Amazing Adventure Against Stigma
Hi! Nice to meet you. Welcome to the Amazing Adventure Against Stigma. Are you ready? Pack your bags and get ready to start!
You first arrive at a place of darkness. Without seeing anything, a voice asks you to wipe the screen for 5 seconds. Then you see a person with stains all over his clothes standing on a stained hillside.
You approach that person and ask why he has so many stains. He explains that those stains suddenly appear on him one day, and they remain on him since then.
You try to touch the stains and discover the origins of them.
You learn that when HR knew that he has mental illness, they refused to hire him.
Even though his work performance is better than others’.
You also find out that when his friends and family found out he has mental illness, they estranged him. Even though he treated them just the same before and after his diagnosis.
Then you realize when his neighbors knew that he has mental illness, they gossiped about him.
Even though they got along well before.
You said, “To be honest, I might have the same reactions as them.”
He said with a shrug, “I understand. Mental illness is commonly misunderstood in our society.”
You are struggling how to respond. ”Why don’t you clarify?” you whispered.
He replied, “I have clarified before, but all that they could see was my mental illness.”
You sighed with mixed emotions, “It must be tough.”
He responded, “Indeed! I have done nothing wrong, but I have to bear with all these poor treatments.”
Then you realise these tenacious stains are stigma. Stigma is the result of the majority categorizing, labelling, having prejudice, and discriminating against people with mental illness. In fact, not only people with mental illness are stigmatized, other social minorities are subjected to stigmatization, too.
The midday sun is dazzling. Among the silent green woods, an idea suddenly flashes through your head. You said, “Oh! I have some cleaning supplies in my bag that might work.”
He replied, “I have tried many different ways to get rid of them, but the stains persist. Anyways, since you have all these supplies, let’s try them out.”
There are four supplies in your bag, including “Equality spray”, “Sympathy water”, “Better than usual soap” and “Understanding detergent”.
You try the “Equality spray” first. After spraying, the stains are fading.
Since 1996, the Disability Discrimination Ordinance has been effective in Hong Kong to protect people in recovery from mental illness in public sphere, including against employment discrimination and enjoy equal rights. Around the world, similar ordinances have been passed in hopes of achieving the same goal, for instance, the United Nation’s Universal Declaration of Human Rights (1948), the UK’s Equality Act (2010), etc.
In reality, discrimination against people in recovery is still prevalent. For instance, they might be denied the right to take sick leave, reflecting societal prejudice towards legitimacy of mental illness. The stigma attached to people in recovery is deterring them from enjoying basic rights.
Besides treating people with lived experience of mental illness experience equally, if we join force in fighting for their rights and advocating for better mental health services and policies, our social impact can be even greater.
The success of “Equality spray” made you eager to try the “Sympathy water”. You pour the water over the stains but it doesn’t work.
Sympathy may appear to be similar to empathy, yet they are actually very different.
For instance, when we see others are hurt or sad, people with sympathy might react with “Aw, look how poor you are.” Sympathy is driven from our own perspective, without any attempt to understand the other person cognitively or emotionally. Thus, the other person may feel alienated and unaccepted.
With empathy, we can appreciate others’ feelings and perspectives and try to listen without judgment. A response, “It must be tough, I feel you” reflects how we try to get in touch with their feelings.
Next, you try the “Better than usual soap”. You try very hard to wipe off the stains but it doesn’t work at all.
Often, we may consider people with mental illness as having a “deficit” and requiring our special treatment. For instance, we may assume we need to treat them like kids as if they don’t know anything and need us to make decisions for them. We may also think they need to be protected and we pay extra care to them. Although we may do this out of good intentions, underlying these actions, we may have many assumptions towards them. People with mental illness don’t need special treatment, all they ask for is equal treatment and if necessary, reasonable accommodation.
Finally, you take out the “Understanding detergent” and it works. There are fewer stains on him.
Stigmatization often stems from a lack of understanding, such as not understanding what mental illness is or think that people with mental illness are dangerous. As we know more, we may realize our prejudice is rooted in ignorance.
Not only do we realize prejudice is ungrounded, we also find that stigma deters us from knowing the person. When we listen and get to know people in recovery as a “human being”, we realize they have varied experiences and stories, just like you, and me. To eradicate stigma, we need to understand more about mental illness and listen to the stories of people in recovery.
He is grateful to you as he realized the stains are gradually disappearing. You also thank him for his trust in sharing his adverse experiences with you.
You both look at each other and smile. He then suggests visiting somewhere nearby where has beautiful scenery.
Both of you arrive at where the mountain ranges rise and fall. The sky is painted in pink. When you both close your eyes and take a deep breath, you two are breathing in the same air.
Then, you two hike through the saddles, passes, ridges and valleys. It’s just like coming across the ups and downs in life.
