Depression – Can We Break the Social Taboo?

November 21, 2013

Depression – Can We Break the Social Taboo?

by Alexander Thornton

Even in today’s so-called enlightened times, sufferers from depression and other mental illnesses face the added burden of the stigma that attaches to their condition as well as ongoing discrimination. Sufferers experience isolation from family, friends and others and are excluded from everyday activities that most people consider normal. They find it harder to find and keep employment and their physical health is adversely affected.

Mental illness has historically been attributed to the effect of demons, character weakness or moral failing and sufferers in most societies have found themselves social outcasts. This means that vast numbers of people face rejection by society. According to the WHO (Fact Sheet No. 369 Oct 2012), depression affects more than 350 million people. Despite its prevalence, less than 50% of depression sufferers receive effective treatment due to lack of resources and trained health care providers. Also the social stigma attached to all mental disorders often prevents many from seeking treatment because they want to hide their problem.

Depression crosses all boundaries of race and nationality. The recently published findings of a study entitled “Burden of depressive disorders by country, sex, age and year: Findings from the global burden of disease study 2010” by researchers from the University of Queensland published on the PLOS Medicine website show that North Africa and the Middle East have the highest rates while the lowest rates are in East Asia, Australasia and South East Asia. The researchers acknowledge, however, that their findings are likely to be heavily influenced by local taboos and access to services: diagnosis rates are probably higher in the West while rates in east Asia, for example, will be lower.

In 2009 Time to Change, a programme in England partly funded by the Department of Health, reported that some 92% of people in Britain believed that admitting to suffering from a mental health problem would harm their careers while 56% would not employ someone with a history of mental illness, despite the provisions of the Disability Discrimination Act (1995). It is this type of attitude that causes people to hide their problem and so avoid seeking treatment.

More recently, researchers examined perceptions of depression in 35 countries around the world, producing a report entitled “Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey.” (Lancet, Vol. 381 Issue 9860. 5 January 2013). The findings are disturbing. Of the sufferers interviewed:

  • 79% reported experiencing at least one form of discrimination.
  • 37% had avoided initiating close personal relationships.
  • 25% had avoided applying for work.
  • 20% had avoided applying for education or training.
  • Experienced discrimination was lower among those who disclosed a diagnosis of depression than those who did not.
  • Nearly half of those who anticipated discrimination had not previously experienced it.

Many nations are making a concerted effort to change the perception of depression with a view to breaking down the taboos and removing the stigma, so that sufferers are more willing to access treatment and to reduce discrimination.  In April 2012, for example, Time to Change began a pilot project in the West Midlands designed to change the attitudes of young people (aged between 14 and 18) towards mental illness. In the 18 months since its inception the initiative has seen a 1.3% improvement in attitude and a 6% reduction in discrimination. The project has now been extended to the South East.

Among others in Britain, Depression Alliance runs regular campaigns to raise awareness and reduce discrimination while Mind is a mental health charity in England and Wales that works to improve the lives of those with mental illness.

In the United States a Mental Health Anti Stigma Campaign is just one of many intended to clear up misconceptions about mental illness. Meanwhile, in New Zealand former All Black star John Kirwan is the face of a campaign to raise awareness and reduce the stigma attached to depression. A sufferer during his playing days, he is heavily involved in television advertising and has even written a book “All Blacks Don’t Cry” about his experiences.

Discrimination has long been part of the human psyche, but barriers are slowly being removed. As discrimination based on race, religion, sexual orientation and so on is increasingly frowned upon so, hopefully, sufferers from depression will gain acceptance and so be able to enjoy fuller lives with uninhibited access to the treatments that can help them so much. It will however, be a long, hard road to erase long held, deep-seated fears and attitudes.

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