Running head: TERM PAPER 1

Term Paper
Michelle A Hill
Wayne State University
















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Definition of the Problem
Mental Illness has, from the beginning, suffered tremendous downfalls from our society.
There is a constant negative stigma associated with mental illness and those who are diagnosed
and seeking any form of healthcare for it. National Alliance for Mental Health reports that one
in five adults in the United States suffers from some form of a diagnosable mental disorder with
an additional thirty-five to forty percent of people going undiagnosed (2007). Ninety percent of
all suicide cases in the United States are directly linked to mental illness, most of which were not
receiving proper care or treatment (National Institute of Mental Illness, 2007). What is the reason
for such tragedy in our country? Why are so many people not able to seek proper treatment to
potentially save their lives or lead healthier, happier lives? The oppression and stigma that is
connected to mental illness has long been a familiar issue in our country. The first law for the
treatment of the mentally ill was passed in Massachusetts in 1676, ordering selectmen to provide
care and protect the community from them (Day, 2009, p. 180). In the 1700s, those suffering
mental illness were locked in almshouses and prisons where they were horribly treated, abused
and in many cases, ultimately murdered. Society didnt wish to support those suffering with
mental illness and they were looked at as being a burden and danger to family and the rest of the
town (Day, 2009). Although society has eased up on the treatment of people with mental
disabilities, the stigma and oppression has remained a norm throughout the years and throughout
the different policies and services that have been implemented by advocates who are trying to
find better opportunities and access to care for those suffering with any mental disorder. People
with mental illness continue to suffer discrimination, including a lack of viable opportunities for
housing and employment, as well as restrictions on the right to vote, obtain a drivers license, or
maintain child custody (Hinshaw, 2006, p. x). This stigma and the fact that it aids to preventing
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equality adds stress to those suffering from any form of diagnosable mental disorder and too
often prevents people from seeking help or treatment.
Policies and Services to Address the Problem
Dorothea Dix, who Secretary Harris says, was once told that the mentally ill dont need
heat because they dont have feelings, made it her lifelong mission to advocate for better living
conditions and treatment of people with retardation and other mental disabilities after visiting a
jail and seeing how horribly neglected they were and the awful conditions they were living in.
Over the years, she eventually persuaded the U.S. government to fund 32 state psychiatric
hospitals under the care of professionals (Unite for Site, 2012); this was the birth of institutions.
In 1946, President Truman passed the National Mental Health Act which established the
National Institute of Mental Illness whose current mission is to transform the understanding and
treatment of mental illness through basic and clinical research (National Institute of Mental
Illness, 2013). These newfound advocacy groups and Acts were the essential building block in
aiding for better treatment and understanding for mental health. It lead to continued growth, and
although healthier and more professional environments were being provided to those who needed
it, many ideologies remained stagnant in the community.
In the 1960s, President Kennedy worked diligently to federally fund and recognize the
issues within the mental health field with his personal connection in mind. President Kennedy
had a sister who suffered from mental illness and he had long seen the lack of care and funding
that was available to her (Day, 2009). He presented the first Presidential message to congress
that dealt with mental health issues in 1963 and ultimately passed the Mental Retardation
Facilities and Community Mental Health Centers Construction Act (National Institute of Mental
Health, 2011). This Act ushered for federal support in the services provided to mental health, in
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relation to the introduction of Medicaid and Medicare, and obligated them to observe the
programs within the CMHC programs. Around this same time, an extreme launch of scientific
research into different mental disorders was underway and the general public questioned the
spending of federal dollars on mental health when the economy was under competition from
recently rebuilt countries who suffered greatly after World War I (Thomas, 1998). Again, mental
health care and its positive direction was being negatively viewed by stigma and lack of
education from the general population.
In 1980, the Mental Health Systems Act was enacted under President Carter who also had
a caring heart for those with disabilities. He stated in his speech before signing the Act that,
throughout most of our history, the mentally ill have been bound up in dark suspicion, victims
of fear and ignorance, confined to institutions and trapped by popular stereotypes. The mentally
ill have been isolated, demeaned, ignored, and misunderstood (Peters & Woolley, 1980). These
words were, and still are, right on track. President Carters dream through the Mental Health
Systems Act was to change preconceived negative attitudes and beliefs about our neighbors in
the mental health community who he stated were, the most underserved group in the Nation, a
group that has not been served well even by those whove dedicated their lives to their care.
