Stigma, Children and Mental Illness

The tragedies of Columbine and similar incidents have led to impassioned calls for increased mental health services for children and adolescents. While there is little doubt that increases are needed and long overdue, this focus alone overlooks an important fact. Even when services are available, children and their parents often fail to make use of them. Although research has revealed that nearly one in five adolescents experience a psychiatric problem, most, including those who acknowledge and express concern about those problems, do not seek professional help.

One factor that contributes to this troubling statistic is stigma. The negative attitudes about mental illnesses that pervade public thinking are hardly exclusive to the adult population. Children learn from a very early age that psychiatric problems are seen as failures of character and will and that those who admit to such problems or receive psychiatric treatment are likely to be avoided and looked down upon by their peers. Even second and third graders appear to have already assimilated the idea that people with mental illnesses are to be viewed less favorably than others.

From where do these negative views come? Certainly, they are influenced by the attitudes and behaviors of adults. Children are witness to disparaging references of those who are disliked or who have divergent opinions as “crazy,” “nuts” or “insane.” Children hear adults complain about people driving “like madmen” or behaving “like lunatics” when they are upset. Children are aware of the hushed and embarrassed tones used by adults when referring to relatives who have undergone psychiatric treatment. In other words, children learn easily that it is bad to be associated with labels that indicate a psychiatric problem.

Children are also indoctrinated to negative beliefs about mental illness through the entertainment media. Films for children often provide stigmatizing images and ideas. Take, for example, Good Burger, a recent film based on the popular Nickelodeon series, Keenan and Kel. Within this whimsical children’s movie is a sequence at the Demented Hills Asylum, where the heroes encounter unkempt psychiatric patients in straitjackets who do things like disrupt a card game by eating the cards and growl menacingly at visitors. For somewhat older children, a recent chart-topping MTV video by the music group N’Sync (entitled “I Drive Myself Crazy”) provided similar images of spaced-out psychiatric patients in straitjackets and padded cells, with the repetition of lyrics featuring the word “crazy.” These stereotypes label people with mental illnesses as frightening, unattractive and undesirable. They are being established or perpetuated within impressionable, young minds.

It is small wonder, then, that children and adolescents do not seek psychiatric help. They believe that to seek help would identify them as one of those unlikable persons they have seen or heard about and leave them vulnerable to ridicule and rejection. As Tipper Gore observed in a May 1999 Time magazine article: “If we are serious about stopping the violence and helping our children, adults need to erase the stigma that prevents our kids from getting the help they need for their mental health.”

Fighting the stigma of mental illness-a task that includes changing the sometimes stigmatizing ways we ourselves refer to mental illness and challenging the media images that communicate negative stereotypes to our children and adolescents-is a fundamental task for helping to ensure that available mental health services will be used successfully by children and their families.

Source: National Mental Health Association, Stigmatizing Media Images Affect Children, by Otto Wahl, Ph.D.