Self-Reflection Surrounding Mental Health Psychopathology in Generalist Social Work Practice
An individual’s sense of right and wrong, normal and strange, are created by the experiences they internalize and integrate into their schemas. Often times, certain topics fail to be discussed or are painted in a negative light. Mental health and mental illness tends to fall in this category, especially because it is seen as taboo. By examining some of the events that have created our beliefs surrounding mental health and mental illness, we can explore our own personal biases. Critical self-reflection is imperative for providing the best treatment for those experiencing mental illness, but in order to do this, we must examine our own interactions with mental health.
From the time it started, I thought there was something wrong with me. Ambiguously, “it”, would later be diagnosed as Panic Disorder. Mental health was a foreign concept to me; therefore, it was through my own experiences that I began to gain a sense of understanding. Additionally, my parents did not understand, creating further distance in our already spotty relationship. When I would describe the sensation of “choking and losing control” my father would tell me that I need to “calm down” because I was doing this to myself. It is evident now, that my father had little experience with mental health. My parent’s experiences with mental illness, or lack thereof, formed the way I would think about myself and others with mental illnesses. The tension around this pushed me ignore the problem, hoping one day it would go away. This was hardly the case.
Things became worse. Not only was my mental health worse, but it began sabotaging my relationships and academic performance. In high school, my anxiety was still present, but now accompanied by depression. I would lay in bed each night thinking about how things would be better if I was just dead, wishing all the time I was just gone. My parents could not understand anxiety, so I was positive they would not understand depression. It would be nearly eleven years that I lived with untreated and undiagnosed mental illnesses, only being diagnosed when I went to UHS so that I would not have to use my parent’s insurance.
It is evident that the majority, if not all, of my beliefs and ideas around mental illness and mental health stem from my own experiences. The stigma attached to these disorders simply compounded the already poor relationship I had with my parents growing up. The thought was that if my parents could not see the problem, then it did not exist. This furthered the idea that people did not go to the doctor for mental health. I thought for a long time that mental illness was something people dealt with in private. At times, I thought that coming out with my mental illness would cause those close to me to label me as “crazy”. Those ideas changed over the course of my college experience. I became an activist for mental health by sharing my own experiences in both public and private platforms, and eventually with my parents. I began to pursue a profession where I could support individuals who have similar experiences to myself. My whole life, I just needed someone to look me in the eye, and tell me “mental health is real. You matter. Your mental health matters.” Now I do this, with my own clients, who need a little push to know they matter, too.
By working with women and children affected by substance use disorders and very serious mental health disorders, I have had to challenge some of my own beliefs. My own mental health issues were related to more common disorders; however, this is not true of all clients. Many clients that I work with have very serious co-occurring mental health disorders. I have struggled greatly with my own biases and stigma related to schizophrenia, because I have failed to actually educate myself on the disorder. I have thought about what individuals with schizophrenia experience. In the case of my first client with schizophrenia, I failed to see that a person’s conditions and diagnosis are not who they are. While this is not always the case, I can genuinely say that I have had judgmental thoughts and failed to put the person first. This is something I have actively been working on, especially by educating myself on commonly misunderstood and stigmatized mental illnesses like schizophrenia, bipolar disorder, and several personality disorders. I, too, have found myself expecting those who have mental illnesses to be and act a certain way based on the schemas I have created related to specific disorders. I know that stigma has played a large role in my mental health beliefs, as the information was obviously not from an accurate source. Much of my own schemas were produce from television, or even books that I read as a young adult. Television has a very specific agenda when it comes to depicting mental illness. It shows individuals as weak, less than, often times dangerous, or seen as “crazy”. I believe I also internalized much of this, and it affected the way I reacted to my own disorders and those of others.
It is evident that through the exploration of my own beliefs, I have stereotypes and negative biases around certain mental illnesses like the ones described above. This has been proven to be common among all types of health care providers. Specific mental illnesses hold more serious and damaging stigma and stereotypes than others. Some mental disorders are specifically seen as less favorable, like those related to personality disorders (Dooley 2018). I know that, I too, fall into this category due to my own ignorance around these mental health disorders. It is evident that disorders that are less understood tend to hold more stigma, which further perpetuates negative experiences for these individuals. I know that at times I have failed to separate a person from their diagnosis, and have worked greatly on being aware of this. I always try to remember that my mental illness does not define who I am, but still is part of my life. I try to use this same mentality when working with my clients, and always remember mental health is not a defining factor.
In order to reduce stigma, I work hard to create conversation around the topic. I have been extremely open with my family, hoping to educate them further on the importance of mental health. I have open and honest conversations with my parents, especially my father, who never quite grasped the concept of depression and anxiety. The stigma attached to even discussing mental illness has faded in my family, and I attribute that to my willingness to discuss stigma and how it not only affected me but how it continues to negatively impact individuals affected by these disorders. By talking about inaccurate stereotypes and providing factual evidence, I take a more educational approach to discussing mental health. This has been seen to decrease public stigma overall. In addition, the use of positivity to encourage empathy is important, in order to decrease negative emotions and beliefs related to stigma and stereotypes (Corrigan & Kosyluk, 2013). This combination has proven to be a powerful tool in both my personal and professional lives.
Being aware of my own biases is one of the most important things I can do as a social worker. I have begun educating myself more thoroughly on mental disorders that are commonly stigmatized or misrepresented by reading literature in both my free time and at my placement. I think the largest thing that I can do as a social worker, is empower each client I work with, by always using person first language and focusing on their strengths. Empowerment has been a central pillar of recovery, providing individuals the autonomy and control to create a positive experience throughout their recovery and after (Jacobson & Greenly, 2001). By using a strength-based approach, empowerment, autonomy and control can be attainable for clients.
It is evident that biases, stereotypes and stigma related to mental illnesses are created as a culmination of the experiences we have had. However, this is not to say that conscious and critical self-reflection cannot guide someone to further their understanding and beliefs on mental illness. By opening yourself up to explore the bias that one holds, we can further provide better care for clients and better understand the experiences we have had over the course of our lifetime. Stigma reduction is extremely important, especially when working as a social worker. This has to be one of the main goals for those providing mental health services, and critical self-reflection opens the door to this change, even if only on a micro level.
- Corrigan, P. & Kosyluk, K. (2014). Mental illness stigma: Types, constructs and vehicles for change. In P.W. Corrigan (Ed.), The stigma of disease and disability: Understanding causes and overcoming injustices. (p. 35-56).
- Dooley, J. (2018). Stigma. [PowerPoint Slides]. Retrieved from https://canvas.wisc.edu/courses/91749/files?preview=3532111
- Jacobson, N. and Greenely, D. (2001). What is recovery? A conceptual model and explication. Psychiatric Services, 52(4), 482- 485.