Kathleen Lapp

The community mental health movement, begun nearly thirty years ago, has been fueled by a vision of mentally ill persons living, freely integrated, as accepted members of local communities. Unfortunately, this vision has not yet become a reality for a large percentage of mentally ill Americans. The stigma of mental illness is one of the primary barriers to the achievement of this goal. For as long as mentally ill persons are feared and shunned, they will not be truly integrated into community living.
      The stigma of mental illness has been broadly documented since the early 1950s. For years, mental hospital patients have been regarded with more distaste and less sympathy than virtually any other disabled group in our society. Studies on public attitudes toward the mentally ill at that time unambiguously established that mental patients were negatively viewed by the general public.
      Studies conducted since 1960, however, have shown mixed results. Some results have shown slightly more understanding. The results of the more negative studies, however, suggest that persons with mental illnesses are still heavily stigmatized, that educational programs have only minimally affected public knowledge, and that when people encounter any form of mental illness, they respond with fear, dislike, and aversion. This stigmatization extends even to family members of persons with serious mental illness and has resulted in significant discrimination in the health care coverage of psychiatric disorders.
      The stigma of mental illness has affected policy decisions in our own state. Funds for the public mental health system are regularly raided to provide everything from public employee pay raises to paved roads to dollars for a variety of pet projects across the state. The sad message for North Carolina consumers, family members, and advocates is that funding for mental health needs is not as important or as worthy as other issues.
      Many people in positions of influence, as well as some in the mass media, have realized that North Carolina is at a crossroads with its mental health system. We now have a window of opportunity to make real change. Policymakers and others can break the bonds of stigma.
     The symbol of the Mental Health Association is a bell. This bell was cast from the actual shackles that were once used in mental institutions on persons with mental illnesses. This bell rings out a hope for a victory over mental illness, the elimination of the stigma that surrounds it, and victory for mental health in our communities, our state, and our country. Hope is real; treatment works; now is the time for victory.