APHA Annual Meeting Reflection by L. Courtien

My Reflection on the APHAAnnual Meeting by Linda Courtien, MPH ‘17

Mental health and the burden of mental illness are public health topics warranting comprehensive research and attention.  In the United States, an estimated 43.6 million adults (aged 18 or older) suffered with a mental illness in 2014.  Mental illness is a condition that does not discriminate against age, race, gender, education, geographical location or creed.  However, our interpretation of mental illness as well as our resources to recovery can make all the difference in improved mental health outcomes.  

The American Public Health Association (APHA) Annual Meeting offered many sessions surrounding the area of mental illness.  I had the opportunity to attend a session titled, “Multiple Stigmas: The co-occurrence of stigma associated with mental illness and limited literacy”.  The purpose of this session was to explore and discuss that individuals seeking mental health services may be struggling to conceal limited literacy as well as the presence of mental illness, and how this impacts their lives and ability to recover.  The researchers worked with a total of 250 participants and gathered data via medical records, standardized reading level assessment and in-depth qualitative interviews.  Interview questions focused on experiences of stigma and discrimination related to limited literacy, mental illness and mental health service use.

Analysis of this data revealed four main themes: experience of stigma, institutional contexts of stigma, concealment and exclusion.  Researchers determined that people with mental illness feel that mental health stigma is considered to be omnipresent. One participant in the study reported, “You might not notice it (mental illness stigma) but it is always there.”  Researchers uncovered a common theme of medical providers not fully understanding both mental illness and limited literacy, leading to participants feeling a “negative reaction” from these providers. This negative reaction is not just from medical providers, but from other community and family members as well.  To reduce this negative reaction from others, participants reported that reducing social circles and living in isolation reduced the instances of feeling judged by others and further “dehumanized”.  Unfortunately, the option to isolate and conceal takes a toll in the individual’s social connections, well-being and opportunity.

So where do we go from here?  Fortunately, mental illness stigma is a problem that is being researched, openly discussed and addressed by organizations such as APHA, National Alliance on Mental Illness (NAMI) and the United States Surgeon General.  This presentation brought something valuable to the mental health field by discussing how additional barriers, such as literacy stigma, can even further reduce service utilization and recovery.  Ultimately, continued awareness and the implementation of strategies to overcome the aforementioned barriers is crucial to improving the lives of the mentally ill.