Discrimination Against the Mentally Ill Remains Strong
> 12/4/2007 11:51:21 AM

Beyond dealing with the effects of their conditions, patients with mental illness also suffer from considerable discrimination in the workplace and the larger community, and this bias shows no sign of receding even in the face of increasing awareness of and empathy for these individuals. In addition to this added societal barrier, patients with some form of mental illness are considerably more likely to become the victims of a long list of crimes, some of them relating directly to their mental health status. Need we even mention how these incidents only serve to compound the distress and paranoia experienced by so many of those patients?

A new report in the British psychiatric journal Mind lists the numbers: 73% of mental health patients interviewed reported some form of victimization in the two previous years, compared to 24.4% of the general population. And the staggering disparity continues: 22% of affected patients had been physically assaulted, compared to 3.6% of the general public. More than 25% had been sexually harassed and 10% sexually assaulted; comparable numbers among the overall citizenry are far lower. Individuals in public housing fared worst, with more than 9 in 10 reporting some form of harassment, bullying or victimization. Behaviors committed by the perpetrators included name calling, stalking, issuing verbal threats and physically taunting victims; 41% of respondents reported being the victims of ongoing bullying, and 1 in 4 had their homes targeted for robbery or related crimes. Less than 1 in 5 stated that they felt safe at all times in their own homes. Why do these patients report such unbelievably high rates of crime? News of one's mental health problems apparently travels very quickly through communities, and those affected may behave in unusual ways that betray their status to casual observers. The criminal class sees these individuals as easy prey even when unaware of their official status, and our legal system must adopt standards designed to protect them just as we do for those with physical disabilities. Many of these offenses should be characterized as "hate crimes" and prosecuted accordingly.

Perhaps most unfortunately, the concerns of these patients are very often dismissed by authorities and even peers as further evidence of their instability, when the truth is far more sinister. 64% of respondents described themselves as dissatisfied with the law enforcement response to their crime reports. And mental health histories still serve as effective methods of discrediting witnesses in court even when pre-existing conditions do not in any way relate to the case at hand. Even treatment for minor depression may also render one ineligible to serve on a jury - in the United Kingdom, such appointments are illegal. While somewhat understandable as an extreme "take all precautions" measure, this policy only contributes to the marginalization of a significant portion of the public. The victims of various crimes may find their credibility undermined and their character assaulted through no action of their own, and that very likely outcome often discourages them from reporting these crimes: more than 1/3 of the study's respondents who did not report crimes committed against them refrained from doing so because they felt certain that law enforcement would not believe them.

The law enforcement community clearly needs to track the number and nature of crimes committed against citizens with mental health issues and prosecute accordingly. Just as one's race or gender should not encourage victimization, mental illness cannot be another excuse for harassment or discrimination, and those who use it in this way should receive additional sentencing. Reasonable guidelines should also be applied to regulate the use of mental health histories in court. They are undoubtedly essential in some cases, but the rampant overuse of such information as a tactic for personal smears and obfuscation must stop.

While the world of criminal justice seemingly has a ways to travel, recent developments in pop culture imply that individuals who face mental disorders may be achieving greater levels of understanding. One perhaps unlikely example is the fact that Heather Kuzmich, a contestant on the most recent season of the popular reality show "America's Next Top Model," has built a modeling career despite beingaffected by Asperger's Syndrome. The frequent ridicule she experienced at the hands of her fellow contestants may not be completely attributed to her condition, but she clearly faces an uphill climb for one seemingly ill-suited to the neurotic, cut-throat nature of the fashion industry. The difficulties presented by Asperger's (social awkwardness and difficulty in communicating with and reading the intentions of others) do not leave one predisposed to succeed in such a ruthless marketplace, but Kuzmich seems to have thrived on that pressure despite falling short of the prize. She claims that her Asperger's led to far fewer problems than she expected, but incidents of disrespectful and mocking behavior perpetrated by other contestants were clear to viewers.

Kuzmich plans to become a public spokesperson for Asperger's, and any attention she could direct toward the cause is welcome. Unfortunately, most patients suffering through mental illness cannot draw sympathy from millions of television viewers every week, and individuals like Kuzmich remain curious novelties to many. Still, the general response to her appearance on the show proves encouraging: she was repeatedly selected by viewers as the show's most popular contestant, indicating that they did not see her as a mental or emotional invalid. Incidents like this one help the public moderate their opinions on mental illness, but structural changes in our society must reflect that reasoned position, and updating our legal and law enforcement systems to reflect the particular needs of patients with mental health conditions will be an absolutely crucial step in the right direction.

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