Resolving mental illness stigma: should we seek recovery and equity instead of normalcy or solidarity?

I am grateful that the editorial by Professor Corrigan ¹ has raised highly important issues regarding discrimination against people with experience of mental illness like myself. I hope that I will be able to enhance this by adding a slightly different perspective on the problem, based on my own experience of stigma. In short, I would like to suggest that the concepts of ‘solidarity’ and ‘normalcy’ are not the most effective and appropriate ways to address the problem of discrimination.

From my point of view, the concept of ‘normalcy’ in approaching mental illness is very vague and does not reflect the real state of affairs. First, since there is a broad continuum between mental health and mental illness, the heuristic boundaries between normality and abnormality are very unclear and difficult to address with anti-stigma interventions. Second, seeing mental illness as like any other illnesses was described as one of the ‘lost paradigms’ of anti-stigma interventions. ² Indeed, the public is deeply aware that mental illnesses are not like any other and is not prepared to see them as a part of ‘normal’ experience, and therefore will hardly be able to accept us as the same.

The concept of ‘solidarity’ in tackling stigma is also controversial. Self-identification with mental illness (and with a group of people with mental illnesses) is a difficult endeavour, requiring a long journey through the personal narrative of illness ³ which may easily lead to depression in some circumstances. ⁴ The positive effect of identification with a group presented in the editorial by Corrigan is hardly applicable to mental health-related stigma: African–Americans and women are African–Americans and women throughout their whole lives. On the contrary, mental illness is not a lifelong disability, as ‘normal’ people often see it. ⁵ Mental illness often occurs only at a certain point in a person's life, and it can be coped with through recovery. Efforts can be directed towards obtaining quality of life equal to that of the rest of society, including a happy family life instead of isolation, properly paid work instead of social benefits, and enjoying comfortable accommodation instead of sheltered housing. Besides identifying with mental illness and searching for solidarity, it is crucial for people with mental illnesses to be able to identify themselves with mainstream society and to feel eligible for the same life opportunities.

Based on the aforementioned considerations, instead of searching for a better category (of ‘normalcy’ or ‘solidarity’) in approaching people with mental illnesses, I would rather welcome those initiatives focused on acceptance and equity that were absolutely necessary to me in breaking down my self-stigma and coming back to society. Fighting structural discrimination and searching for better access to life chances and equal opportunities, provision of appropriate patient-centred care and focus on full recovery would probably be more beneficial in terms of demonstrating the equity of people with mental illnesses and promoting their acceptance by other members of society.