Pre-Departure Research Critique 1
In Mysore, I’m interested in exploring the effects of mental illness and how societal stigma impacts a
person’s ability to receive an education, employment, health care, etc. I also hope to explore stigma against family members of severe mentally ill patients and how it impacts them socially as well as psychologically.
According to Koschorke, Mirja, R. Padmavati, Shuba Kumar, Alex Cohen, et al. (2017), those living with
severe mental illness are more likely to live with their families and rely largely on them for economic support and daily care. Family members are usually the ones who make health care decision on behalf of those persons and it can be a huge burden for them. The stigma that is put on those who are mentally ill are usually also mirrored onto their caregivers.
Research on how stigma affects the mentally ill and their chances at employment and compensation
under the ADA in the United States is vast. One thing I’m interested in learning is if what we know on stigma can be used to help inform practices in India in regard to how to treat those with mental illness more fairly.
One thing that can be attributed to higher stigma towards mental illness is the lack of knowledge and
information available to those in the community. Anything new and different can be quite scary to people, one way to help people become more accepting of others is the opputunity to teach them how these struggles affect others and hopefully create more compassion towards them rather than disregarding them as inferior and unworthy of help.
Trani J-F, Bakhshi P, Kuhlberg J, et al. (2015) found that unemployment and lack of income are factors
that contribute to serious mental illness and can at times make a persons illness worse off. They also found that stigma towards the mentally ill, negatively impact poverty. The impact of poverty, along with lack of income, make it harder for individuals with mental illness to get better. One of the most negatively held views towards the mentally ill is that they are a danger and violent and cannot be in the work force. These types of opinions are some of the most detrimental, because it isolates those with mental illness, making it nearly impossible for them to show improvement and hold the capacity to function normally in society. For Indian men with schizophrenia, it was found that employment is an essential role and a condition that allows for a higher chance of rehabilitation and self confidence. Indian women with serious mental illness, are more likely to be abandoned by their husbands, and be seen as burden to the rest of their family. Their illness usually makes them incapable of fulfilling their social and familial roles, usually relying heavily on their caregivers for help.
In regards to research here in the US, I’ve done research in the past on the effects of stigma on the
mentally ill and how that affects their chances of employment and their protections under the Americans with Disabilities Act of 1990 (ADA). I wanted to add a bit of what I’ve researched in the past here, since much of it is closely tied to what I hope to explore further in India:
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Self-stigma refers to the subjective perception and awareness of negative stereotypes associated
with one's mental illness and can lead to negative beliefs that they themselves are “dangerous, incompetent, and irresponsible.” (Forgeard 2016). Mental illness stigma and discrimination can affect people’s lives in dramatic ways, it can make it difficult to find a job, a home, and insurance. Mental illness and the stigma that comes with it, can also alienate those from others, jeopardizing a person’s relationships with family, friends, and coworkers.
According to the National Alliance of Mental Illness, there is an 80% unemployment rate among
the mentally ill in the United States (NAMI.org). Discrimination plays a large role in how the mentally ill are perceived, “In a 2006 survey, 62% of Americans said they were unwilling to work with someone with schizophrenia.” (Szabo, 2017). Institutions may not take into account that some mental illness’ vary.
Unemployment can also create a negative effect on a person’s mental health. Sometimes a person’s
lack of employment can often make their symptoms of mental illness worse, which in turn makes it harder for those to keep a job long because they are so worried and stressed. Race, gender, class, and sexual orientation can also play a large role when applying for work in addition to their disability. Unfortunately, many disability rights laws fail to consider how these different identities overlap. Tending to separate disability civil rights and race civil rights, gender rights, etc. "both groups have historically been viewed as biologically inferior; blacks are seen as lazy and unintelligent, while the disabled are characterized as feeble, incapable, and are often objectified." (Nelson 1045) The concept of disability is just as problematic as issues brought up in other civil rights groups. "Disability has functioned historically as a justification for inequality not just for disabled people, but covertly for women and minority groups as well." (Nelson, 2006).
Women and minorities have higher rates of mental illness. In part by “Increased exposure to
racism, discrimination, violence and poverty” which can greatly affect their mental health and can lead to an increase in symptoms of mental illness (Nelson, 2006). However, it could be that there isn’t enough data on how mental illness affects men, and how many seek treatment, because of the stigma associated with men and fragility. The way society aims to define the boundaries of what is “normal”, whether through race, gender, sexual orientation, ethnicity and disability creates a divide between people. By “defining the outsider, we define the insider, the white, middle class, able-bodied, heterosexual man who is the norm.” This creates a group mentality, separating people by us and them, which can create a hostile environment for both the oppressors and oppressed. Where “we label their behavior as beyond the limits of normalcy. Insiders always have the privilege of labelling outsiders” (Nelson, 2006).
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I’d like to meet with people who suffer with mental illness and their families to better understand the
problem. Reading about it is one thing, actually speaking to someone who experiences it firsthand is different. I’d also want to speak to physicians and psychiatrists who treat others and how they feel the health system can be better improved to support those who are mentally ill and how the views of others and community stigma impacts the availability of treatment.
I hope to go to medical school and pursue a career in Psychiatry, one of the biggest reasons for this
interest is my own experiences with mental illness and first-hand experience with the health care/ hospital system. Mental illness is a struggle for people everywhere, but given this opportunity to learn about what factors impact a person’s ability to cope and function normally is something I can use to inform research in the future.
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References
Forgeard, Marie J.C., Pearl, Rebecca L., Cheung, Joey, Rifkin, Lara S., Beard, Courtney Björgvinsson,
Thröstur (2016), Positive beliefs about mental illness: Associations with sex, age, diagnosis, and clinical outcomes, Journal of Affective Disorders, Volume 204, 2016, doi: 10.1016/j.jad.2016.06.038.
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Koschorke, Mirja, R. Padmavati, Kumar, Shuba, Cohen, Alex, et al. (2017). Experiences of stigma and
discrimination faced by family caregivers of people with schizophrenia in India, Social Science & Medicine, Volume 178, 2017. doi: 10.1016/j.socscimed.2017.01.061.
Koschorke, Mirja, R. Padmavati, Kumar, Shuba, Cohen, Alex, et al. (2014). Experiences of stigma and
discrimination of people with schizophrenia in India, Social Science & Medicine,Volume 123, 2014. doi: 10.1016/j.socscimed.2014.10.035.
NAMI.org. Mental Illness: NAMI Report Deplores 80 Percent Unemployment Rate…, NAMI: National
Alliance on Mental Illness.
Nelson, C. A. (2006). Starting anew: The ada's disability with respect to episodic mental
illness. Mississippi Law Journal, 75(4), 1039-1062.
​Szabo, Liz. (2017) Bleak picture’ for mentally ill: 80% are jobless, USA Today
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Trani J-F, Bakhshi P, Kuhlberg J, et al. (2015). Mental illness, poverty and stigma in India: a case–control
study. BMJ Open 2015;5: e006355. doi:10.1136/ bmjopen-2014-00635
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