Stigma: Changing the Conversation and Changing Lives

Renee Binder, MD
APA President

I was reminded recently of the death of an acquaintance who was at the top of her career when she died suddenly after complications from surgery, according to her obituary. I later learned that she had died from suicide, possibly in response to her struggle with chronic pain and resulting depression. 

Stigma serves as a barrier to seeking treatment often because of fears of discrimination. A few years ago, a patient requested that I not keep any records and wanted to pay me in cash. He was concerned that if his psychiatric records were ever discovered, his career could be negatively impacted. Were this man’s concerns legitimate? In a more public incident Sen. Tom Eagleton was forced to withdraw as a candidate for vice president in 1972 after it became public that he had suffered from depression and undergone ECT (electroconvulsive therapy). 

According to the Merriam-Webster Dictionary, the definition of stigma is a set of negative and unfair beliefs that a society or group of people has about something; it is a mark of shame or discredit. 

How can we begin to address mental health stigma? Here are several ideas: We need courageous spokespersons who are willing to come forward and talk about mental health issues that they or their families are experiencing. Former Rep. Patrick Kennedy is one such champion. He has openly discussed his struggles with mental illness and substance abuse and how treatment has helped him lead a productive and rewarding life.
We can learn from the LGBT community and their struggles with stigma and negative stereotypes. They have taught us that “coming out” by public figures and celebrities can decrease stigma.


Another way of combating stigma is for my fellow mental health professions, psychiatrists and others, to take responsibility for examining the language that is used by the media and in our society. Words such as “lunatic,” “crazy person,” or “maniac” convey images of people who are out of control and dangerous rather than people who are experiencing a mental illness and deserve our compassion and support in getting effective treatments. 

Mental health professionals and others can take an active role in drawing attention to language and advocating for more appropriate, compassionate and less stigmatizing language. Mental health care is an essential part of health care. Almost everyone will suffer from a mental health problem at some point in his or her lifetime.. But for people to be willing to access the mental health care they need, we have to continue the fight against stigma.

If we are successful in addressing stigma, and we must be, then not only will we change the conversation, we will also change people’s lives and change the culture. We will finally reach the point where all of us can openly talk about someone’s death by suicide and encourage people with mental health problems to seek the help they need without fear of judgment or harmful repercussions.

By Renée Binder, M.D., APA President