Mental Health Stigma: The Week Washington Erupted

By Mary Giliberti, J.D. | Aug. 03, 2017


When former White House communications director Anthony Scaramucci’s remarks called President Trump’s now-departed chief of staff Reince Priebus a “paranoid schizophrenic,” prefaced by profanity, he was widely condemned for his malicious vulgarity—and properly so. 

Much attention focused on the crudeness of his remarks, but less so the implications of the “paranoid schizophrenic” part of his outburst. Use of a medical diagnosis for political mud-slinging exploits the prejudice and stigma that traditionally has surrounded mental illness. Unfortunately, it is a reflection of a much deeper problem.

Almost 20 years ago, the landmark U.S. Surgeon Mental Health Report identified a key public health problem; stigma discourages many people from seeking help when they need it. It also deters our investment as a society in the mental health care system.

Less than 48 hours after Mr. Scaramucci’s quote became news, a syndicated Washington Post columnist fed the flames by asking satirically, “What do we do if the President is really crazy?” The column was peppered with slang such as  “nutter,” “barking mad,” “mad as a March hare,” “off his rocker” and “a few fries short of a Happy Meal.” It recounted advice from mental health organizations on how to address mental illness as a way to mock the President. We expect more from leading journalists and their editors in setting tones that influence public perceptions and attitudes.  

Stigma is non-partisan. Democrats and Republicans alike perpetuate it. During the 2016 Democratic primaries Senator Bernie Sanders joked: “When you watch these Republican debates, you know why we need to invest a lot in mental health.” It was the type of joke that both used stigma for a laugh and trivialized serious illnesses like schizophrenia or bipolar disorder.

Such remarks denigrate the achievements of many individuals who have struggled with such illnesses. Those with schizophrenia have included Nobel Prize-winning economist John Nash and law professor Elyn Saks, winner of a MacArthur Foundation “genius grant.” They also are insensitive to the many families who have, or have had, loved ones with the illness—including Nobel Prize winner Dr. James Watson, who co-discovered the double-helix structure of DNA and actor Alan Alda.

Perhaps most perniciously, they discourage young people from getting help at a time when science is telling us that early intervention in schizophrenia is critical to achieving better outcomes.

Mental illness does not discriminate. It affects Republican and Democrat families. Ironically, the week’s stigma eruptions happened during the week of the Senate’s vote on a health care bill that would have cut billions of dollars from Medicaid—the program that is the lifeline for millions of people with mental illness.

More than 2 million adults have schizophrenia. The average age of onset tends to be in the late teens to early 20s for men and the late 20s to early 30s for women. It does not mean that a person has a "split" or multiple personalities. Instead of slang, wisecracks, and jokes, we need leaders willing to educate national, state and local communities about effective public policy solutions.

Investment in mental health services and supports is needed. Early intervention programs for young people experiencing psychosis need to be expanded. Support for scientific research through the National Institute of Mental Health is essential.  Housing, jail diversion and employment programs are also needed.

Go to any jail or homeless shelter in America and you will quickly realize that these are serious illnesses that deserve serious responses. To address the stigma that erupted in Washington, D.C. last week, Scaramucci should directly apologize for his harmful and stigmatizing comments.

Perhaps Scaramucci’s successor, politicians from both parties and members of the press could visit community mental health clinics, early intervention programs, a recovery clubhouse, and research centers to get a better understanding of these issues. This would go a long way in educating the American people and helping to eliminate stigma. It is time to get out of the partisan gutter and elevate the public dialogue on mental illness.

Donna Comiskey
We have come so far. However, we still have a long journey ahead. Together we must continue to support and educate the masses! Lead from where you are!
8/7/2017 10:14:24 AM

8/4/2017 11:40:26 PM

JoAnne G
As a nation we are not caring for this very diverse population. We lack progressive insight on how to best treat / care for our loved ones in a humane long term plan of care. The gap of services in our communities is shameful.
8/4/2017 3:11:32 PM

Joan Rapp
I am grateful to Mary Gilberti for cataloging some of the very discriminatory and damaging remarks that have been flying the political scene over the recent months. This kind of rhetoric continues to create pain and frustration for individuals and families trying to escape the kind of stigma that keeps people from seeking help and continues to marginalize those with mental health challenges.
8/4/2017 2:23:00 PM

Brad Benson
As a parent and caregiver of a son with schizophrenia (diagnosed at 19 now 26) this hit me in gut & heart. 1 in 5 people on this planet have a defined mental illness, after joining NAMI and learning more about my son's illness I learned that my combat related PTSD is an mental illness. Investment in mental health services and supports is needed. Early intervention programs for young people experiencing psychosis need to be expanded. Support for scientific research through the National Institute of Mental Health is essential. Housing, jail diversion and employment programs are also needed. Sadly nothing has changed, my goal in life is work toward everyone understanding that when they see that manic person they understand that the person is simply having a heart attack in their brain. We all know how to react to a heart attack.......
8/4/2017 1:16:23 PM

J Norman
My grandson needs more help
8/4/2017 10:59:29 AM

It is really hard to get close ones to fully understand what my life has been like since I entered the world of serious mental illness called severe depression.
8/4/2017 12:17:35 AM

Jane Napper
Family and other caring individuals have Far Too Much Faith in our mental health systems as a whole!
8/3/2017 10:45:50 PM

Diana Lozano
Using Mental Illness in a crude method is unacceptable. People do not make fun of Cancer victims ...there is no difference !!
8/3/2017 6:34:40 PM

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