The Mark of Shame: Stigma of Mental Illness and an Agenda for Change

by Stephen P. Hinshaw

Millions of people and their families are affected by mental illness; it causes untold pain and severely impairs their ability to function in the world. In recent years, we have begun to understand and develop a range of effective treatments for mental illness. Even with this shift from moralistic views to those emphasizing the biological and genetic origins of mental illness, punitive treatment and outright rejection remain strong. Public attitudes toward mental illness are still more negative than they were half a century ago, and the majority of those afflicted either do not receive or cannot afford adequate care. As a result of all of these troubling facts, applying the term "stigma" to mental illness is particularly appropriate because stigma conveys the mark of shame borne by those in any highly devalued group.

Mental illness tops the list of stigmatized conditions in current society, generating the kinds of stereotypes, fear, and rejection that are reminiscent of longstanding attitudes toward leprosy. Mental disorders threaten stability and order, and media coverage exacerbates this situation by equating mental illness with violence. As a result, stigma is rampant, spurring family silence, discriminatory laws, and social isolation. The pain of mental illness is searing enough, but adding the layer of stigma affects personal well being, economic productivity, and public health, fueling a vicious cycle of lowered expectations, deep shame, and hopelessness.

In this groundbreaking book, Stephen Hinshaw examines the longstanding tendency to stigmatize those with mental illness. He also provides practical strategies for overcoming this serious problem, including enlightened social policies that encourage, rather than discourage, contact with those afflicted, media coverage emphasizing their underlying humanity, family education, and responsive treatment.

The Mark of Shame is a deeply inspiring and passionate work that is realistic and filled with hope. It combines personal accounts with information from social and evolutionary psychology, sociology, and public policy to provide messages that are essential for anyone afflicted or familiar with mental illness.

Genres: Nonfiction

352 pages, Hardcover

First published December 4, 2006

About the author

Stephen Hinshaw grew up in Columbus, Ohio and attended Harvard and UCLA. A professor of psychology (UC Berkeley) and Psychiatry (UC San Francisco), he is an international presence in clinical psychology/mental health, with over 320 articles/chapters and 12 books. He received a Distinguished Teaching Award in 2001; his Teaching Company (‘Great Lecture’) series, “Origins of the Human Mind,” appeared in 2010. He has been recognized by the Distinguished Scientist Award from the Society for a Science of Clinical Psychology (2015), the James McKeen Cattell Award from the Association for Psychological Science (2016) for a lifetime of outstanding contributions to applied psychological research, and the Distinguished Scientific Contributions to Child Development Award (2017) from the Society for Research in Child Development. He lives in Berkeley, California, with his wife, Kelly Campbell; they have three sons. His newest book, "Another Kind of Madness," chronicles his father's recurring mental illness and the doctor-enforced silence surrounding it, plus the huge need to combat stigma.

https://en.m.wikipedia.org/wiki/Steph...
www.stephenhinshawauthor.com

Reviews

[Ryan · Rating 5 out of 5]

Necessary read for all working within the field of Mental Illness

[Dan · Rating 5 out of 5]

This was a fascinating look into the history of mental illness and stigma. It's sad that much of what this book covers is still an ongoing problem.

[Kyren · Rating 4 out of 5]

I think this book presents some very important information regarding the notion of shame or stigma associated with mental illness. Whether you work in the profession, or have a friend or family member diagnosed with a mental illness or are yourself diagnosed, I think this is a must-read.

It first talks about what it is about mental illness that makes it a stigma. Why for instance are people likely to feel less compassion for someone with bipolar disorder than for someone with diabetes despite them both being biological in origin? It also looks into the nature versus nurture debate, diving into why it is clinically proven that that people have more sympathy for someone who has anxiety or depression or OCD because of a childhood trauma than they do someone whose identical illness is more biological or genetic in origin. The book also talks about the rise in stigmatization over the past few years.

Later chapters cover the history of perception of mental illness both from both from biological and sociological perspectives. One of the things I found most interesting about the book was learning how biological attributions for the cause of mental illness does not reduce stigma. Unlike diabetes or heart disease, which have virtually no stigma, when mental illness is considered to be biologically cause, people still evoke less sympathy and tend to instead interpret the person as resulting from inferior or faulty genes! (an argument people do not similarly apply to those with other genetic diseases). Unfortunately it seems this tends to spark a rise in eugenics-based views of mental illness and more antagonism. The problem of course with purely sociological explanations is that in the absense of biological cause (or if there is believed to be no biological cause), then abnormal behavior is construed as a moral and ethical problem and hence the person is faulted and stigmacized for not working hard enough or not having enough control of themselves--again the person is faulted and lack of empathy ensues.

It seems that the models of mental illness that tend to promote acceptance and decrease stigma are ones that de-emphasize the biological attributions and view the person as someone whose behavior, thoughts, etc. belong on a scale from 'normal' range to extreme and just happen to fall somewhere on that scale. Thw scale model tends to remind people that their own range of functioning can range and therefore the behaviors and thoughts of the mentally ill are understood as different in degree, but (with few exceptions) not different in kind. Rather than be defined as something 'other', someone who is mentally ill is defined as more like 'off-center' (my words, my paraphrase). Interestingly this approach also seems to be the most 'liberal' of approaches from the political perspective, in that it assumes empathy/sympathy is of primary importance and diminishes or eschews the view that the 'problem' is a moral or ethical flaw. Rather similar to the ways in which liberals are characterized as treating the poor, under-educated, minorities, etc as compared to political conservatives.

In any case, this book both disturbed me-- in so far as the current state of perspectives on mental illness were clarified for me in a disturbing way-- but also gave me some hope. Hope that while stigma certainly does exist for persons suffering from mental illness ranging from depression, anxiety, bipolar, OCD, schizophrenia, etc., that there are things that can be done to reduce stigma. And at least some people are working on it.

[Anna Miller · Rating 4 out of 5]

I thought this book was very factual and presented very useful information on the mental illness stigma. I appreciated that they looked at the stigma from a historical point of view and why/how it's become what it is today. I also thought the "agenda for change section" was very useful and had great tips on how to change the community to be anti-stigma. I also likes that it included personal stories and accounts.

[Joanna · Rating 4 out of 5]

I used this as research for a presentation I gave on mental illness. Specifically, I had to research stigma and mental illness and this book was great. I did not read the book in its entirety but I was able to find the information I needed within the chapters outlined for overcoming stigma.

[Whitney · Rating 4 out of 5]

essential

[Lydia]

Important

[Chrissie · Rating 4 out of 5]

Good book - I would have liked to see more about stigma and mental health professionals and/or mental health consumers. I wasn't as interested in American legislation