I started reading about stigma and mental health, I’d like to know more of the experience, attitudes and their effect. A couple of minutes of searching and I found a research paper I can’t forget. The title gives a hint to the findings – Bromley JS, Cunningham SJ. ‘You don’t bring me flowers anymore’: an investigation into the experience of stigma by psychiatric in-patients. Psychiatry Bull 2004; 28: 371-4.

The researchers found that within the comparative populations studied “The psychiatric patients received about half as many cards as the medical patients (60 v. 112). Gifts to the psychiatric patients were often practical in nature and seldom included luxury items such as flowers. Disclosure of admission for mental illness (compared with the physical illness group) was significantly lower, both to family members (139 v. 193, P=0.041) and friends.”

Earlier this week I talked with someone who has been diagnosed with a mental health issue. I don’t think she would mind me sharing her diagnosis here but I can’t recall exactly what her condition is. I do recall that she acutely aware of the attitudes of others in regard to her diagnosis, she is afraid of rejection by friends due to the label given to to her state. As a result she has little contact with her friends and people who might be the most supportive. Social withdrawal is one of her coping mechanisms, and her friends, most of them anyway, are not reaching out. Her self imposed isolation is protective.

This is where the story at the heart of the research paper has a kick: “This study provides evidence for what is often thought to be true, namely that at times of crisis psychiatric in-patients receive fewer gestures of support from family and friends.” Just when you need them the most…

Sadly isolation, self imposed or otherwise, plays a role in perpetuating stigma. One of the best understood means of reducing stigma among the general population is through direct contact with a friend who has mental health issues – a classic chicken and egg situation.