In ancient Greece, a “stigma” referred to a brand that was used to mark slaves and criminals.
Similarly, for centuries, people suffering from mental illnesses were treated no different from
criminals and slaves, as they too were imprisoned, tortured, and killed. Today, although
persons suffering from mental illnesses are no longer treated in this manner, the stigma or
shame as a result of a diagnosis or symptoms associated with a mental illness still exists as a
barrier to recovery. In Latin America and the Caribbean, despite the implementation of
mental health reforms in some countries, with important objectives including reducing the
stigma attached to these illnesses, this issue still exists. We can therefore imagine how the
issue is compounded in countries that are still behind in implementing any tangible reform.
Fairly recently, I was a part of a conversation where it was being shared that I have interest in
incorporating sports and fitness with psychology to help to improve the mental wellbeing of
young people. In response, someone muttered, “you haffa crazy to want to do dem tings.” I
was quite shocked, which is probably the reason I did not challenge the individual or ask for
an explanation. I am not sure what was meant, but I can only infer, since it was not the first
time that the term, “crazy” had come up in discussions surrounding the mental health field.
It appears that we unconsciously think of mental illnesses, like schizophrenia, bipolar
disorder, and other severe conditions with symptoms that include delusions, hallucinations,
illogical or disorganised thinking, and risky behaviour when we hear the term mental health.
A quick google search of the term, “crazy” highlights that words such as “mad,” “wild,” and
“aggressive” constitute one of its definitions, and so it may seem that the use of the term is
justified. However, despite the sometimes extreme and dangerous manifestations associated
with these illnesses, other psychological disorders exist with symptoms that are less extreme.
Furthermore, a diagnosis of these severe illnesses does not mean that individuals live in a
perpetual state that exhibits these symptoms. Nevertheless, the language we use to describe or
refer to persons living with mental illnesses, and the associated assumptions may contribute
to the stigmatisation of persons who are suffering from mental illnesses or poor mental
wellbeing.
Before we delve further, it is important to differentiate between mental health and mental
illness. The terms are often used interchangeably, and although related, are NOT the same.
Mental health focuses on our emotional, psychological, and social wellbeing and is impacted
by our ability to adjust to everyday challenges i.e., stress, interpersonal relationships and
decision making. A mental illness, on the other hand, is a diagnosable condition based on an
established criteria which usually comprises persistent symptoms that affect mood,
behaviour, and the way we think. Poor mental health is not always indicative of a mental
illness and those who suffer from mental illnesses can experience periods of good mental
health. Moreover, it may not always be necessary to seek professional help for concerns
related to mental health, but professional treatment is strongly recommended for persons with
a mental illness.
Due to the lack of education and sensitisation within the Caribbean, we can be very
insensitive about identifiable differences. Take for instance the use of the words, “dunce” or
“retarded;” words that we sometimes use unreservedly. Imagine referring to a child with
dyslexia or a developmental delay as such. Additionally, labels such as “addict” or
“alcoholic” not only result in shame for the afflicted individuals and their support systems,
but also perpetuate a lack of compassion from other members of society. The impact of these
attitudes on those suffering is isolation, reliance on unhealthy coping mechanisms such as
further substance misuse, and an aversion to help seeking, which further compounds their
illnesses.
In Antigua and Barbuda, there has been increased advocacy for the prioritisation of mental
health and the development of the mental health system to include updating legislation and
relevant policies; the creation and implementation of services and programs; increased
access; and the need for human and financial resources. To compound matters, a look at the
antiquated Mental Health Act illustrates language that perpetuates the shame associated with
mental illness. For a person suffering from a mental illness to be referred to as “feebleminded,” an “idiot,” or “imbecile” highlights an urgent need to revise this misinformed
perception.
Even though these illnesses may deviate from what we view as normal behaviour, in some
instances, they are extreme versions of what we consider normal. For example, anxiety, a
diagnosable disorder can be the consequence of unhealthy coping habits used to manage
experiences such as worrying about the future or other aspects of life. Although some
illnesses result in symptoms that are deemed “abnormal,” we must not forget that the illness
only constitutes one part of the individual. When we erroneously formulate an entire identity
for these individuals based on their illnesses (eg. schizophrenic woman, autistic child) and
use language that increases shame, we help to hinder the recovery process.
Through the use of appropriate and conscious language (e.g. a person with substance use
disorder or a person who has an addiction) and realising the severe impact that the alternative
labels have, we can work towards eliminating stigma. Furthermore, an understanding that it is
normal to struggle with our mental health at times, that a mental illness does not define an
individual’s identity and extreme manifestations do not perpetually persist, we can strive
towards being fearless about seeking professional mental health assistance in the same way
we go for physical check-ups.
This article is for educational purposes and is comprised of research findings and personal
reflections. The views of the author do not reflect the views of all mental health professionals
and the advice provided does not substitute professional help. If you know someone who may
require professional assistance, please contact a mental health professional.