The Mental Health Systems Act of 1980 built off of President Kennedys Community
Mental Health Act and allowed for even better funding and less burden on individual states. It
also enacted better treatment and more person-centered ways to care. Since more funding was
allocated to the mental health field, the hopes of less stigma was highly hoped for by the Carter
Administration. However, as community-based centers continued to boom and
deinstitutionalization was fully underway, it became detrimental in many cases.
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With the movement of closing psychiatric hospitals and opening community centers, a
glitch was created and the system began to move backwards. There were simply too many
individuals than these centers had room for. Many people who had mental illness were left
homeless, on the streets, in shelters, and in jails (Sheth, 2009). Violence rates increased from
patients who were no longer receiving medications and treatments and communities feared the
newly-released individuals and those who were in nearby community centers. This was a huge
contributing factor in peoples continued negative perceptions of those with mental illness.
Since this time, community centers have been able to rise. People who suffer from mental
illness now have access to much more within the community and are able to center their goals
and treatments around themselves as individuals. Community centers and group homes are
everywhere with mandatory trainings for staff and continued observations by licensing
organizations. Although our Nation has come a long way in the treatment of the mentally
impaired, barriers within the community and peoples attitudes remain indefinitely and often lead
to limited funding and less than positive participation from society. This becomes a vicious cycle
as too many people are not seeking help, and in few horrific cases, are broadcasted for serious
crimes which again curb the publics view.
The Social Problem in a Global Perspective
As we know, mental illness does not discriminate. It exists in all races, genders,
communities and countries. Outside of the United States, many countries have focused on
different policies and ways to fund better care, but the horrendous views and stigma attached to
mental illness seems to linger everywhere.
In 2007, England enacted a new Mental Health Act. The vision for this revision was to
detain people in order to protect them or other people form harm and the need to respect
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peoples human rights and autonomy (Hall, 2009). England, who still utilizes hospitalization
treatment for the mentally disabled, sought to ensure better treatment to clients through age-
appropriate services, specialized healthcare professionals, and trained best interest assessors.
Unfortunately, there is still a major flaw in their system which is blatantly similar to the United
States: stigma. It is clearly written that this act is to detain and protect other people. With a
provision in an Act that is aimed to better the lives of the mentally ill, it is completely vulgar for
a direct negative stereotype to be attached to it. However, we cant forget that the thoughts and
horribly assumed assumptions about those with mental illness were undeniably carried over to
the United States from England. With the thoughts presented in England, it would be in bad taste
to say that they are more advanced in their fight to understand and bring equality to the mental
health population. The stigma that affects mental illness is deeply rooted and experienced around
the world.
In a recent survey and study conducted in Canada, the horrific statistics were extremely
similar to those in the United States. Canada also has a Community Mental Health system that is
comparable to the United States CMH system. Access to care and funding for treatment isnt as
much of a barrier to care because of their universal healthcare, but unfortunate views that are
shockingly parallel to studies conducted to the United States are. It was found by the Canada
Medical Association that forty-six percent of those asked believe that mental illness is an
excuse for poor behavior and personal failings, forty-two percent would no longer socialize
with a friend diagnosed with mental illness, fifty percent would not tell friends or coworkers that
a family member was suffering from mental illness, and fifty percent believe that depression is
not a serious condition (Nichols, 2008). These numbers, which coincide with statistics in the
United States, clearly depict the poor views placed on mental illness by the public. However, an
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estimated twenty percent of Canadians go undiagnosed compared to the United States alarming
sixty-six percent. While access to healthcare is sure to be a factor in the difference of
undiagnosed cases, the awful stereotype association is still undeniable.
While countries such as the US, England and Canada are still working towards the
alleviation of negative views, other less fortunate countries still have a much farther road to
travel. Kenya does recognize mental health programs that focus on community care, but a mere
0.01 percent of their health budget is spent on mental health care. This outrageously small
number leads to misfortune of an average of one psychiatrist for every half a million people with
only one third of these psychiatrists working within the public sector. Although a general health
insurance is provided to Kenyan citizens, it only covers hospital bed charges and is only granted
to those who are employed (Kingori, 2012). This leads to an overwhelming amount of people
who suffer from mental illness being inadequately cared for and in majority of cases, especially
within the poor community, completely untreated.
