I am confused by mental illness stigma campaign messaging. I “get” human rights abuses, I “get” age and
sex discrimination; there are legal recourses for these in many countries. I
understand prejudice when we’re talking about discrimination, but anti-stigma
campaigns are a different beast. Where are we going with mental illness
anti-stigma campaigns, and why?
These campaigns talk about “changing the conversation” about
mental illness, which means, to my mind, at least, that they have an agenda to infiltrate minds. Anti-stigma
campaigns aim to mold people’s thoughts to conform to the latest fashions and
trends, and they encourage people to want to sign onboard, to be part of the “in”
crowd and not a self-stigmatizing small minded misfit, a.k.a. a bigot. You want
to be invited to the right parties? Check your ability to question the sense of
what is happening at the door.
Anti-stigma campaigns are peculiarly American in origin, but
adopted by many English speaking industrialized countries. Canada comes to
mind, as there is less resistance there to American messaging due to its geographic proximity and slavish
desire to be invited to the noisy party going on right on its doorstep. Anti-stigma
campaigns have heavy political undertones, and, with politics comes money. They
should not go unchallenged, but they are extremely hard to find out what the
real agenda or organization may be behind them. They appear to me to be
essentially marketing gimmicks to rebrand thought in ways that benefit certain
interests. Yes, in the case of mental illness anti-stigma campaigns, I’m
heading in the direction of pointing a finger at pharma, without being able to
get at solid evidence. (Please forgive me for not putting the requisite
quotation marks around mental illness, a stigmatizing term if there ever was.)
What message are we supposed to take away from people wearing tee-shirts
that say “bipolar” next to tee-shirts that says “sister”? Or actress Glenn Close saying “schizophrenia,
schizophrenia, schizophrenia, schizophrenia. See, it has no meaning?” What would people in India, Thailand, France
or South Africa take from this messaging? They would probably be confused. They
may not have labels for their relatives. They’ve got their own understanding of
mental illness, and, judging from the World Health Organization’s findings that
recovery rates are much higher in the developing world than in Western
industrialized countries, these people must be doing something right, stigma
and all.
On World Health Day (Thurs. 10 Oct.), I watched the documentary
film Hidden Pictures, directed by, and narrated by, Delaney Ruston, M.D.
From the official website:
"Artistically crafted, with unforgettable characters, Hidden Pictures is
unprecedented in it's (sic) scope. The filmmaker, who grew up under the shadow
of her dad's mental illness, takes us on her journey to uncover personal
stories in India, China, Africa, France, and the US. Moments
of profound frustration and unparalleled compassion emerge. Ultimately we
witness the incredible change that individuals such as actress Glenn Close are
bringing about."
I had trouble with this film
on several levels, despite its offering some interesting glimpses into
different countries’ mental health systems, and their shortcomings. In
Thailand, a person can be locked up indefinitely on someone else’s say so,
without legal recourse. That’s a human rights issue. In the East, face saving
and respect for one’s elders can override human rights concerns. That’s an
ingrained cultural issue. South Africans seek out the advice of traditional
healers, with predictably mixed results. That’s cultural, too. In India, there
is intense pressure not to divulge an illness because doing so has severe
implications for marriage prospects. Culture, again. France has very well
developed medical care and social systems, but unemployment is high, and it is
especially difficult for anyone, who
is out of work for several years to gain a foothold in the job market. That’s
cultural, but also economic.
Glenn Close, who founded the Bring Change 2 Mind anti-stigma campaign, is a
hint that the viewer of this documentary is about to be subjected to the export
of a Westernized biochemical view of depression, bipolar disorder and
schizophrenia in countries as diverse as India, Thailand, South Africa, and France.
Bring Change 2 Mind’s mission is tailored to a pharma only approach, without
having to say so: To end the stigma and
discrimination surrounding mental illness through widely distributed Public Education
Materials based on the latest scientific insights and measured for
effectiveness. To act as a portal to a broad coalition of organizations that
provide service, screening, information, support and treatment of mental
illness.
There is more than a whiff of
pharma in Hidden Pictures.
Delaney Ruston's credibility problem in developing countries with their own
cultural traditions, and better track record in overcoming mental illness, is
that she is an American M.D., schooled in the biochemical model of the
"disease," Her medical training has taught her that people with
schizophrenia who now seem “normal” must have been misdiagnosed! (It’s there in
the film.) In one scene, Dr. Ruston, as the narrator, refers to "the best
medical care" as we simultaneously see boxes of prescription drugs being
put on a shelf.
Dr. Ruston has cultivated
ties to celebrities like Close and former U.S. Senator Patrick Kennedy, who
also appears in the film —red flag warnings that money, power and industry are
trying to gain international respectability through the seemingly innocuous
footage of a film about compassion and caring. The American style Ruston brings
to the film has a Hallmark card feel to it (so do pharma ads), the
narrator and her camera focusing on how alike we all are, no matter where we
live. Well, yes, in many ways that's true. I feel good about that, I don't feel
good about how scientifically speculative information about the biochemical
nature of the major mental health problems is being spread through a stealth
campaign called stigma.
A feel good scene shows
middle school children in the International School in Delhi "overcoming stigma" by learning about mental illness and the brain. We see brain
charts and a kid who hasn't a clue that he is learning science that is merely wishful thinking at this stage, spouting the usual stuff about the biochemical nature of mental illness. The
teacher takes an active, nurturing role in pushing the non-existent science. These
carefully cultivated celebrity connections can open international doors, and
not just for filmmakers. I'll bet a lot
of the parents of the middle school kids work for pharmaceutical companies in
Delhi.
The real life stories of
people struggling with mental illness were interesting, don’t get me wrong, so
from that viewpoint, it is forty minutes well spent. But, I do strongly suspect
that there is a hidden agenda behind the hidden pictures. Getting people and
organizations to talk about stigma is pharma’s social marketing technique. Superficially,
it seems harmless, but it also seems very much about getting drugs to some of
the world’s most populated countries.
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