One of the objectives of Beautiful Distress is to fight stigma. Therefore, from now on, we will publish a regular column about stigma on our site. Read the first contribution by Wilco Tuinebreijer, first medical director GGD Amsterdam and Chairman of Beautiful Distress.
COLUMN No.1. - BRANDING
Stigmatization originates from the historical concept of “branding”. In the context of contemporary stigmatization of psychiatric patients I would like to add two concepts: stereotyping and marginalization.
People with psychiatric disorders are often depicted in a stereotypical way.
For example, it is generally assumed that people with a mental illness are dangerous or that they can not work. In this way patients are excluded from normal activities deemed valuable to our society. For people with psychiatric problems, it is hard and not at all self evident that they will be able to get a job, maintain normal relationships or even to have a place to call home.
These three things typically contribute to a positive self-image, or a positive identity, which in turn empowers people to participate in society.
Psychiatric patients are excluded and marginalized and have fewer opportunities to participate. Many studies show this.
Is it justified? It will not surprise you that I think not.
First, the chances that you or I will go through a psychiatric episode at some point during our lives are more than 25 percent. Moreover, the dividing line between normal and not normal is very thin and dependent on the zeitgeist.
Stereotyping also leads to flat imaging of a group which, in case of psychiatric patients especially, can easily be misused. For example, in the past, Jews were stereotyped and as a group blamed and used a a scapegoat by those in power in Nazi Germany for all kinds of problems that were historically and socially different and much more complicated. We all know what then happened in the Second World War. In a similar way people with a mental illness were stigmatized and murdered on a large scale during this same period.
Now, in 2017, we see the same mechanisms still in operation: psychiatric patients are still stigmatized, along with currently refugees, Muslims.
In public discussions people with mental problems are generalized and depicted as unpredictable and dangerous. This even leads to new legislation that is currently being prepared in the Netherlands that will make it easier to impose restraints on so called “confused people”.
At the same time there seems to be a growing awareness that stigmatization damages people and deprives them of their chances to participate fully. In mental health care and in politics the word destigmatisation is high on the agenda and there are many programs that focus on de-stigmatization. Few of them have been proven effective, although I think that this will change soon.
One thing does emerge from research. De-stigmatization starts small, with patients and their families, and also in the community, by developing joint activities. That is why the development of projects by Beautiful Distress which involve collaboration between artists and patients, staff, family or the neighborhood - as in the Artist-in-residency program – are a step in the right direction. Art is relatively free of value judgments and political ambitions and can also, for that reason, contribute to de-stigmatization.
The next contribution to this column will be by Vos Beerthuis, psychiatrist in Amsterdam.