CLINICAL HANDBOOK OF SCHIZOPHRENIA

CHAPTER 51STIGMAPATRICK W. CORRIGANJONATHON E. LARSONMental illness presents a complex phenomenon that cuts into human lives like a doubleedgedsword. On the one hand, illness and medication side effects negatively impact emotions,cognitive abilities, memory, problem-solving skills, decision-making abilities, socialskills, communication skills, and other domains. On the other, stigma leads to discrimination,which removes people’s opportunities to reach and maintain life goals. Completeintervention requires addressing both problems. This chapter focuses on the latter: thestigma of mental illness. Several processes initiate the stigma of mental illness. We reviewthe impact of stigma by first discussing the mental illness label.PROCESSES AND STRUCTURES THAT LEAD TO STIGMAMental Illness LabelIndividuals labeled with mental illness often fall victim to the corresponding stigma.These labels arise through different mechanisms. Health care professionals label individualswith mental illness through diagnostic processes. Professionals intend to help ratherthan to harm people with mental illness; despite the intent, diagnoses produce labels thatorient the public to be prejudicial. Similarly, people may receive the label through association;for example, individuals observed leaving a support group held at a mental healthcenter might be labeled “mentally ill.” Labels lead to stigmatizing public reactions againstindividuals so labeled. The negative social reactions exacerbate the course of psychiatricdisorders. Individuals with mental illness may also label themselves and internalize the label,which can result in self-stigma.Common responses to the labels of mental illness include fear and disgust. People experiencingthese reactions tend to minimize contact and distance themselves socially fromindividuals with the label. Avoidance negatively impacts individuals with mental illness,because they lose opportunities to interact with people and to pursue life goals. Thesekinds of experiences facilitate the process of becoming a “mental patient” rather than becominga human being with hopes, dreams, and life goals. Labels produce stigmatizingreactions that cause harm in the lives of individuals experiencing mental illness.533