Stigma

Statements issued from the White House are like severe weather advisories. If you live directly in the path of an oncoming storm, you will listen intently to every word; the farther away you live, the less impact it will have.

Such may be the reaction to President Obama’s declaration this week to end stigma associated with mental illness.

If you suffer from a mental illness, have a family member, close friend or colleague with mental illness, or are a mental health professional, President Obama’s speech caught your attention. If not, you likely moved on to another news item.

To paraphrase a common refrain: He was preaching to the already converted.

President Obama declared, “The brain is a body part, too; we just know less about it. And there should be no shame in discussing or seeking help for treatable illnesses that affect too many people that we love. We’ve got to get rid of that embarrassment. We’ve got to get rid of that stigma.”

What will be the cumulative effect of his speech in our community? Will it reverberate, shock our senses into a new attitude toward people with disabilities? After all, there but for the grace of the Ribbono shel Olam go I.

Attitudes are hard to change. Although it may not be an aveirah to harbor thoughts that perpetuate stigma, it is an important attribute to change, one that requires self-discipline and is necessary for kvod ha’adam. If the negative perception associated with people with disabilities constituted a sin, for which one had to atone with coins in a pushke, then the stigma pushkes would be overflowing every day.

There have been significant positive strides in lessening stigma in the last 20 years. It has reshaped our views towards cancer, Down syndrome and autism.

In one generation, we transformed the ubiquitous “yene machlah” to an open dialogue on cancer. Whereas once, children with Down syndrome and autism were placed in secluded programs, today, these children have specialized educational and social programs that transcend inclusion.

Over the last decade, we have broken down (some) barriers with a more open dialogue on child abuse, eating disorders, drug and alcohol addiction. This has resulted in many more families seeking and receiving desperately needed professional help.

Anxiety disorder, obsessive compulsive disorder and post-partum depression are more socially accepted within our midst in mild forms. Let’s call these stigma with a small s.

What is Stigma with a capital S?

How does it manifest itself?

This type of Stigma involves rationalized discrimination — in housing, employment and social isolation. It is a Bermuda Triangle of Stigma.

Men and women with severe depression, bi-polar disorder, schizophrenia, personality disorder, schizoaffective disorder are the individuals to whom President Obama was referring. A vast majority of these people can lead healthy lives with medication, talk therapy and strong family and communal support.

Too often, the public views these individuals through the myopic lens of sensationalized media — the mentally unstable gunman gone berserk who killed on a rampage, the homeless man who pushed a woman into the path of an oncoming train. Read on, and the report will often say, “He wasn’t compliant with his medication. He was a social isolate.” One horrific story is one too many, and we’ve had too many over the years.

Nevertheless, the overwhelming majority of people with mental illness are very stable. Liken it to remission in cancer.

These men and women starve for acceptance, relationships, to be a part of our community from the inside out, not from the outside looking in. At OHEL, we work with and treat hundreds of such individuals every day.

Rationalized Stigma is when we are asked for an opinion about a potential shidduch for a person with some ailment, and we respond with the deadly force of hurricane winds.

Stigma with a capital S is viewing those who seek mental health counseling as being sick or unstable, as if to say someone who never enters the door of a social worker or psychologist is therefore perfectly healthy and stable.

Discriminatory Stigma is inadequate insurance coverage for those with mental illness. (Do we really need health insurance companies to market policies for pets before providing parity for those with mental health issues?)

Each one of us works to improve ourselves, in our learning, our middos, our weight, our self-control in not texting while driving.

President Obama could very well have been speaking to the Jewish heartland, beseeching us to improve our attitude towards people with mental illness. These are the children of people we know, good people yearning to live as neighbors, as good Jews. Most important is not to cast our eyes upon them as “those people.”

Acknowledge to an elderly couple with a son or daughter with mental illness that we can’t begin to understand some of the difficult choices they faced in life. We can immeasurably help by renting an apartment or helping to find a shidduch for a man or woman with mental illness who hasn’t dated in 10 or 20 years.

Or perform an ultimate kindness by giving such a person a job. That is not only breaking down stigma, it is elevating the lives of people with mental illness.

David Mandel is Chief Executive Officer of OHEL Children’s Home and Family Services.