Will Framing Mental Illnesses as Brain Disorders Reduce Stigma, or Make Things Worse?

I posted on Facebook about the director of the National Institute of Mental Health, Thomas Insel, pushing towards society referring to mental health disorders (also referred to as behavioral disorders) as “brain disorders” (you can see the video here: http://www.ted.com/talks/thomas_insel_toward_a_new_understanding_of_mental_illness). The question I posed after posting the video was, how do you think referring to mental illnesses as “brain disorders” will impact the stigma towards these conditions?

Thankfully, I found an answer. Patrick Corrigan, the king of stigma research, has already researched this topic and produced a paper, “At Issue: Stop the Stigma: Call Mental Illness a Brain Disease” (http://schizophreniabulletin.oxfordjournals.org/content/30/3/477.full.pdf). In the paper, he writes that explaining that mental illness is biological and genetic does reduce the public’s view that mental health conditions are the fault of the individuals with the condition. However, it has a reverse reaction as well: it causes people to believe that individuals with MI are then different than others, provokes a negative attitude towards these individuals, and reinforces stereotypes like the belief that people with mental illness are dangerous since the illness is “ingrained” in them and they are not able to control it.

Corrigan writes that psychosocial explanations for mental illness have decreased stigma, as it frames mental health conditions as “understandable reactions to life events,” such as child abuse, difficult life transitions, drug use, and trauma. However, we cannot just refer to mental illnesses as psychosocial, because not everyone who experiences a traumatic or life-changing event will develop a mental health condition—which could increase self-stigma, as one who develops mental illness might think they are weaker because they developed the illness when someone in similar circumstances did not.

The last issue is that while people can learn that mental health disorders are biological, genetic, and a reaction to life events, there is a lack of understanding that recovery is possible. To address this, Corrigan has shown that education about recovery, and even more powerful, contact with a person with mental illness, provides a balance to the public’s understanding: mental illness has biological and psychosocial components, recovery is possible, and there are numerous individuals with mental illness living successfully in recovery.

So what is the solution? Do we refer to mental illnesses as brain disorders?

Brain disorders will certainly be on my list of “words that mean mental illness that I can use so I don’t say mental illness 50 times in one post.” However, I don’t think we can switch over the term without teaching the public that recovery is possible and without more individuals in recovery coming out about their mental health challenges.

The debate on what term to use other than mental illness – mental health issue, mental health challenge, mental health disorder, behavioral health disorder, and more – shall continue. There will always be debate (and if anything, I’m happy there’s a variety of terms to choose from in my posts!), but what is most certain is that we need individuals with lived experience with mental health at the forefront of making that decision – and in collaboration with those who do not. 

“Nothing about us without us!”