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American Attitudes Toward Mental Illness

Throughout our history, a number of traditions and themes have developed in relation to American society. At times, these themes create a dynamic tension. For example, there is often a call for the federal government to tax less. However, in times of disaster, we expect the government to spend money to help our community. Such desires create a dynamic tension between different ideas and values.

There is also such a dynamic tension in relation to individuals with mental illness. This partly comes from our desire to take care of those who are not able to take care of themselves. Historically, in many countries from which Americans originally came, the king, queen, or government took care of those who could not care for themselves. However, there is also a tradition in America related to pioneers’ settlement of our vast lands. This is represented by the pioneer or cowboy spirit in which we support the individual’s right to do what he or she wants and to live the type of life desired.

As Americans, we have contradictory attitudes toward mental illness. In terms of treatment, 94% of Americans believe it can help people with mental illness lead normal lives. This might suggest that society would encourage treatment of mental illness and reduce any stigma around seeking help. However, it is estimated that only about 20% of those with a mental disorder actually sought help in the prior year. This may have resulted from embarrassment or an attempt to hide the condition from others. This leads to less treatment and may, in turn, affect work and life opportunities. The attempt to hide mental problems may also reflect a reality, as only around 60% of Americans believe that people are generally caring and sympathetic to people with mental illness.

The picture becomes more complicated when we realize that in any given year, about one fourth of all adult Americans have a mental disorder, including anxiety, depression, and substance abuse. Emotional problems and psychological distress are also experienced by those with chronic physical conditions such as arthritis, cancer, diabetes, and cardiovascular problems. Given the large number of individuals experiencing different types of emotional problems and psychological distress, you might expect that these conditions would be more accepted. However, stigma and negative attitudes toward mental illness are common in the United States.

The dynamic tension between taking care of others and being independent becomes clear when we see homeless individuals in our community who have a mental illness. This raises a number of questions. Can we take these individuals off the street if they don’t want to be taken to a shelter? If they do not want to take medication, can we force them to take it if this would help them function better in our community? Should it be the police or health care workers that work with these individuals? In the final chapter of this book, which focuses on legal and ethical issues and mental health, a number of these questions will be considered.

Thought Question: Who do you believe should take care of the mentally ill in American society?

Note: Data presented above are taken from Centers for Disease Control and Prevention (CDC) (2012).

How do our sensory, motor, emotional, and cognitive systems work together?

How do physiological processes influence our behavior and experience?

How do our neurons form networks?

In order to help focus their work, scientists often concentrate primarily on one of these levels of analysis. However, in this book I want to consider a more integrative approach that draws on a number of these levels. Further, you should not take any one of these levels of analysis as more important or truer than another. A similar plea was made by George Engel in 1977 when he helped to develop the biopsychosocial approach to understanding mental illness.

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