacks on their persons or property.

Based on these distinctions, I think we can make a very clear claim that people with mental illnesses are oppressed due to at least three, and maybe all of these faces of oppression. Clearly, as already indicated by the stigma, people with mental illness are marginalized. Those with mental illness can be fired from jobs and denied health services. They are targets of violence in the form of physical and verbal attacks and ridicule. People with mental illness are constructed as not “normal”–instead they are “other-ed” through stereotypes–images of mentally ill as violent, unreliable, or incompetent. As Young argues, “the culturally dominated undergo a paradoxical oppression, in that they are both marked out by stereotypes and at the same time rendered invisible…The stereotypes so permeate the society that they are not noticed as contestable” (p. 59).

As noted, people are uncomfortable talking about mental illness and therefore it is often just not even talked about, rendering it truly invisible, yet everywhere. Two high school students recently tried to talk about depression in their high schools only to be censored by their principal.

In addition, because people’s notions of the mentally ill are so ingrained, often those with mental illness have internalized the stereotypical notions, which in many cases leads to feelings of shame and lowered self-worth. As someone who suffers from depression, sometimes I feel overwhelmed with the pressure to prove I am not “crazy,” unstable, or incompetent. I also think it is very important to note that mental illness is one of very few illnesses that people are encouraged in some ways to hide. Those diagnosed with cancer or diabetes are not discouraged from speaking about their illnesses. Yet, mental illness is often considered a family secret; something not to discuss with respectable company. But, we need to stop considering mental illness a weakness. It is a disorder, a flaw of biology and chemistry, not a flaw of a person’s character or ability.

So what should be done in order to be more socially just educators? First of all, start talking about mental illness. Unpack the stereotypes with other teachers and, of course, students. Discussing facts about mental illness is a good first step of reducing the shame that many youth feel. I personally recommend the Peabody award-winning documentary “Hearts and Minds: Teens and Mental Illness” which demystifies mental illness for teens through the stories of four teenagers.

A second recommendation is simply having empathy, not sympathy for people with mental illness. I cannot tell you how many times in my life I have been told to perk up or just cheer up. Hmm … if only I had thought of that! While friends and family are well-intentioned with statements like this, it can come across as belittling and irreverent. Mental illness is not something that someone can snap out of. Instead, offer your listening services and moral support through daily or weekly check-ins.

Third and finally, I would be remiss if I didn’t advocate the use of literature to talk about mental illness. As a middle and high school English teacher, there are many wonderful books that could open up conversations about people with mental illnesses. I will offer a few of my suggestions, but there are many more great ones.

Depression and Suicide:

• It’s Kind of a Funny Story by Ned Vizzini
• Thirteen Reasons Why by Jay Asher
• Hold Still by Nina LaCour

Anxiety Disorders:

• I Don’t Want to be Crazy by Samantha Schutz
• Fangirl by Rainbow Rowell

Eating Disorders:

• Wintergirls by Laurie Halse Anderson
• Elena Vanishing: A Memoir by Elena Dunkle

Bipolar Disorder:

• Crazy by Amy Reed
• Freaks Like Us by Susan Vaught

Thought Disorders (e.g. Schizophrenia) :

• Chopsticks by Jessica Anthony and Rodrigo Corral
• Cameron and the Girls by Edward Averett

PTSD:

• The Impossible Knife of Memory by Laurie Halse Anderson
• Something Like Normal by Trish Doller

Self-Harm:

• Cut by Patricia McCormick
• Scars by Cheryl Rainfield

Reference

Young I. M. (1990) Justice and the Politics of Difference. Princeton University Press, Princeton.

Michelle M. Falter is a doctoral candidate in the department of Language and Literacy Education at the University of Georgia, and former editor of the Journal of Language and Literacy Education. She has been a secondary English teacher for ten years, having the privilege of teaching in both the United States and abroad in countries such as The Dominican Republic and Germany. Michelle’s scholarship focuses on the role of emotion in the English classroom, and helping educators co-construct knowledge with their students using participatory, critical, and dialogical teaching practices. Michelle can be contacted at mfalter@uga.edu or on twitter @MFalterPhD.