Bandy X. Lee, The Conversation
The problem is especially acute in the workplace. While individuals with mental illness often wish to work and are able to, their unemployment rates remain three to four times those of individuals without mental illness.
I’m an expert on mental health, and I have found that to dispel stigmas surrounding mental health in the workplace, researchers like me need first to tackle several myths.
1. Everyone has different abilities
Let us examine the first myth: that mental illness makes one less able to do a job.
Mental disorder does not interfere with all capacities, and can sometimes improve others. One study shows that almost half of U.S. presidents suffered from some kind of mental disorder. Some have performed the most challenging tasks in history.
For example, Abraham Lincoln’s severe depression is said to have made him more compassionate, while Theodore Roosevelt’s hypomanic moods made him an exuberant and influential personality.
There is plenty of evidence that, given the right supports, people with mental illness can be successful at work. Conversely, individuals do not have to have a mental illness to lack the mental capacity to do a job.
2. Mental versus physical illness
The second myth is that mental illness is associated with moral failing, unlike physical illness.
In our own lifetimes, we may remember the stigma and secrecy that surrounded cancer and AIDS. Scientific research and education helped these prejudices give way to understanding.
The more we know, the more we understand that mental disorders are not moral failings or subjective complaints that people can simply “snap out” of, but are serious, debilitating and deadly medical conditions like any other.
Within medicine, psychiatric diagnoses are some of the most reliable. And while there are no blood tests, there are standardized scales that can be just as dependable for diagnosing and monitoring prognosis.
3. Mental illness does not equal violence
The third myth is that those who have mental illness are dangerous.
Media and public perception continue to perpetuate this myth, even though large-scale studies have shown no difference in levels of violence from the general population. People with mental illness are actually more often victims of violent crimes than perpetrators.
In 2017, after a mass shooting in Texas, President Donald Trump stated that “mental health is your problem here … this isn’t a guns situation.” He reissued similar statements after other mass shootings in Parkland, Florida; in Pittsburgh, Pennsylvania; in Thousand Oaks, California; in El Paso, Texas; and in Dayton, Ohio.
4. Challenging stigmas
Finally and sometimes fatally, the myth persists that speaking about mental illness increases stigma.
Erving Goffman gives a compelling description of how stigma stereotypes a person as abnormal, deformed and dangerous. Stigma, hence, is a form of violence. It originates from ignorance or misunderstanding and harms those suffering from mental illness by depriving them of their humanity.
Stigma creates for people with mental illness conditions for social exclusion, employment discrimination, victimhood to violent crime and increased suffering, which can lead to self-stigma, poor self-care and greater depression and suicide.
For example, Trump recently accused Intelligence Committee Chairman Adam Schiff of being a “a maniac … a deranged human being” and “a very sick man,” but he is not the only politician to do so. Invoking mental health as an insult further stigmatizes those already suffering in harmful ways.
Speaking about mental illness helps educate and dispel myths. Demystifying mental illness and distinguishing it from the person and a person’s abilities is critical to diminishing stigma and improving the lives of those already burdened with mental illness.
Why people work
Work is more than a means for material support. It is also a major way individuals stay mentally healthy and socially integrated.
Especially for those dealing with a serious mental illness, employment is important for daily structure and routine, a sense of self, meaningful goals and opportunities for friendships and social support.
The workplace is therefore an important setting for speaking about mental health and illness. Breaking the silence can be beneficial for removing barriers to seeking treatment, staying well and staying employed.
Employers already bear much of the burden of mental illness. As 85% of employees’ mental health conditions go undiagnosed or untreated as of 2017, employers subsume more than US$100 billion in lost revenue and 217 million lost workdays each year. Prejudicial attitudes also exclude needed talent in the workforce.
Exclusion from the workforce can result in material deprivation, loss of self-confidence and self-identity, and isolation and marginalization that are key risk factors in mental health. High lifetime unemployment even lowers life expectancy, presumably as a combined result of stress, depression, reduced health care and loss of social networks.
Workplace interventions to interrupt the secrecy and stigma surrounding mental illness can be effective. Some programs might involve psychoeducation, increasing mental health literacy, workshops, online courses that target prejudicial attitudes and behavior, and crisis intervention training.
Awareness of inequalities with respect to race, gender, age, sexuality, class and other related factors, as well as the benefits of diversity, have grown recently, but society has a long way to go with mental illness.
Dr. Bandy Lee is a forensic psychiatrist and an internationally recognized expert on violence. She is the editor of "The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President," published in 2017 and updated in 2019. Trained in medicine and psychiatry at Yale and Harvard Universities, and in medical anthropology as a fellow of the National Institute of Mental Health, she is currently on the faculty of Yale School of Medicine’s Law and Psychiatry Division. She served as Director of Research for the Center for the Study of Violence (Harvard, U. Penn., N.Y.U., and Yale), co-founded Yale’s Violence and Health Study Group (MacMillan Center for International Studies), and leads a project group for the World Health Organization’s Violence Prevention Alliance.
She has consulted with the governments of Ireland and France, as well as multiple U.S. states on violence prevention programming in prisons and in the community. She played a key role in initiating reforms at Rikers Island, New York City’s correctional facility known for extreme levels of violence. She has been teaching students studying to be public defenders and to become asylum attorneys at Yale Law School since 2003, and a Global Health Studies course of her design, “Violence: Causes and Cures,” since 2013. She has served as consultant to the World Health Organization Violence and Injury Prevention department, UNESCO, and other United Nations bodies, and as speaker to the World Economic Forum. Her interests are in global health approaches to violence prevention and multisectoral collaboration. Her opinions expressed here are solely hers.
Disclosure statement: Bandy X. Lee previously received funding from the National Institute of Mental Health (NIMH).
Note: This article is republished from The Conversation under a Creative Commons licence.