The lacking treatment and awareness of mental health greatly saddened Kenyas leading
psychiatrist, Frank Njenga, who interviewed with CNNs Leposo Lillian in 2012. Njenga spoke
of the desperate need to fund mental health care and his three-decade mission to advocate for
policy and the negative stigma associated with mental health. During his interview he stated that,
Today the discussion of mental health issues on this continent is focused and is positive.
Njenga has been able to provide awareness and help positively influence peoples views on
mental illness. This effect, will hopefully place a greater one on mental health care and policy
within the country.
Through different policies and barriers to care, stigma has remained immobile throughout
the world. Between the differences in the numbers of those seeking treatment in Canada
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compared to the US because of universal healthcare, and the gradual shift of views in Kenya that
will hopefully lead to better access to care, its hard to say what the best route is in order to fully
alleviate the burden of the intense stigma focused on mental health. Is it possible to curb nations
outlooks? Can the larger amount of people become educated and aware of the actual facts
associated with mental illness? The media certainly isnt taking any steps to help acknowledge or
help this social issue.
The Impact of Social Perceptions
Since I can remember, there has been an awful view placed on people who have mental
illness by the media. Media stereotypes emphasize the high rates of violence among those with
mental illness and treat the entire topic with misinformation and even ridicule (Hinshaw, 2006,
p. x). Each horrible crime and murder case seems to be highlighted with the assumption that the
culprit of the crimes suffers from some form of mental illness. Its no secret that the media can
sway the opinions of viewers, so with the awful insights that they are feeding to the public, its
not shocking that negative stigmas and stereotypes continue to run rampant. The media leaves
people concluding that the majority of crime-inflicting individuals have a mental disorder and
that the bulk of those with a mental illness are violent and dangerous.
During the recent Batman theatre shooting and Sandy Hook Elementary massacre,
implications of mental illness were made before identities of the culprits were even revealed. Is it
because only a crazy person commit such a crime? Is it because normal people would never
be able to do such a thing? It seems like it is an easily attainable assumption, but its extremely
unfair and belittling. Each discussion on the media outlets described in awful detail only the
severe, uncommon qualities of someone suffering from a given mental illness. The illness was
made out to be a through-the-board indication that everyone diagnosed with it, suffered from the
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same thoughts, ideas and personality. People who had the same, or similar, mental illnesses were
given shame because of the extreme minority that committed a tragic crime.
Who would choose to be associated with such an impairing notion? The undesirable and
ignorant link that media outlets connect to mental health undoubtedly play a role in the ample
amounts of people who delay seeking help or use concealment as a coping mechanism. With so
many cases of mental illness going undiagnosed, the statistics for reported suicides are alarming.
Ninety percent of all suicide cases are associated with mental disorder and in America, suicide
claims more deaths than cancer and homicide (Clubhouse International, 2013). These numbers
are greatly influenced by lack of actual information, education and awareness by the general
public which then leads to unrecognized and untreated cases of mental illness across the nation.
My Beliefs
My personal belief about the cause of this social issue is stemming, with ancient attitudes
being the leading contributor. Just as many other values, norms and beliefs are instilled in us as
children that are derived from our family history, so is mental illness. Since the beginning of
time, there has been inhumane and despicable thoughts and treatments bestowed upon those
suffering with mental illness. Once any habit is formed, it is always hard to break. Especially
when it lingers throughout the entire world.
Although many developments and policies have sought to ease the terrible thoughts
related to mental illness, it is far less than the transformation that is needed. I truly believe that
the adverse stigmas that are related to mental health play a huge role on the delay of proper
funding and education in the field of mental health care. One, or even a few, policymakers may
not discriminate, but he or she is not able to implement anything without combined support from
other government officials and the public.
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With access to care being extremely too lax and too much of a burden for many to seek
treatment, it does sometimes occur when mental illness is linked to a tragedy. These examples
aid continued stereotypes and continued barriers to care. Its an extremely hard and frustrating
war to be against. If more care and treatment was available with less of an associated stigma, I
think that many of the unfortunate tragedies we are aware of would be dismantled. However,
when the media goes haywire with breaking stories about how mental illness negatively affects
communities, it adds to peoples already damaging perspectives and the circle of barriers and
stigma continues.
At this point, I think that advocacy and education is essential in helping this social
problem. With growing support and understanding, upsetting statistics may be able to be
decreased. Healthcare and treatment may be sought more easily and government officials would
be more willing to address major flaws in the mental healthcare system.
