The Merriam-Webster dictionary has three definitions for stigma: 1) “a mark of shame or discredit,” 2) “an identifying mark or characteristic,” and, archaically, 3) “a scar left by a hot iron.” Those who have suffered from discrimination of any kind should be able to easily identify with the third description. In this analogy, the hot iron may be clinical depression, bipolar disorder, schizophrenia, substance abuse disorder, or any other kind of mental illness; the scar is the identity by which the world sees the person affected—and even how they see themselves. Public stigma affects persons with mental illnesses in their daily lives in many ways, such as making it more difficult to obtain health insurance, regardless of certain legislation changes; increasing discrimination in school and the workplace; and maintaining an inaccurate and harmful link between mental illness and gun violence. These problems can begin to be resolved by educating the public about mental illness to remove the stereotypes and stigmas. 

In the article “The Long and Winding Road of Mental Illness Stigma,” author Jonathan Cohn reviews a brief history of the stigma surrounding mental illness and its effect on healthcare. Cohn cites a 2015 report issued by the CDC which found that “serious psychological distress” is found more than seven times higher in households that are below the poverty line than households that are at least four times above the poverty line. It was also reported that “people with serious distress were less likely to have health insurance than those without serious distress” (Cohn 480). These two points begin to show that persons with mental illnesses are without means to seek or receive professional help. While it is true that this report does not account for results from the Affordable Care Act, there still exists barriers to mental health care. For example, those with insurance still have trouble in “[finding] professionals who will take their insurance” and “[covering] the copayments and deductibles they owe every time they fill a prescription, see a therapist, or get in-patient treatment” (Cohn 481). 

Furthermore, a recent (2015) study by the National Alliance on Mental Illness found that it was three times more likely to have difficulty finding psychiatrists, therapists, and substance counselors than finding physical health specialists. So, if a person suffering from mental illness is lucky enough to have insurance or be reasonably affluent, they will still invariably have trouble receiving professional help. Cohn continues to explain that, although society has made a bit of progress in the direction of parity between mental and physical health, there is still much more work to be done. For example, in the beginning, mental health was not covered at all by insurance because of its susceptibility to abuse. However, employers began to realize that better mental health equates to higher workplace productivity. This revelation did not mean all obstructions to treatment were gone, though: “Insurers were still wary … and they typically put limits on what they would spend, even though they had no similar limits for the treatment of other kinds of illnesses” (Cohn 482). Also, while some seemingly helpful parity bills became laws in the 1990s and 2000s, many of them had loopholes that limited the amount of care a mental health patient could receive (loopholes which could not exist for other conditions).

Continuing the line of thought regarding the effectiveness of bills, laws, and legislation on public stigma, many pieces of information can be drawn from the article “Addressing Public Stigma and Disparities Among Persons with Mental Illness: The Role of Federal Policy” written by Janet R. Cummings, Stephen M. Lucas, and Benjamin G. Druss. For example, to begin the discussion, Cummings et al. says, “Beyond its symbolic value, federal law can only directly address one component of stigma: discrimination” (e1). The article in whole reviews antidiscrimination legislation that has improved the situation of persons with mental illnesses, explains why these laws are still insufficient, and provides examples of how legislation itself is insufficient for change. Tremendously helpful to the argument for destigmatizing mental illness, the article cites Corrigan in explaining the four social-cognitive processes of stigma: cues, stereotypes, prejudice, and discrimination. As previously stated, legislation can only make an impact on discrimination; that is, “the behavioral manifestation of prejudice that occurs when those with or those believed to have mental illness are differentially treated” (Cummings et al. e1). It is also important to note that this discrimination can originate externally as well as internally. Common examples of discrimination include potential employers rejecting the application of a person with mental illness because of their disability (external discrimination), or a person with mental illness not applying for a job because they believe they are incompetent (internal- or self-discrimination). Attitudes obviously cannot be changed via laws; however, actions—discriminatory behaviors—can be.

The first “landmark legislation for mental illness discrimination” described in the article is the Mental Health Parity and Addiction Equity Act of 2008. It should be well-known that there have historically been major differences between insurance for medical care versus mental health treatment; in 1996, the Mental Health Parity Act tried to address this inequality, but it was “extremely limited in the protections it offered” (Cummings et al. e2). This was improved upon in 2008 with the MHPAEA, although it still is obviously not entirely sufficient. The second legislation was the Education for All Handicapped Children Act of 1975, which addressed discrimination against those with mental illnesses in school. This law basically moved toward the direction of allowing kids with disabilities to have academic accommodations and be treated as normal kids. It, too, has been renamed and expanded over time: for example, it also began to include social work services and rehabilitative counseling to students as accommodations or “related services.” The third legislation that article addresses is the Americans With Disabilities Act of 1990, which addresses “workplace discrimination against those with disabilities [and] also provides protection for those with psychiatric disabilities” (Cummings et al. e3). It was expanded upon in the following ways: in 1997, it was clarified how the ADA applies to psychiatric disabilities; in 2008, it was clarified further by including an even longer list of “major life activities” that disabilities could affect in a person. 

However, Cummings et al. claim that these legislations and their improved forms are still insufficient because protection is “not uniform for all subgroups” (e3). Three causes of this non-uniformity listed are: “(1) explicit language about inclusion and exclusion criteria in the statute or implementation rules, (2) vague statutory language that yields variation in the interpretation about which groups qualify for protection, and (3) incentives created by the legislation that affect specific groups differently” (Cummings et al. e3). To briefly give one example before moving on: regarding the first reason, any individual with a diagnosis recognized by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition can find protection under the ADA, but its explicit language prevents protection for those who abuse or are dependent on illicit drugs.

