As those who work in the field of mental health know only too well, mental illness carries a stigma that adds a significant burden to the challenges already facing many clients. Unlike other medical conditions such as cancer or heart disease, mental illness is often seen as a personal weakness or a character flaw. The detrimental effects of this stigma are well understood. In his 1999 Mental Health Report, former Surgeon General David Satcher asserted that “Stigma assumes many forms, both subtle and overt. It appears as prejudice and discrimination, fear, distrust, and stereotyping. It prompts many people to avoid working, socializing, and living with people who have a mental disorder. Stigma impedes people from seeking help for fear the confidentiality of their diagnosis or treatment will be breached.”

What perpetuates the stigma? Unfortunately, it’s not just outdated social attitudes. In fact, negative images and distortions about mental illness abound in current popular media. The National Alliance on Mental Illness (NAMI), an advocacy group for people affected by mental illness, publishes a regular column on their website called “StigmaBusters”, which asks members to send in alerts about stereotypes they find in the media. Examples include a November 2010 episode of the popular musical comedy “Glee”, which mocked and trivialized bipolar disorder in a scene where a “crazed” Mary Todd Lincoln is shown shouting at a teapot. A recent issue of Vs., a high-end fashion magazine, features actress Eva Mendes as a patient in a psychiatric institution, writhing on a bed to keep from being restrained. A new television commercial for Burger King shows “The King” on a rampage, chased and then taken away by men in white coats. Some of the most egregious examples have appeared around Halloween. This past fall, “The Pennhurst Asylum,” a Halloween “insane asylum” attraction, opened on the grounds of the former Pennhurst State School and Hospital outside Philadelphia, sparking a controversy that included protests from former residents of the facility (http://www.nami.org/).

If negative images in the media are helping to form the popular perception of mental illness, what are some ways to help clients cope with their effects and counter the stereotypes that the images perpetuate? Advocacy organizations like NAMI offer support to individuals with mental illness and their families, and participating in groups like “StigmaBusters” is one way that people can become advocates, doing their part to fight inaccurate and hurtful representations of mental illness. The Mayo Clinic website (http://www.mayoclinic.com/health/mental-health) is another excellent resource that describes steps to cope with stigma, including advice on how to seek support and educate others about mental illness.

And it’s not all bad news in the media. The Voice Awards, sponsored by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), recognize writers and producers of television and film who have given voice to people with mental health problems by incorporating dignified, respectful, and accurate portrayals of people with mental illness into their scripts, programs, and productions. In 2010, a Voice Award for best documentary went to actor Joe Pantoliano for his film No Kidding, Me Too!, which explores the journey of several individuals with mental illness and includes a candid account of his personal struggle with depression. Although best known for his roles in The Matrix, Memento, and the televisions series “The Sopranos,” Pantoliano is an activist, working to raise social awareness and understanding of mental health through a non-profit organization that he created to encourage members of the entertainment industry to help educate the public about mental illness. “We know this is a tough fight,” says Pantoliano. “We know years of ingrained socialization causes people to recoil or isolate anyone with the scarlet letter of mental illness…. However, we also know that by releasing the talents of those with mental illness—by giving them the opportunity to use their outstanding artistic and intellectual skills—we will vastly improve the world. And this is a cause worth supporting” (http://nkm2.org/about-us/).

In your practice, is stigma affecting your clients? How do you help clients to cope with stigma, and what resources have you found to be most useful? We want to hear from you, so post your comments and let’s start the conversation!
While federal and state mental health parity laws have seemingly made access to mental health services easier for individuals, a new study released in the April issue of Psychiatric Services, the journal of the American Psychiatric Association, says that many of those surveyed were not aware of their extended benefits.

Researchers studied the results of Timothy’s Law, New York’s state mental health parity law, by conducting telephone interviews with 54 employed individuals who had private insurance. Of the 54 respondents, 32 were adults diagnosed with mental illness and 22 were parents of children diagnosed with mental illness.

Most of those surveyed had been informed of their insurance coverage benefits before the state parity law went into effect in 2007, but were not aware of the extended coverage as a result of the law. Individuals also reported that their health plan provided unclear or incomplete information about their benefits, they had more difficulty obtaining information on mental health benefits than on medical/surgical benefits, and they felt their insurance companies were managing their mental health care benefits more aggressively than their medical/surgical benefits.

Those surveyed also reported difficulty finding a high-quality mental health care provider in their network as well as problems with health plan provider lists, such as outdated provider lists and long waits for appointments.

Forty-nine states have passed mental health parity legislation. What can be done in other states to educate individuals on their mental health benefits? What do you know about your state’s benefits?

To read more about this study, click here.
Last week, 22-year-old James Durbin wowed the audience—as well as viewers all across the country—as his amazing voice and incredible performing style helped catapult him to the next round on the popular television program “American Idol.” Now among only seven finalists in the competition, Durbin seems unstoppable. Yet success has not come easily to this young Californian, who copes with the twin diagnoses of Asperger’s and Tourette’s disorders. Since his appearance on “American Idol,” Durbin has been very open about the effect of these two conditions on his life and his musical career.

Although awareness of Asperger’s disorder (a high-functioning form of autism) has grown in recent years, Tourette’s is less well known. According to the National Institutes of Health, Tourette’s is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The early symptoms are almost always noticed first in childhood, with the average onset between the ages of 7 and 10 years. Tourette’s occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics or transient tics of childhood. Although Tourette’s can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.

Durbin’s positive attitude and his success as a performer have made him a hero for many children with Tourette’s disorder. Durbin says that he loves hearing that people are inspired by his history of overcoming adversity. “It fuels me to do better and to push myself even further,” he told USA Today in a March 8 interview.

In the past, television and movies have often highlighted Coprolalia, a form of Tourette’s disorder in which patients curse or spit out racial epithets uncontrollably. In reality, only about ten percent of patients have this severe form of Tourette’s. With the media attention generated by performers like Durbin, some common misconceptions can be dispelled, and the public can see a person with Tourette’s who is talented, successful, and popular. Durbin summed it up on a recent episode of “American Idol” when he said, “I have Tourette’s and Asperger’s, but Tourette’s and Asperger’s don’t have me.”
Dr. Gerard Gioia was honored by the Children’s Miracle Network with the Children’s Miracle Achievement Award last week at the charity’s annual celebration in Orlando, Florida. Dr. Gioia was named as one of three caregivers of the year for his work and research on concussions.

Dr. Gioia is a pediatric neuropsychologist and chief of the division of pediatric neuropsychology at Children’s National Medical Center, the local Children’s Miracle Network hospital for the metropolitan Washington, DC area. Dr. Gioia’s work with the Safe Concussion Outcome, Recovery, and Education (SCORE) program centers on improving the way concussions in youth are treated as well as helping teachers, parents, coaches, and doctors to determine when it is safe for children to return to both school and play. Concussions make up between 80 and 90 percent of all brain injuries in the United States and account for more than 1,000,000 emergency room visits each year.

PAR congratulates Dr. Gioia on this achievement!


Dr. Gioia is coauthor of the Tasks of Executive Control™ (TEC™), the Behavior Rating Inventory of Executive Function® (BRIEF®), the Behavior Rating Inventory of Executive Function®–Preschool Version (BRIEF®-P), the Behavior Rating Inventory of Executive Function®–Adult Version (BRIEF®-A), the Behavior Rating Inventory of Executive Function®–Self-Report Version (BRIEF®-SR), and related software products.