Erasing the Stigma of Mental Illness

Former First Lady Rosalynn Carter has been an advocate for the mentally ill since she was first lady of Georgia in 1970. Her efforts to erase the stigma of mental illness and to lobby for needed services for the mentally ill and their caregivers have earned her numerous accolades. On Wednesday, she will be honored at the Didi Hirsch Community Mental Health Center’s leadership luncheon at the Regent Beverly Wilshire Hotel. An interview with Mrs. Carter will appear Friday in Life & Style.

The following excerpt is from her new book, “Helping Someone With Mental Illness: A Compassionate Guide for Family, Friends and Caregivers” (Times Books).

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“ ‘Superman Will Die . . . Killed by a Superlunatic, an Escapee From a Cosmic Insane Asylum!’ This was the headline in papers around the country heralding the Man of Steel’s imminent death in a comic book released in September 1992. And just one month later, the newspapers in Georgia heralded “Six Flags Over Georgia to Open New Halloween Attraction: Asylum of Horrors.’ ”

Those were the opening lines of a speech I gave in 1992. Unfortunately, media depictions that discriminate against those who suffer from mental illnesses and contribute to the stigma continue today.

“TV Ad Features Straitjacketed Man Ranting in Padded Cell.” This headline was the subject of a Stigma Alert from the National Stigma Clearinghouse circulated to the mental health community in October 1997. The ad, jointly sponsored by Universal Studios and Pepsi-Cola, aired throughout Southern California, publicizing the Universal theme park’s “Halloween Horror Nights.” It showed a man wearing a straitjacket in a padded room, ranting and bouncing off the walls. A guard outside the cell was drinking a Pepsi-Cola. Exasperated, the guard shuts the peep door on the thirsty man inside.

Just a few months earlier, Nickelodeon released “Good Burger,” a summer movie for children, in which a subplot takes place in an asylum. The film’s heroes are kidnapped, carted off in straitjackets, and thrown into a padded cell at Demented Hills Asylum.

And when the bombing took place in Atlanta during the 1996 Summer Olympics, the headline of the local newspaper heralded, “Search Is on for ‘Random Nut Case.’ ” And the article began, “The hunt for the Centennial Olympic Park bomber is likely to focus initially on home-grown terrorists or what police officials and security experts refer to as a ‘random nut case.’ ”

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It seems as though I and many others have been fighting myths, misconceptions and stereotypes about mental illnesses for decades. And although much has changed over the years, we can see from the media coverage that much is left to be done. Why else would “60 Minutes” veteran Mike Wallace admit about his own depression, “I just didn’t want people to know of my vulnerability. I was ashamed. It was a confession of weakness. For years, depression meant the crazy house.”

And why else would actress Margot Kidder, following a much publicized episode of mental illness, confess that she’d rather be thought of as an alcoholic and drug abuser than a person with manic-depression? As she told Barbara Walters in a televised interview, “Mental illness is the last taboo. It’s the one that scares everyone to death, and I have to include myself in that until the last few months.”

Would either of these famous people have felt the same had they been diagnosed with a physical illness such as diabetes or high blood pressure? Despite the growing body of knowledge, a tremendous gap still exists between what the experts know about brain-related illnesses and what the public understands. The challenges involved in promoting better mental health for all Americans are many and complex, but none demands more of our attention than that of society’s attitudes toward mentally ill individuals.

It didn’t take long for me to learn about the impact of stigma when I first began working in the field. I would call mental health meetings when Jimmy was governor of Georgia and the only people to show up would be a handful of dedicated advocates and a few government employees, who probably came only because my husband was governor. At that time, no one would admit to having a mental illness; no one would acknowledge that a family member was suffering. Funding for mental health programs was always inadequate. It seemed they got only what was left over after all other health needs were addressed. And when we began establishing community group homes for mentally ill people, we ran into every roadblock imaginable--from neighborhood organizations and city council members to zoning laws hurriedly passed.

I have a vivid memory of stepping off the airplane in Valdosta, Ga., on the way to a meeting about a planned group home, and being informed that the city council had voted the night before to deny approval. It was not a pleasant day!

It is significant to note, though, that although group homes for people with mental illness are nearly always opposed, once established and the community members get to know their “new neighbors,” the stigma, almost without exception, vanishes. This happened in Valdosta, after we were eventually able to get permission to develop the home. The community soon just “adopted” the recovering patients, and the home became a model for other cities.

I hear about the problem of stigma over and over in the thousands of letters I have received from people who know about my interest in mental health. A young college student who wrote to me in the late 1970s summarized the dilemma quite well:

“Because I am aware that many people are truly ignorant when it comes to the subject of mental health, I have concealed that I am going to a therapist from most people. I do this not only to escape the fact that I might be labeled a ‘crazy’ person but because I am 21 years old and will soon be looking for a job after I graduate from college next year. The fact that I have been emotionally ill might get in the way of finding a good job.

“I feel that if people were made aware of the widespread problem of mental illness and its true nature, and . . . that most people can be helped and even cured, then we all could start to be more open about mental illness and have people who need help receive it and be accepted by others as readily as they would be if they had a physical illness. After successful treatment they should be as able to lead normal and productive lives as they would if they had been cured of a physical disease.”

I couldn’t agree more. Yet, unfortunately, 25 years later, we as a society have still not reached that point. That is why I have decided to write this book. My goal for many years has been to see the stigma of mental illness eradicated. And I believe the more we educate ourselves, and the more we come to know our mentally ill neighbors, the closer we come to attaining that goal.

Today, science has made dramatic breakthroughs in our understanding of the causes and treatments of mental illnesses. We now know that many have hereditary and physical components, that they are not the result of a weak will or misguided parenting as we had once believed. If you or someone you love is suffering from mental illness, there is no reason to feel ashamed.

I am pleased to have this opportunity to write about these issues that have so absorbed me over the years and about the exciting developments in the field. I know there is still much to be learned and much that remains to be done if we are to continue to improve the quality of life for those who suffer, many in silence.

But today, there is help and hope for those with mental illness.

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From “Helping Someone With Mental Illness” by Rosalynn Carter. Copyright 1998 by Rosalynn Carter. Reprinted with permission of Times Books, a division of Random House Inc.