In the article “The Shame Game: Dispelling stigma allows young people to get the mental health support they need,” author Marilyn Elias begins with an anecdote to describe the school experience of a typical teenager with mental illness. The first story is that of a teenager named Erin from Minneapolis who reportedly experienced hostility from peers regarding her recent hospitalization and apathy from teachers and staff when they noticed this hostility. Although the studies are not cited, Elias claims that studies show “nearly two-thirds of teens coping with mental illness reported stigma from their peers” and “just half of students said they’d be willing to sit next to a class-mate with mental illness” (Elias 35). Elias quotes director of the Virginia Adolescent Research Group Joseph Allen saying, “Normalizing challenges with mental health is key to reducing stigma among teens” (Elias 36). That is, teaching kids or teenagers that having depression, anxiety, and other forms of mental illness can result in less hostility and discrimination faced by those with mental illnesses. Elias states that a study conducted by the Adolescent Communication Institute at the Annenberg Public Policy Center supports this information. Dan Romer, head of the study, says, “You have to give kids facts that counter stereotypes, and then many are open to change” (Elias 36). The author continues by describing strategies and curriculum at different schools that incorporate mental health awareness to curb stereotypes. Furthermore, she shows how self-stigma can be just as detrimental to students as external stigma in that it can cause them to be too afraid or ashamed to reach out for help. 

Public stigma obviously does not only exist for students in school, however. Similarly, persons with mental illnesses can and frequently do experience discrimination in the workplace. Roni Jacobson debates the potential benefits and disadvantages (and dangers) to revealing one's mental illness to an employer in the article, "Should You Tell Your Boss about a Mental Illness?" Like Elias, Jacobson begins with an anecdote—in this case, of a veteran who suffers from post-traumatic stress disorder and whose condition is made worse by circumstances at his workplace. His dilemma is briefly described by saying, "He felt uncomfortable hiding his condition, but he struggled to decide whether to tell his employer about it” (Jacobson). To move on from anecdotal rhetoric, a 2011 survey by the Chartered Institute of Personnel and Development is reported in saying that “about a quarter [of more than 2,000 people surveyed] reported experiencing a mental health problem on the job,” and “in the U.S., depression alone causes employees to miss 200 million days of work every year, costing employers $31 billion in lost revenue” (Jacobson). Although it is such a common and widely experienced problem, many people tend to come up with false excuses for missing work or underperforming to mask the truth to avoid being discriminated against. This can be a logical line of reasoning because “other people may begin to perceive them differently, and the repercussions, such as being excluded socially or passed over for assignments, could damage their careers” (Jacobson). To provide more evidence, Jacobson cites another survey performed in 2010 wherein 40 percent of U.K. employers said, “they considered hiring someone with a mental illness to be a ‘significant risk’ to the company” and that “many employers believe that people with mental illnesses are difficult to get along with and unreliable.” 

However, admitting to one’s disability or mental illness can entitle one to certain accommodations. As stated previously in this paper, the ADA entitles those with mental illnesses to “reasonable accommodations” in the workplace, which could include “flexible working hours, access to a quiet area and additional feedback from supervisors” (Jacobson). People who suffer from mental illnesses constantly find themselves having to juggle this dilemma between suffering discrimination and potentially facing benefits and tolerance. Furthermore, Jacobson explains that the ADA protections are not always enough: “many managers are not familiar with the details of the law, and people who experience discrimination often lack the resources to bring their case to court.” It is reported that ninety percent of ADA cases are lost. Therefore, Jacobson claims that one should not risk the consequences of disclosing a mental illness to an employer unless one’s work has begun to suffer, and that it is critical to consider the “workplace climate.”

Another aspect to mental illness stigma that is not always considered is the stigmatized link between mental illness and gun violence. In John Oliver’s segment “Last Week Tonight” published in October of 2015, one of the main points he brings up about the stigmatization of mental illness is how quickly politicians are to blame mental illness after a mass shooting. At the time of the video three presidential candidates for the recent election were shown attributing recent cases of gun violence to mental illness. This is an offensive and highly inaccurate leap to make. 

Oliver does not expressly cite all his sources, however, so more research was done by reading the article “Gun Violence, Stigma, and Mental Illness: Clinical Implications” by Dr. Jonathan M. Metzl. This article “critically addresses 4 central assumptions that underlie many US political and popular associations between gun violence and mental illness” (Metzl 1). These four assumptions are that (1) mental illness causes gun violence, (2) psychiatric diagnosis can predict gun crime, (3) US mass shootings teach us to fear mentally ill loners, and (4) because of the complex histories of mass shooters, gun control “won’t prevent” more mass shootings. According to the article, “fewer than 3% to 5% of American crimes involve people with mental illness, and the percentages of crimes that involve guns are lower than the national average for persons without a diagnosis of mental illness” (Metzl 2). Furthermore, “basing gun-crime prevention efforts on the mental health histories of mass shooters risks building ‘common evidence’ from ‘uncommon things’” (Metzl 3). That is, it is more dangerous to be quick to associate gun violence with mental illness because the underlying problem is not being addressed. 

There are few people who would expressly state (in public, at least) that the stigmatization of mental illness is a problem. However, there are numerous examples of evidence that promote that the public believes the opposite. Firstly, mental illness stigmatization prevents those with mental illnesses from readily obtaining health insurance. Secondly, increasing discrimination in school and the workplace is evidence that less people think of it is a problem. Thirdly, stigmatization perpetuates an inaccurate link between gun violence and mental illness, and it is frequently used to promote gun control debate—not actually do anything about those who suffer from disabilities. One of the most effective ways of destigmatizing mental illness is to educate the public—especially kids in school—that mental illness is common and not something to be afraid of or make fun of. 
