Mental Illness, Stigma, and Halloween

by Monique Johnson, MD

October 31 is fast approaching and, as usual, the National Alliance on Mental Illness (NAMI) is gearing up to address stereotypes that often get perpetuated through Halloween attractions, festivities, and costumes.(1) The most common stereotype is one that links mental illness strongly to violence by tagging haunted mansions as insane asylums that house blood-thirsty murderers in straitjackets.

That people with mental illness are dangerous is inaccurate. In fact, data from the well-known NIMH's Epidemiologic Catchment Area (ECA)(2,3) study support that most people who are violent are not mentally ill, and most people who are mentally ill are not violent.(4) Despite these facts, society is ingrained with prejudice toward mental illness. The result—affected patients harbor shame, self-blame, and secrecy, all of which discourage them from seeking treatment.(5)

With its StigmaBusters campaign, NAMI seeks to change perceptions by using “a network of dedicated advocates across the country and around the world who seek to fight inaccurate and hurtful representations of mental illness.”(1) The Substance Abuse & Mental Health Services Administration (SAMHSA) has a similar antistigma campaign.(6) Research indicates that stigma may be reduced by three key approaches: protest, education, and contact.(7) Protest methods highlight stigma as a moral injustice that ethical people should rally against, while educational approaches dispel misinformation and myths by supplying facts. Contact raises awareness through face-to-face interactions between people in the stigmatized group and the general public.

This year on All Hallows Eve give due consideration to stigmatizing Halloween images and how you can help change negative perceptions of patients with mental illness.

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References

1. National Alliance on Mental Illness (NAMI) web site. Fight Stigma: StigmaBuster. Available at http://www.nami.org/template.cfm?section=fight_stigma. Accessed October 14, 2009.
2. National Institute of Mental Health (NIMH) web site. Psychiatric Epidemiology. Available at http://www.nimh.nih.gov/about/director/publications/psychiatric-epidemiology.shtml. Accessed October 14, 2009.
3. Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York, NY: The Free Press; 1991.
4. Friedman RA. Violence and Mental Illness: How Strong is the Link? N Engl J Med 2006;355:2064-2066.
5. Hinshaw SP and Stier A. Stigma as related to mental disorders. Annu Rev Clin Psychol 2008;4:367-393.
6. Substance Abuse & Mental Health Services Administration (SAMSHA) web site. Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health (ADS Center). Available at http://www.promoteacceptance.samhsa.gov. Accessed October 14, 2009.
7. Corrigan P and Gelb B. Three programs that use mass approaches to challenge the stigma of mental illness. Psychiatr Serv 2006;57:393-398.