NAMI Calls on Presidential Commission to Fight Stigma as Part of Reform

Nine Areas Identified For Reform In Treatment System; Commission Warned That Promises Must Not Be Broken Again.

Jul 18 2002

Washington, D.C. - The National Alliance for the Mentally Ill (NAMI) today testified before President Bush's "New Freedom" Commission on Mental Health -- pointing to a recent, offensive headline in the Trentonian as an example of how people with mental illness are devalued by stigma, which leads to lack of investment in treatment and recovery.

"Twenty percent of Americans experience mental illness. Two-thirds never receive treatment," said NAMI board president Jim McNulty, who has lived with bipolar disorder for almost 20 years. "Stigma is a big part of the problem."

On July 10, the Trentonian -- one of 23 daily newspapers nationwide owned by the Journal Register Company -- used the headline "Roasted Nuts" to describe a fire at Trenton Psychiatric Hospital. NAMI has called the incident one of the worst examples of institutional prejudice and discrimination in recent memory.

"In 2002, the fact that such a headline could be written and then actually published underscores the problem of stigma and how the lives of people with mental illness are devalued," McNulty said. "It also underscores what the U.S. Surgeon General reported less than three years ago."

  • Stigma is "the most formidable obstacle to future progress in the arena of mental illness and mental health ... manifested by bias, distrust, stereotyping, fear, embarrassment and/or avoidance."
  • Stigma leads people "to avoid living, or working with, renting to, or employing people with mental disorders, especially severe disorders such as schizophrenia ... It reduces patients' access to resources and opportunities (e.g., housing, jobs) and leads to low self-esteem, isolation, and hopelessness. It deters the public from seeking, and wanting to pay for, care. In its most overt and egregious form, stigma results in outright discrimination and abuse. More tragically, it deprives people of their dignity and interferes with their full participation in society."

McNulty called on the Commission to build "a bully pulpit" with its recommendations that will encourage the President, Congress and other civic leaders to address forcefully both attitudinal and structural stigma throughout society.

He also warned that the President and Congress must ensure that the Commission's recommendations are not ignored once they are made-reminding the audience of promises made and broken in the 1970s and 1980s, after the last mental health commission appointed by President Jimmy Carter.

In comprehensive testimony submitted to the Commission, NAMI discussed numerous proposals for reform in nine broad areas:

  • Consolidation and coordination of mental health services at the federal, state and local levels, including single providers for core services locally and collaborative set-asides for housing.
  • Assertive community treatment models to reduce psychiatric emergencies, hospitalizations, and criminalization.
  • Taking steps to engage hard-to-serve individuals in treatment and services, including involuntary treatment as a last resort, subject to due process.
  • Recovery-oriented services, with an emphasis on housing and employment.
  • Inpatient and long-term care options for people who require them.
  • Greater investment in education of healthcare, criminal justice, and other professionals about mental illness.
  • Empowering consumers and families to drive treatment, recovery, and education programs.
  • Building a professional mental health work force through scholarships and loan forgiveness programs for persons who commit to serve in under-served regions or communities, and integrating consumer and family peer counselors.
  • Development of anti-stigma guidelines for the news, entertainment, and advertising industries, and support of consumer and family organizations using professional guidelines as advocacy tools.