The stigma of mental illness is a persistent and pernicious force against which people with mental illness, their families, and those who provide services to them must continually struggle. As noted in the Surgeon General's report on mental health, stigma manifests itself in distrust, bias, fear, stereotyping, embarrassment, anger, and/or avoidance. Stigma derives in part from poor or incomplete understanding of causes and treatment for mental disorders.

Stigma translates into problems that must be addressed by the public mental health system if it is to provide needed services to people with mental illness. Among the most major problems is the reluctance of nearly two-thirds of all people with diagnosable mental illness to seek treatment. Stigma is not the only issue that discourages people in need from seeking treatment, but among many populations, including rural populations and members of many distinct cultural groups, it clearly keeps many away from needed services and supports. ^[1]  

Stigma also manifests itself in negative public attitudes towards payment for mental health services. Even with passage of mental health insurance "parity" laws in nearly two-thirds of the states, private insurance coverage for mental illness often remains inequitable in terms of co-payments and dollar or durational limits on coverage. At the same time, support for public funding of mental health programs remains soft relative to public willingness to pay for highways, prisons, or even other health services.

In recent years, a common approach by the mental heath community to the problem of stigma has been to point out that mental illnesses are illnesses like any other. Much faith has been placed in the promise of research to clarify the etiology of mental illness and to further improve treatments that already can demonstrate effectiveness comparable to treatments for "accepted" diagnoses such as heart disease, cancer, and diabetes. While this approach to stigma and discrimination can be shown to have had some effect, it is clear that public support for greater expenditure on mental health services has simply not materialized.

Recent years have also seen a rise in greater awareness of other problems associated with mental illness, particularly within the law enforcement, judicial, and corrections fields. Low public investment in mental health services has resulted in a system that often cannot adequately meet the complex needs of the people it is meant to serve. A stark symptom of this undervalued and underfunded system is the increase in criminal justice contact for people with mental illness. Without adequate services, many commit the petty crimes that bring them to the attention of law enforcement and the courts and that may result in stays in jail or prison.

Recommendations:

a.

Create public support for the investment necessary to make high-quality, comprehensive mental health services available to those who need them.

b.

Present a common front to advocate for greater investment in improved mental health services.