After shocking events in our country, such as in Alphen aan den Rijn where Tristan van der V. shot six people and then himself in the shopping center, the newspapers are again full of (negative) reports about people with a mental disorder. How does stigma affect people with mental illness?
Micro
Stigma affects a patient with a mental disorder. For this patient, who has a chronic mental disorder, the label ‘psychiatric patient’ also takes on personal meaning. The patient will eventually come to terms with the lower status and his self-esteem will decrease, social isolation will arise and the patient will avoid professional help. The patients ultimately sideline themselves due to insecurity, lack of self-confidence and low self-esteem. The negative images appear to be an obstacle to the patient’s return to social life. It hinders obtaining work, housing and social relationships.
The mandatory literature of GP-V-106, Identification in social-agogical work (Sluiter pp. 64), mentions 4 mechanisms through which people come to terms with their situation. One of these mechanisms, accommodation, is actually what is the case in this patient with a mental disorder. I quote:
‘According to Nijhoff, this phenomenon (social stratification) is based on mechanisms of social control. These mechanisms ensure that people do not really resist when they find themselves in a disadvantaged position. (…) Nijhoff describes four interrelated mechanisms that contribute to people not escaping their disadvantaged social position:
- Individualization: When people find themselves in adverse or miserable circumstances, they tend to think that they are the only ones facing such problems.
- Subjectification: the person who finds himself in unfavorable circumstances only thinks he is the only one, but also has the feeling that he is to blame for it.
- Accommodation: people accept their situation and take their problems for granted.
- Atomization: self-destruction that occurs when people believe in the hopelessness of their social position or circumstances.
Meso
In the Netherlands there are currently no authorities involved in media monitoring, which would be beneficial for combating stigma.
Mental health care providers deal with people with a mental disorder. Unfortunately, there is still often stigmatization towards patients within mental health care by their care providers. It is important that care providers do not allow themselves to be influenced by the negative images that prevail in society. This is not an easy task. The book ‘Basic Book Social Work, People and Participation (Steketee & Spierings pp. 177)’ writes the following about this:
‘It is a professional challenge for a social worker to deal carefully with the definitions of the problems of marginalized groups, such as those are presented in the media, in the neighborhood and between the various professionals. What you hear and see is not always the reality of the problem.
You could say that there is an appeal to normative professionalism (this concept is described as follows in the book ‘Signaling in social-agogical work (Sluiter pp. 37)’: ‘The concept of normative professionalism has been developed as a critical counterpart of the technical professionalism view that emerged in the 1980s in the wake of product- and output-oriented thinking and now dominates the welfare sector. This involves the appeal to make that normativity explicit, to justify it reflexively and to let it be normative for the own professional actions’. ) of the care providers. There must be real attention for the patients and there must be a connection with the living environment of patients. The views in society have a less important role in this. The aspects that hinder people from achieving their full potential in society, in this case stigmatization, must be influenced. In practice, it appears to be very difficult for healthcare institutions to take on the latter task.
I believe that people with a mental disorder should be treated as full human beings, perhaps with a disability, but that does not make them ‘lesser’ than ‘healthy’ people. Every person is unique, everyone has certain behaviors that are specific to that person and therefore it is not fair to exclude people with a mental disorder from society.
Macro
Canadian researchers determined in 2004 that mass media is a primary source of information for the population about mental health patients and mental health care itself. According to O. Wahl, this is the researcher on media and stigma in the United States, this is even more important than personal contact with a patient with psychological problems. These researchers believe that the mass media mainly shows negative images and stereotypes, which is mainly focused on the incorrect relationship between mental disorders and violence. These researchers also noted that there is a link between negative media representations and the general population’s views on mental disorders. These negative views appear to have an impact on the lives of people with psychological problems. The negative images that the media gives about mental disorders are also said to influence the government’s and politicians’ response to mental health issues. In times of crisis, such as now, this is distressing because it may affect the financial support that the government provides to mental health institutions. In addition to the media, upbringing, culture and education play a role when it comes to stigma. The question is whether stigma is created by the media or whether the media goes along with the negative views that society already has.
The Dutch researcher Herro Kraan has determined that this situation also applies to the Netherlands. In Dutch society there is also the view that psychological disorders cause negative behavioral consequences, involving crime, nuisance and aggression.
Tristan van der V., the gunman who took the lives of 6 people in Alphen aan den Rijn, turned out to be schizophrenic. This fact ensures that negative views about people with a mental disorder in the Netherlands are strengthening.