Monday, June 18, 2018

Book Ends: "Written Off" by Philip T. Yanos

Book Ends: "Written Off" by Philip T. Yanos
A Column by Kurt Sass
Examining Stigma with a Critical Eye

Dr. Yanos, a Ph. D. and Professor of Psychology at John Jay College, has written a captivating and well-researched book on the history, foundation, and most importantly, the effects of stigma about mental illness. This stigma includes the stigma by others (media, government, community and society in general), but also the stigma mental health consumers place on themselves (Self-Stigma)

Dr. Yanos has certainly put a tremendous amount of time and effort into this book as there are almost 500 references cited. Many of these references point to a current theme: The stigma and misconception (by both society and consumers alike) that once a person has had a psychiatric episode they will never go back to having a normal life.

Dr. Yanos points out many true instances of how this stigma has affected people's lives. The Nazis, for example, started an extermination campaign of their own people who had mental illnesses in 1939 called the T-4 program. The rationale behind this (even advertised in propaganda films) was that these were "mercy" killings and acts of euthanasia, as people with mental illness were incurable.

Another example is the actress Margot Kidder, who was extremely popular from the Superman and other movies. In fact, by the 1980s, she was one of the most popular actresses in the world.  In the 1990s, however, she suffered a psychotic break, which was widely publicized. Although she has not had any episodes in many, many years, she feels that people still think of her only in terms of the breakdown, and that this has hurt her career tremendously.

Of course, it is not only celebrities who have to deal with stigma. Dr. Yanos relayed the story about a single parent in Kansas, who, shortly after giving birth in 2009, experienced a psychotic episode. Her daughter was taken into custody by child welfare authorities. The mother was treated and recovered. She petitioned to regain custody but was denied even though she never abused or neglected her daughter, even while she was symptomatic. The judge in the ruling stated that her condition "is permanent and there is no likelihood the condition can be reversed." She went on to give birth to another child in 2011 and has been allowed to keep custody of that child, but not her first born. As of 2014 things have remained the same.

The last story I would like to share from the book is how stigma from the community can cause mental health consumers to suffer from "Self-Stigma." While doing an ethnographic study in Los Angeles, a sociologist came across the case of an intelligent, outgoing man in his 30s, living in a community residence. Due to all the stereotypes he heard over the years that no one ever recovers from mental illness—although he was no longer suffering from any symptoms of his mental illness—he was desperately struggling and grappling with these negative stereotypes and stated that he had a "futureless future." He feared that he was becoming a "human rock," and that he had no hope. He eventually committed suicide.

Alas, there is hope. Research from the book has shown at least three strategies that have proven to work. The first is Cognitive Behavioral Therapy. The second is a National Anti-Stigma Campaign. (Note: The United States has local campaigns, but not a national one.) The last one is peer support.
I have given just a few examples of the stories showing how stigma can impact people's lives and the names of the strategies most effective in fighting stigma. I highly recommend you read this book to both read more of the stories and to find out how the strategies mentioned above work.

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