Recovery From Schizophrenia: Psychiatry And Political Economy

FIGHTING STIGMAAlthough the mentally ill have been in the community for half a century, we havescarcely begun to educate the public about the nature of major mental illness.Community mental health professionals in parts of Italy have taken this challengefar more seriously and have succeeded to a greater extent. Leading up to 1978,when Italy enacted its mental health reform law, daily newspaper articles, radiobroadcasts, television interviews, discussions and books involved the generalpublic, politicians and union officials in a debate that was genuinely theirs, notjust an issue for psychiatrists. 70 In Trieste, the emptying of the mental hospital inthe 1970s was celebrated with a city-wide parade and other festive occasions; theold mental hospital was thrown open to the public for film festivals, repertorytheater and art exhibitions; 71 businesses employing the mentally ill are veryprominent in the public eye, advertised by brilliantly designed brochures filledwith graphic art. These initiatives, writes sociologist Michael Donelly,mobilized a wide sympathy and interest among the people of Trieste, andprobably displaced at least some of the fears which the breaking down ofthe asylum walls would otherwise have occasioned. 72Can we be as effective as the Italian reformers in tackling stigma?TREATMENT 293Neighborhood campaignsSurveys of public attitudes reveal negative attitudes but also a reservoir ofgoodwill toward the mentally ill. When neighbors of a new group home for peoplewith mental illness in south London were surveyed, two-thirds expressed awillingness to help the new facility and showed interest in learning more aboutmental illness. 73 Organizers found that this goodwill could be mobilized by afocused education campaign that encouraged neighbors to initiate social contactwith mentally ill residents. 74 During the campaign, informational packets(videotapes and written materials) were distributed, and social events and informaldiscussion sessions were organized. The campaign decreased fearful and rejectingattitudes and increased contacts between group-home residents and their newneighbors. Thirteen per cent of the neighbors made friends with patients orinvited them into their homes, whereas no neighbors did so in an area that wasnot exposed to the educational program. 75 Campaigns that increase contact withpatients can be expected to improve attitudes, since personal knowledge ofsomeone with mental illness is associated with greater tolerance. 76Such projects suggest that neighborhood action campaigns are feasible andeffective. Can broader social campaigns achieve a similar impact? One approach isto tackle the mass media that shape the public perception of mental illness.