You two feel tired after the hike and lie down on the grass watching the floating clouds. You realize that all of us are living under the same sky. At this moment, both of you feel so relaxed, like sleeping on the clouds.
When occasionally forgetting your existence, you both put your hand on each of your own left chest and listen to your heartbeat. It is amazing to discover that both of you have the same heart rate.
Suddenly, all the dirt reappear on him and in the surroundings. He receives a notification from his phone. His facial expression seems gloomy after looking at the phone. You takea look and discover it is a local news stating:
“Suspected mentally ill committed arson in the mall
Yesterday afternoon, a man committed arson at a shopping mall. Firefighters arrived to put out the fire. It might be possible that the man has mental illness.”
There are different comments following by:
“The mentally ill are psychos! They belong in the asylum, not out on the streets terrorizing people!
Oh no! My friend has anxiety. Will she turn nuts some day?
It’s so scary! I dare not going to crowded places.
You are surprised to see the news and the comments. You think about what does “suspected mentally ill” mean? Why report that when it is not verified?
He seems to understand what you are thinking. He raised his head and said, “Many people didn’t know that the mass media is one of the mediums that create and perpetuate stigma.”
Often, the media would portray news in an exaggerated or faulty way, depicting people with mental illness as dangerous or horrifying. Such sensational plots are not uncommon in films or TV shows, causing the public to equate mental illness with violence.
In fact, research showed that people with severe mental illness accounted for only 4% of the violent crimes, and their mental illness often are not the drivers behind the crimes. Instead, the crimes may be attributed to drug addiction history, unemployment, being assaulted, or other family factors. In contrast, one out of every six people with severe mental illness have been violently attacked in the past year.”
The afternoon sun is now hiding behind the gloomy clouds. The stains in his clothes and the valley start to increase. You feel worried.
You said, “Aw, what can we do now? It appears that our previous efforts are wasted.
He, on the contrary, is quite carefree. He said, “Not necessarily.”
You tried again to wipe off the stains on his clothes. This result is out of your expectation.
You said, “Wait, how come it is easier to clean now?”
He replied with a smile, “I guess it’s because you have embarked on this anti-stigma journey and have used equality spray and understanding detergent, all these make stigma less stubborn. Thank you so much!”
You replied with a shy smile, “To be honest, it’s my first time fighting against stigma. I am still not that familiar with mental illness.…”
He said, “We learn with each other along the way. Shall we have a quiz?”
He said, “We have six true or false questions. The first question is Mental illness is irrelevant to me”
You answered, “False!”
He said, “That’s correct. In Hong Kong, 1 in 7 have depression, anxiety, or mix of the two, which is more common than having diabetes, heart disease, or cancer.”
He continued, “The second question is People with mental illness are prohibited from marriage in some countries.”
You answer with hesitation, “This question is quite difficult. I guess it is false.”
He said, “It appears not. Up to 37% of the 193 UN member states prohibit people with mental illness from getting married.
You reply, “Oh! I see. Let’s continue.”
He said, “The next question is People have mental disorder because their mind is not strong enough.”
You reply, “I can answer it in confidence. The answer is false.”
He said, “That’s correct! Mental disorder is multi-determined by genetics, psychosocial and cultural factors, environmental conditions etc. Take depression as an example. One of the factors that contribute to depression is the dearth of a neurotransmitter, serotonin. When serotonin is lacking, the brain tends to process information negatively. Thus, people aren’t stubborn or can’t let go, biology affects their thinking automatically. “
He said, “Your result is good. Here is the next challenge. The question is most countries grant people with mental illness the right to vote.”
You said, “It should be true?”
He said, “It appears not. Among the 193 member states of the United Nations, up to 89% of the countries set a certain amount of restrictions on people with mental illness’ right to vote.
You said, “That many! That’s out of my imagination.”
He said, “The fifth question is people with mental illness never recover.”
You said, “I am not so sure. Would you tell me the answer?”
He said, “The answer is false. Everyone’s recovery journey is different. In general, people use a combination of medications, psychotherapy, social support, and other appropriate ways to improve their mental health condition. Personal recovery does not require the absence of symptoms, rather, people can live with their symptoms and can continue to live ordinary lives, work as usual, and have a meaningful life.
He then continued, “The last question is only a small proportion of people with mental illness seek professional help.”
You answered, “I think it is true.”
He replied, “That’s right. Among people with common mental disorders (i.e., depression, anxiety and mixed anxiety and depressive disorder), only 26% of them sought help. Reasons that prevent them from seeking help include fear of discrimination, don’t recognize this is psychological distress, don’t know where to get mental health services, etc.
You calculated and said, “I answered 4 correctly.”
He said with a nod, “No matter what the results, gaining better understanding towards mental illness can reduce stigma.”
After the quiz, you realise that the stains on his clothes are decreasing. He turned his head and said to you, “Thank you for accompanying me on this lonely journey.”
