Perceptions Of Mental Illness

“The term “mental illness” was coined by people who were humane in their inclinations and who wanted very much to raise the station of (and the public’s sympathies toward) the psychologically disturbed from that of witches and “crazies” to one that was akin to the physically ill.

And they were at least partially successful, for the treatment of the mentally ill has improved considerably over the years. But while treatment has improved, it is doubtful that people really regard the mentally ill in the same way that they view the physically ill.

A broken leg is something one recovers from, but mental illness “allegedly” endures forever. A broken leg does not threaten the observer, but a crazy schizophrenic? A host of evidence shows that attitudes toward the mentally ill are characterized by fear, hostility, aloofness, suspicion, and dread.

That such attitudes infect the general population is not surprising, only upsetting. But that they affect the professionals – attendants, nurses, physicians, psychologists and social workers – who treat them is more disconcerting.

Such attitudes should not surprise us. They are the natural offspring of the labels patients wear and the places in which they are found. Consider the structure of the typical psychiatric hospital. Staff and patients are strictly segregated.

Staff have their own living space, including their dining facilities, bathrooms, and assembly places. The glassed quarters that contain the professional staff, which the pseudopatients came to call “the cage,” sit out on every dayroom.

The staff emerge primarily for care-taking purposes – to give medication, to conduct therapy or group meeting, to instruct or reprimand a patient. Otherwise, staff keep to themselves, almost as if the disorder that afflicts their charges is somehow catching.

The average amount of time spent by attendants outside of the cage was 11.3 percent (range, 3 to 52 percent). This figure also includes time spent on such chores as folding laundry. It was the relatively rare attendant who spent time talking or playing games with patients.

The hierarchical organization of the psychiatric hospital has been commented on before, but it is worth noting again. Those with the most power have the least to do with patients, and those with the least power are the most involved with them.

Recall, however, that the acquisition of role-appropriate behaviors occurs mainly through the observation of others, with the most powerful having the most influence.

Attendants not only spend more time with patients – required by their hierarchy – but, also, insofar as they learn from their superior’s behavior, spend as little time with patients as they can. Attendants are mainly in the cage: where models, action, and power are.

It has long been known that the amount of time a person spends with you can be an index of your significance to him. If he initiates and maintains eye contact, there is reason to believe that he is considering your requests and needs.

If he pauses to chat or actually stops and talks, there is added reason to infer that he is individuating you. In four hospitals, the pseudopatients approached the staff member with a request or question.

The degree to which staff avoided continuing contacts that patients had initiated was overwhelming. By far, their most common response consisted of either a brief response to the question, offered while they were “on the move” and with head averted, or no response at all.

The encounter frequently took the following bizarre form: (pseudopatient) “Pardon me, Dr. X. Could you tell me when I am eligible for grounds privileges?” (physician) “Good morning, Dave. How are you today?” (Moves off without waiting for a response.).

It is instructive to compare these data with data recently obtained at Stanford University. It has been alleged that large and eminent universities are characterized by faculty who are so busy that they have no time for students.

For this comparison, a young lady approached individual faculty members who seemed to be walking purposefully to some meeting or teaching engagement and asked them questions. Without exception, all of the questions were answered.

No matter how rushed they were, all respondents not only maintained eye contact, but stopped to talk. Indeed, many of the respondents went out of their way to direct or take the questioner to the office she was seeking.

Similar data were obtained in the hospital. Here too, the young lady came prepared with questions. After the first question, however, she remarked to her respondents “I’m looking for a psychiatrist,” or “I’m looking for an internist,”

Within medical school setting, once having indicated that she was looking for a psychiatrist, the degree of cooperation elicited was less than when she sought an internist. Individuals who are mentally ill feel ‘powerlessness and depersonalisation’.”

Adapted from: On Being Sane in Insane Places by David L. Rosenhan. Originally published in Science, New Series, Vol. 179, No. 4070. (1973).

Now you know the power of Trauma Informed Care. Let’s turn this framework into a mindset for personal, social and political change. If you are unable to, you might need help first, to get safe or become ‘unstuck’ from trauma. Reach out for trauma informed care. #YouBelong

With love,

Dr Louise Hansen
Psychologist
PhD in Psychology
Human Rights Activist

#HealingTrauma #Justice4Australia #YouBelong

Trauma Informed World was inspired by Kopika and Tharnicaa; two faces that remind us everyday of Australia’s cruel refugee system. One of many systems in Australia that remind us of the negative operation of power. #HomeToBilo

You can listen my talk with Dr Cathy Kezelman AM, President of Blue Knot Foundation on my own healing journey, training and study and how it has informed my work and advocacy for a trauma informed world here:

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