Stigma among people with mental health problems

A great deal has been written about the stigma associated with mental illness. Much of it has focused on stigma present in doctors, psychiatrists, and other professionals (for example: NORDT, C., ROSSLER, W. & LAUBER, C. (2006) Attitudes of Mental Health Professionals Toward People With Schizophrenia and Major Depression. Schizophrenia Bulletin, 32, 709-714).

But we often forget that doctors and patients/ service users are part of the general public, and attitudes held by doctors are often similar to those held by the 'general public'. One might expect that those with experience of mental health problems might have had their attitudes modified by their experience, and that they would be less stigmatising.

This is unlikely, however, and someone with a history of chronic depression, who has lots of contact with other service users, was telling me that there remains an implicit 'hierarchy' of illnesses. The hierarchy operates by partially accounting for changes in behaviour or level of group activity. For example, if someone hasn't taken part in social activity, the extent to which the rest of the group 'disapproves', or excuses their absence depends on the person's condition.

The hierarchy is:

1. bipolar disorder
2. schizophrenia
3. depression
4. alcohol problems
5. drug problems

That is, those with bipolar disorder have a greater leeway for behaviour - the reason given was that it is somewhat "trendy". Those with drug problems come second place to alcohol problems. Guess addictions are always disadvantaged in this respect.

So, despite professional attitudes often being critiqued, such apparent stigma is perhaps equally present among service users...