You said with a bit of surprise, “Lonely? Don’t you have friends and family that support you?”
He looked down and said, “Some of them do, but many still have some misunderstanding towards mental illness. Despite their good intentions, they still have microaggressions towards me.”
So, what is microaggression?
Microaggression occurs when we apply our assumptions or biases against people with mental illness and intentionally or unintentionally express our discrimination through our words, tone of voice, or actions. For example, if we know that our new boss has a mental disorder, we may express our doubt towards his ability to lead. Behind this thought, we assume that people with mental illness may be less capable or intelligent.
Microaggression prevails in our daily lives. Yet don’t despair. If we listen to people in distress and attend to our language and non-verbals, not joke around mental illness, we are already changing the social norm. So, never underestimate your influence! Creating an equal society needs everyone’s input.
Looking at your puzzled face, he explained in detail, “I have encountered some microaggression scenarios. For example, in the workplace, once my colleague told me that working on the team is very stressful. He asked if I could handle it in view of my mental illness.”
He continued, “I guess he’s trying to be considerate, but I am actually stronger than they think. That makes me think if he is questioning my ability. He can simply care about me just as he cares about other colleagues under stress.”
He mentioned another example, “My mother talked to me previously about my small appetite in that period. She asked if I was depressed again. I know that my family genuinely cares about me. I have little appetite because my company is downsizing, which stresses all my colleagues and myself out. It makes me feel that my family cannot see me beyond my illness.”
You are accompanying him and listening to what he said. Also, you pat him on the shoulder to show support.
He said, “My friend told me to stop excessive thinking. They think I can only recover if I am determined to change.” The way she puts it makes me feel that I can’t recover because I am not trying hard enough. How I wish I could turn off my “tendency to overthink”, just as I turn off my light in my room! It’s not like you could stop your sneezing when you have a cold, right? I hope she understands that this is easier said than done.”
You thought for a while and said, “Microaggression sounds trivial. Are you being too sensitive?”
He also thought for a while and replied, “When others only see my mental illness but not me, such as when my neighbors distance me in the elevator lobby, colleagues doubt me every time I speak, microaggressions add up and can bring devastating consequences.”
You sighed and said, “It is indeed difficult to be free from microaggression in our daily lives!“
He said, “I understand. I may have microaggressions towards other people, too. What matters is we become aware that our words or actions may carry biases and assumptions, By gradually changing ourselves, we are gearing towards a stigma-free society.“
You said with an anxious voice, “Gosh, now I’m so scared of hurting you by blurting out something inappropriate!”
He said with a smile, “Thank you for being considerate! Do not worry too much. As long as you continue to care and actively try to understand others wholeheartedly, microaggressions will gradually disappear.”
The sunset is like a reddish egg yolk. It dyes everything into cadmium orange. A tiger cub is wandering in a mountain afar. While your empathy for him grows deeper, the stains also disappear quickly.
You said, “Hey, the stains are nearly all gone. How can we completely get rid of them?”
He replied, “It is not enough to rely on a few people. If all of us are willing to make this collective effort, stigma has a chance to be eradicated in the society. Are you willing to join force in our mission?”
You stand up and raise your right hand.
I pledge to learn more about mental illness, be more aware of my own prejudices and misconceptions towards mental illness,
encourage others to understand more about mental illness, treat people with mental illness equally, speak up against incidents of discrimination or microaggression and support mental health issues and advocacy work.
He is deeply moved and says, “Thank you so much! Together with you, we hope that more people will pledge to fight for a stigma-free society!
You answered, “With more of us joining this journey, stigma will be gone soon!”
He said suddenly, “Do you notice that you have stains on you too all along?”
You sit down, lie your chin on your hand and make yourself into the thinker’s pose. You said, “They have been there all along, and I can’t get rid of them. It’s strange because I don’t have a mental illness, so I have no idea what they are.“
He bends over and tries to wipe off the stains in your leg.
You are stunned to say, “So, they can be wiped away?”
He answered, “Actually when we reduce stigma to help others, we are also helping ourselves.”
In fact, mental illness stigma affects every one of us, not just those with mental illness. Given mental illness stigma is so prevalent, even having an emotional distress may be seen as weak. Thus, we don’t dare to tell anyone or to seek help when we are feeling down, because we worry how others may perceive us. Destigmatization gives room for all of us to talk about mental health.
You nodded in reply, “Now, I truly understand that our every word and action might contribute to stigma. Stigma is related to every one of us, and we can work concertedly together to eliminate stigma.”
The silhouette of the Baobab tree gradually fading in the dusk. It’s time to go back home too.
You ask, “I thought we’re at the end of the journey, how come there is still stigma?”
He answers, “Stigma still exists in real life. Let’s strive to get rid of it in our daily lives.”
Thanks for being with us on this journey. We welcome you to embark on this amazing adventure against stigma again and to build a stigma-free society together.