Vales and Ethics
The social topic of stigma associated with mental illness is directly relatable and relevant
to many of the National Social Worker Associations Code of Ethics. Service, social justice,
dignity and worth, importance of human relationships and integrity are key values and ethics that
can aid to the best possible treatment of this issue.
Service should be granted to everyone who is in need, without financial incentive being
expected. As a social worker, its important to recognize social matters and to address them from
the upmost ethical standpoint possible; regardless of payment.
Social Justice is extremely proportional to this issue, too, because it involves a social
workers responsibility of pursuing social change or oppressed individuals and groups.
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Information, services and resources are all associated with the value of social justice and are all
needed in order to positively influence this matter.
Another value that can relate to the subject is dignity and worth of the person. The
ethical principle of this outlines that social workers are to treat every person with respect and
care while also being mindful of any diversity or differences. People who have mental illness
should still be shown the same amount of respect as any other individual that one may come in
contact with. Its crucial to understand their differences and promote and enhance their lives and
needs of people who are in need of services.
The importance of human relationships is also huge in this matter. Many people have
negative views which then poorly influence the human relationships they have with people who
have a mental illness. Its important, as a social worker, to be aware of how important
relationships are and to promote healthy and positive relationships that can help change and
promote someone.
Lastly is integrity. In any case, it is important for a social worker to behave in a
trustworthy and continually aware manner. Ethical principles and values should always be kept
in mind when working with any individual or group. Without integrity, its impossible to truly
assist someone who is in need.
Concluding Thoughts
Negative stigmas and stereotypes have long affected the mental health field. From the
beginning of recorded cases, mental illness has been viewed in numerous damaging lights and
has had dreadful impacts on many who need care. Without stigma association and with a better
educated public, access and stereotypes could diminish as barriers to care and could enhance and
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save ample amounts of lives. Prior treatment, inadequate funding influenced by those who dont
recognize the severe importance of mental health care, and continued deteriorating views of
mental illness are a huge social issue that must be addressed.
















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References
Ali, A. (2009). Changes to the mental health and mental capacity acts: Implications for patients
and professionals. The Psychiatrist, 33, 226-230. doi: 10.1192/pb.bp.108.023333
Clubhouse International. (2013). Key facts about mental illness. Retrieved from
http://www.iccd.org/keyfacts.html#young
Day, P. J. (2009). A new history of social welfare. Boston, MA: Pearson Education, Inc.
Frank, R. G., & Gilied, S. A. (2006). Better but not well: Mental health policy in the United
States since 1950. Baltimore, MD: The John Hopkins University Press.
Unite for Site. (2012). A brief history of mental illness and the U.S. mental health care system.
Retrieved from http://www.uniteforsight.org/mental-health/module2
Kingori, J. (2012). Kenya. Basics Needs Basic Rights. Retrieved from
http://www.basicneeds.org/kenya/index.asp
Kliff, S. (2012, December 17). Seven facts about Americas mental health care system. The
Washington Post. Retrieved from
http://www.washingtonpost.com/blogs/wonkblog/wp/2012/12/17/seven-facts-about-
americas-mental-health-care-system/
Leposo, L. (2012, January 31). Kenya doctor fights mental health stigma in traumatized
continent. CNN Health. Retrieved from http://www.cnn.com/2012/01/31/health/frank-
njenga-mental-health
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Nichols, M. (2008, August 17). Stigma of mental illness: Shocking survey from Canada. Anxiety,
Panic and Health. Retrieved from http://anxietypanichealth.com/2008/08/27/stigma-of-
mental-illness-shocking-survey-from-canada-us-likely-the-same/
Peters, G. & Woolley, J. T. (1980, October 17). Jimmy Carter: Mental health systems act
remarks on signing s. 1177 into law. The American Presidency Project. Retrieved from
http://www.presidency.ucsb.edu/ws/index.php?pid=45228
Sheth, H. (2009). Deinstitutionalization or disowning responsibility. International Journal of
Psychosocial Rehabilitation, 13(2), 11-20.
Thoman, A. (1998). Ronald Reagan and the commitment of the mentally ill: Capital, interest
groups, and the eclipse of social policy. Electronic Journal of Sociology, 3(4). Retrieved
from http://sociology.org/content/vol003.004/thomas_d.html
U.S. Department of Health and Human Services. (2011). National Institute of Mental Health.
Retrieved from http://www.nih.gov/about/almanac/organization/NIMH.htm