Research Day

The Crippling Stigma of Psychiatry

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Introduction: Psychiatry is a field that by its nature must consider not only a patient’s symptomatology, but also their environment and sociocultural framework. Studies have shown that patients who themselves hold personal stigma against mental illness are more likely to have less recovery at one and two years of follow-up. These personal stigmas are often shaped by the viewpoints of the patient's family. Despite tremendous ongoing progress in the United States in overcoming the stigma associated with mental illness, it remains a very challenging part of the practice of psychiatry. Many cultures continue to approach the causes, treatments, and aftermath of psychiatric disorders in ways that are not always beneficial to the suffering patient. Unfortunately, these cultural practices can cause patients to fear their families will turn their backs on them and hinder recovery. Case Description: This case study is centered around a 31-year-old Asian American who was admitted several times with worsening depression and suicidal ideation. Hospitalization was precipitated, to a large degree, by lack of acceptance by his family and friends. His major symptoms all relate back to guilt and shame over his sexuality and mental illness. The patient feared that his parents, Chinese citizens, would disown him if he were to share his sexual preferences with them because of the cultural prohibitions against homosexuality. He also feared they would not accept his mental illness or appreciate his struggle. Unfortunately, his lack of familial support and the strong stigma against homosexuality and mental illness in the Asian culture has contributed to multiple readmissions to our facility. Discussion: The healing process in mental health is multi-factorial and a large part depends on the support of family and loved ones. Stigma can often carry such a burden that it makes the healing process in a family much more difficult and prolonged. These issues came to light during the treatment team meetings with this patient's family, who reacted to the news with denial. Our patient, and many others across the world,struggle with the lack of support from their loved ones and family, with the stigma of others tainting and enforcing stigma of their own. Conclusion: While the stigma and approach to psychiatry has come a long way since the era of isolating patients with mental illness, this case is one example of how there is still much work to be done in normalizing the field of mental health.

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