There is a time when a mentally ill person may realize that they need help. Symptoms worry them or others, enough that they consider getting treatment. Studies have shown that majorly the stigma, or fear of the consequences of being labeled “mentally ill”, prevents a person who realizes he or she may need help. The stigma of mental illness makes it hard enough for a person to accept that he or she has a mental illness. Half of the severely mentally ill do accept that they are suffering with mental illness, but because of the stigma and discrimination they don’t seek for the professional help and there are number of stigma related reasons
- Fearing loss of self-esteem;
- Fear of being on psychiatric medication;
- Fear of being exposed as a person on psychiatric medication;
- Expecting that they will spontaneously get better if they just keep the illness hidden from others;
- Believing that doctors might not give them proper attention;
- Fearing rejections in the community;
- Fear of being left out in the society or even in the family;
- Fearing losing the love or respect of their family or other loved ones;
- If employed, being afraid of their employer finding out;
- Fearing losing custody of their children; or
- Fearing that someone they know could see them at the psychiatrist’s office.
Stigma and Discrimination
The stigma of mental illness is one of the foremost barriers deterring people who need treatment for their illness. About two-thirds of people with diagnosable mental disorders do not receive treatment. Stigma toward mental illness is pervasive all over the world. Stigma refers to stereotypes and prejudicial attitudes held by the public. These pejorative attitudes induce them to fear, reject, and distance themselves from people with mental illness. If the sense of stigmatization is not catered in time then there are high chances of stress which ultimately lead to even suicidal attempts.
Stigma also extends to family members. Family members of people with mental illness have lowered self-esteem and more troubled relationships with the affected family member.
The cost of care is among the most frequently cited barriers to mental health treatment. About 60–70 percent of respondents in large, community-based surveys say they are worried about cost. Some researches indicate that if there is health insurance then the people do not fall in this barrier and then they go for any Mental Health Services. Rises in co-payments of mental health services are associated with lower access. It has also been observed that people are more concerned about the price they are paying for any mental health issue than about other medical problems.
Mental Health System Barriers
Unfortunately there are some Mental Health Services or hospitals which have no good reputation as far as their services, management, structure and treatment style is concerned. In early times there were asylums, where the patient used to live chained, socially cut off, with heavy medications which kept them sedated all the time and even there used to be physical punishments to the patients as well if they showed any psychotic symptoms. Still there are some facilities which are following these inhuman, non professional and non therapeutic ways in order to treat the patients. Such set ups make the community resistant towards the admission to the Mental Health services of the one who is suffering with any mental health problem. They have the view that their patient’s condition would get worse if he or she gets admitted even about those facilities where there is a professional and therapeutic atmosphere.
Substance abuse and mood disorders frequently co-occur, with 51 percent of mentally ill. Treatment of co-morbid alcoholism and depression with selective serotonin reuptake inhibitors (SSRI) reduces suicidality. Thus, detection and treatment of substance abuse and mental illness must be in consideration in the treatment of mental health problems.
For the primary care setting, numerous professional groups recommend routine detection of problem drinking in all patients, as well as counseling for non-dependent problem drinkers. Nevertheless, problem drinking often goes undetected in primary care. In recent surveys, about 40 percent of primary care physicians do not perform routine screening for substance abuse. The most commonly cited reasons are lack of time and fear of spoiling the relationship with the patient. Studies indicate that if there is a Dual Diagnosis of Drug addiction and any other Mental Disorder, then there must be a well structured program for treating both. If not, then the recovery from drug addiction or mental illness would not be ensured.
In order to reduce the barriers in the path of getting the treatment from mental health problems, the stigma must be removed by raising the voice regarding the realities and extinguishing the myths regarding the mental health problems and treatments. Even this must bring into the awareness of the community that if you carry on with the treatment of the mental disorder and follow as the psychiatrist and counselors say the cost of treatment lowers down. Moreover, the new mental health facilitates must be established where the latest knowledge and research based treatment modalities are inculcated. If there is already an established facility where the respect of the patient remains intact, then it must be promoted by the community and by the professional working with it.