How Profitable is the Stigma around Mental Illness?
by lstum1 on April 25, 2014 - 11:43am
Recently, I came upon the topic of mental illness and the critique of pharmaceutical methods being highlighted over other methods of treatment for people who have mental illnesses. This was brought to my attention through a post on the NewsActivist website. I was also interested in the stigma associated with the issue of mental illness, which can be every bit as debilitating as the illness itself. I found an organization called “Mental Health America”, that has been around for over one hundred years, that seeks to eliminate the stigma of mental illness and support people with mental illnesses and their families. While their work is valuable and perhaps even indispensable, I question through a Marxist lens whether their efforts will ever lead to comprehensive change.
Mental Health America’s strategy is based on a specific theory of change. This organization operates under the belief that a multifaceted approach to eradicating mental health/substance abuse, educating and removing stigma, lobbying for change, and providing community services is the most effective way to solve this social problem.
Mental Health America has been around since 1909. They were founded by Clifford W. Beers, a former patient. Because of their history they have a good reputation and their legacy gives them legitimacy. They are also partnered with 240 affiliates in 41 states. They receive donations from individuals as well as businesses and organizations. This is their capital. They also have experts and volunteers that help them with large scale activities like lobbying as well as small scale activities like organizing 5Ks and community services. This is another form of capital. Another asset they have is the Clifford Beers Society.
Mental Health America’s primary outputs are policy reforms and evaluations, and community events. As a result of their lobbying they have succeeded in areas of policy including criminal justice, youth, students, trauma, and improving services available to people with mental illnesses, trauma, and addiction or other substance abuse problems. Their community events include the events listed above: 5K’s, Capitol Hill day, conferences, and other ways of raising awareness and gaining funds and volunteers.
Mental Health America has a couple of outcomes that can be seen to be short term. Their first short term goal, or outcome, is to get people interested in volunteering and to get people involved in their local communities in this issue. This can take the form of helping organize events, or it could be educating others about the proper way to discuss and think of mental illnesses and the people who have them, or it could include organizing centers where support is available for people who need help in their community. The second short term outcome is the actual support provided for mental illness sufferers and their friends and families. This is a stressful and difficult time for both the person suffering as well as the family members who may be scared, confused, or not sure how they can help. Mental Health America provides educational materials as well as support services for these people.
Some of the goals, or outcomes, that are considered intermediate include involving the community in education about mental illness, and building up resources and knowledge in communities so that there are support services in place for members of that community who deal with mental illness. This can include events that raise awareness, or other ways that knowledge can be spread. It can also include methods used to dispel the stigma associated with mental illness. This is an intermediate measure because society takes a long time to change, and because the fact that stigma exists means that mental illness still exists, which goes against Mental Health America’s main goal of eradicating it. Another intermediate outcome of Mental Health America is lobbying and working towards policy change, and evaluating policy that concerns mental health issues. This may look like sending experts to consult with policy and lawmakers, or it may look like press releases with information about mental illness. It also includes groups of people with mental illness or that work with people with mental illness going to be seen by these lawmakers to make the policies they advocate for seem relevant.
The long term outcomes of this organization include ending stigma associated with mental illness as well as the eradication of mental illness, substance abuse and addiction. This includes trauma such as post-traumatic stress, as well as biological or environmentally caused mental illnesses such as those caused or worsened by substance abuse. In addition to ending the stigma of mental illness, Mental Health America’s main long term outcome is to eradicate mental illness permanently. They seek to ensure that everyone has good mental health, or the ability to handle everyday life.
Mental Health America has many activities that they organize nationally that have been mentioned briefly above. These activities are as follows: Mind Your Health 5K, Mental Health America Conference, Statewide Consumer Network, It’s My Life, Capitol Hill Day, and awareness for May as Mental Health Awareness Month. The Mental Health Awareness conferences are held multiple times a year and in different places, but they all raise awareness for and offer support to people living with and recovering from mental illnesses. Statewide Consumer Network is a program that helps companies be aware of how they handle mental health issues. It’s My Life is a special awareness program that targets women of color with mental illness, a group that does not often seek help for this issue due to the stigma associated with it. Capitol Hill Day, as stated previously, is a day for lobbying on Capitol Hill for policy that supports individuals with mental illnesses. Finally, Mental Health Awareness Month is designed to do what all of these other events, programs, and activities do—raise awareness for mental illnesses and mental health issues, and raise support.
After researching this organization, which seems to be at the forefront of the mental health support movement, I find myself considering the manner in which our current economic system operates, specifically the pharmaceutical industry, and I wonder if perhaps the elimination of stigma surrounding mental illness or indeed even mental illness in general, is possible. Surely it is more profitable now when people are afraid of being judged, and dependent on medications, for these companies? Companies that have such a vested interest in sickness as well as possessing the vast resources at their disposal surely have some way to ensure they stay in business.
This reminds me of the theories of Karl Marx, specifically his critique of capitalism in which he states that the capitalist can and does only benefit at the detriment of the laborer (Marx, Engels, & Kivisto, 2011). While labor is not the primary issue here, and instead consumerism is, the parallel can nonetheless be drawn between these two scenarios. The gain of the pharmaceutical company can and does only come at the literal and societal expense of the person with a mental illness. Therapy and rehabilitation are often upstaged by prescriptions, which are seen as a more concrete solution to the problem. This is a coercive relationship between corporation and citizen at best, and a predatory one at worst. Additionally, the class divisions that exist in our society make it so that only certain people can afford these prescriptions, if they do work and are necessary. If healthcare were to be removed from the private sphere of profits and capital, and were instead considered a public necessity, then the primary incentive for suggesting treatments would be efficiency—whether it truly be medication, or if it be therapy or other methods.
Right now, the existence of stigma is something that is a detriment to the everyday lives of people. However, it rarely if ever has bearing on the lives of those who stand to gain from its maintenance, unless it is on a personal level. In fact, I suggest that stigma is an important tool for cultivating and increasing the dependency of mental illness sufferers on prescription medications. If people felt comfortable discussing their mental illness and coming to terms with it, then those with mild mental illnesses that don’t affect their everyday lives might feel they are fine the way they are, just diverse. On the other hand, those who have complicated or debilitating mental illnesses may be better able to come to terms with them and figure out the best treatment for them if they were able to do so within a judgment-free space where there were not ulterior motives for suggesting treatment.
I believe it is necessary to evaluate the manner in which these services are provided to people who need them, and the way that we assume medications are the best way to solve mental illnesses. Perhaps larger scale approaches such as political reform and community building can help people with these problems succeed and be as healthy as they can be.
Marx, K., Engels, F., & Kivisto, P. (2011). Manifesto of the Communist Party. In Social Theory: Roots and Branches (4th ed., pp. 17–24). New York: Oxford University Press.