Mental Health

Stigma Still Shadows Psychiatric Care

02.27.06, 12:00 AM ET
MONDAY, Feb. 27 (HealthDay News) — A new analysis finds Americans conflicted when it comes to psychiatric drugs: Most think they would work well, but they still wouldn’t use them.

While people increasingly understand mental illness, have sympathy for it and appreciate advances in its treatment, the stigma associated with taking antidepressants and psychiatric drugs remains high, according to a new report from researchers at the Indiana Consortium for Mental Health Services Research at Indiana University, Bloomington. The report was funded, in part, by the National Institute of Mental Health.

“Even though people verbalize the notion that they are accepting of psychological disorders of all kinds, there is this residual feeling that a psychological disorder is a character flaw,” said Dr. Charles Goodstein, a psychoanalyst and clinical professor of psychiatry at New York University School of Medicine.

This stigma means that, for many, “not using means they never had such a flaw at all,” he said.

In the study, the Indiana team reviewed data from the 1998 Surgeon General’s Social Survey of 1,400 Americans. They found that:

* Approximately two-thirds said psychiatric drugs do help people with mental health woes deal with day-to-day anxiety, control their symptoms, and improve family relationships;
* Just 56 percent said they would be willing to take medication to alleviate panic attacks;
* 41 percent would do so if they were diagnosed with depression;
* And only about a third would be willing to take them for personal troubles or stress.

Why the reluctance to take psychiatric drugs, when most would have little qualms about taking a drug to ease a physical malady?

“I think they are afraid of what is going to happen to them, which for most people is undo caution,” said sociologist Bernice A. Pescosolido, director of the consortium. “They’ve been primed by the media about what might happen in the first two weeks, when some people have a risk for suicide.” She noted that psychiatric medications must not be taken unless the patient is being monitored closely by a doctor experienced and qualified in their use.

There is reason for concern, added Goodstein.

“Sometimes the drugs are prescribed excessively or for some type of performance enhancement, and they do have side effects,” he said. “They should not be taken in casual ways. Too often patients get them from practitioners just because they have samples around.”

People may also shy away from psychiatric drugs because they think they will face stigma from others, Pescosolido said. She recounted the story of a friend who, following her divorce, took her fifth grader for therapy. After the boy’s doctor prescribed him an antidepressant, he said, “That’s it! I can’t run for president.”

Much depends on whether a patient trusts the doctor who prescribed the drugs, Pescolido said. About seven of 10 Americans reported trusting their own physician, but six of 10 were skeptical of doctors in general, suspecting them of taking unnecessary risks, charging for unnecessary services, performing unnecessary surgeries and not acting in their patients’ best interests.

And though many of the new generation SSRI antidepressantsm such as Prozac, Paxil and Zoloft, are part of long-term therapy, 47 percent of respondents said psychiatric medications should be discontinued once symptoms go away.

“There is a real link in the public mind between mental illness and ‘dangerousness,’ and that is what is fueling the stigma,” said Pescosolido. “Americans have become more sophisticated and knowledgeable about mental illness, and everybody assumed the stigma was going away. We can’t accept that.”

The report will be published online Tuesday by the Indiana Consortium for Mental Health Services Research.

More information

For more on mental health and mental disorders, visit the U.S. National Institute of Mental Health.

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