Mental Health, Occupational Therapy, Social Justice Commentary

Start with Stigma: talking about mental health

Talking about mental health and illness is starting to be a thing in Malaysia, people are becoming better informed and our government is also actively talking about the matter. I *was* of the opinion that the more we talk about these topics the closer we would be to developing some solutions.

I was wrong.

Recently a friend of mine starting making it her mission to educate people about mental illness. Specifically, educating people to be cautious of people who have personality disorders ( specifically narcissistic, psychopathic, and sociopathic PDs). She keeps touting a website written by someone who claims to have these diagnoses (and who is making money from providing consultation for people whose lives are touched by people with these diagnoses), and while she knows full well that I do not approve of armchair psychiatry – I have even sent her links of why armchair psychiatry is unethical and does more harm than good – she will still persist in “educating” the general public about these diagnoses in very stigmatising ways.

I get that she has had a scare of some sort with someone who allegedly has this diagnosis, and her wanting to warn other people is perfectly understandable. I acknowledge that it’s an important topic to her and I can’t stop her from talking if she insists on it, so my suggestion to her was that perhaps she ought to read about how to talk about these mental illnesses in a less stigmatising way. But no, whatever I say falls on deaf ears. She is “protecting people from harm” and I am just a spoilsport obstructing her good work, I should “agree to disagree”. I thought she would eventually get tired of the topic and stop talking about it, but she seems to be getting worse and selectively educating herself about the worst aspects of PDs.

So no, it’s not talking about mental illness which is important. It’s more important *how* we talk about them. Sometimes when we say people should learn more about mental health, perhaps we forget that most people don’t really know where to start. And I notice many people tend to start with the symptoms and stop there. This can actually reinforce stigma.

In the occupational therapy programme I taught, stigma is the first thing which students learn – before they learn of any other conditions. They learn about it in their History of Occupational Therapy classes, because that was how the profession started in Malaysia – working with stigmatized people who were isolated from others and till today, may continue to remain isolated from others (under these particular circumstances it was due to leprosy, I believe some of these early clients may still be around, although very old).

Understanding stigma is more important than understanding diagnoses. Stigma is what obstructs people from seeking and getting help and support for their diagnoses. If you care about championing mental health, educate yourself about stigma first and foremost and do your absolute best NOT to perpetuate it under any circumstances (especially when you’re making a deliberate effort to talk about mental illness). Perpetuating stigma only does more harm than good.

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