Stigma: Part 2. How does stigma about schizophrenia affect people?

“When stigma is present, any individual belonging to a particular category, such as schizophrenia, is assumed to possess all of th enegative stereotypes associated with that category and is therfore feared, disliked, or avoided. (Mueser, K. and Gingerich, S. 2006, p. 431)


Stigma can be caused by people’s exposure to biased information. For example, though the number of people with schizophrenia who are violent is quite low, only slightly higher than the general population, there is an idea among the general public that most people with schizophrenia are extremely violent. This is in large part due to the disproportionate amount of news coverage and media (movies, etc.) stories of people with schizophrenia who are violent. There seems to be a tendency for people to try to distance themselves from frightening experiences, like “He was a heavy smoker, that’s why he got lung cancer. I’m different, I don’t smoke, so that won’t happen to me.” In relation to schizophrenia, they might think, “She has schizophrenia, no wonder she freaked out and attacked four cops. I don’t have schizophrenia, so that would never happen to me.” People cling to this difference, despite the real fact that many more people without schizophrenia are violent against police than people with the disorder.


The effects of stigma are profound, ranging from people refusing to hire someone or rent an apartment to a person with mental illness to people just plain avoiding them out of misplaced fear. Neighbors fight against a proposal to open a group home or halfway house in their area, people call the police on peaceful, well-behaving strangers, and news reports frequently equate mental illness with crime. Schizophrenia has some of the worst stigma of all the mental illnesses. An additional issue is self-stigma, in which a person incorporates stigmatized beliefs that they then apply to themselves. Self-stigma can result in a person’s refusal “to acknowledge having schizophrenia because he feels that to accept the label would be tantamount to admitting he is crazy, worthless, or has nothing to contribute to society” (Mueser, K. and Gingerich, S. 2006, p. 432) or in feelings of hopelessness and grief and giving up on goals and resigning themselves to a lesser life than they could achieve.


The tragedies of stigma include the decrease in the quality of life of people with schizphrenia and the loss of some of the wonderful things people with schizophrenia can bring to the world. I personally have had clients who came in intially dejected, self-hating, and passive, thinking they were the lowest of the low and couldn’t’ do anything. Many of them have since started working, building friendships and hobbies, and bringing joy to their families with their kindness. As I mentioned in the previous blog post, the news and movies discard this type of story as one that won’t sell, one that’s not worth mentioning. However, I feel it’s the most important type of story worth mentioning regarding people with schizophrenia, as it gives them hope and gives the rest of us the knowledge that these people matter and bring a lot of good to the world.


In the next part of this series of blog posts, we’ll take a look at what you and your family and friends can do in the battle to fight stigma.





Mueser, K. and Gingerich, S. (2006). The Complete Family Guide to Schizophrenia

Stigma: Part 1. We finally see a heroic main character with psychosis in a video game!


As the people who have been in my therapy groups will know, I am a video game player. So I was interested when one of my group members told me about a video game called Hellblade: Senua’s Sacrifice, a game in which the main character is portrayed as having psychosis, including hearing voices, seeing visions, having paranoia, and flashbacks. Intrigued, I read several reviews about how the game’s portrayal of psychosis was handled. (e.g. Distance, Critical, “Perspectives Differ on How ‘Hellblade’ Handles Mental Illness”,; Lacina, Dia, “What Hellblade: Senua’s Sacrifice Gets Wrong About Mental Illness”,; Lloyd, James, “How Hellblade: Senua’s Sacrifice Deals with Psychosis”, Not surprisingly, the reactions were mixed, with some people praising the game’s sensitivity and insightfulness and others finding the portrayal invalidating and hollow. However, the fact is, it’s rare to see a character with psychosis being a nuanced character who isn’t evil or pathetic. It’s even more rare to find a positive main character with psychosis, be it a movie, book, or video game. I can come up with a handful—the movie “The Soloist,” the movie “A Beautiful Mind,” and now, this video game. (An argument could also be made for “Benny and Joon,” and I’m sure there are some newer ones I’m missing, but you get the idea.) I’m not saying that these are realistic characters, or that they’re handled perfectly, I’m noting that the idea of treating a main character with psychosis as a real person, who is neither a villain nor a pathetic object of pity, is a relatively rare one. I’m encouraged by this development, while at the same time still disappointed by the flaws in portrayals of characters with psychosis and by the slow progress of awareness/understanding of these symptoms. The primary reason for this appears to be stigma against mental illness, especially against people with psychotic symptoms.Stigma. “People with schizophrenia and their families have to live with an extraordinary amount of stigma. Schizophrenia is the modern-day equivalent of leprosy, and in the general population the level of ignorance about schizophrenia is appalling.” (Torrey, 2013, p. 356) Serious mental illness is often seen as worse than physical or intellectual disabilities, and, more dishearteningly, the fault of the person with the illness. (Corrigan and Lundin, 2001, p. 15) Stigmas are stereotypes, and with mental illness, they almost always affect the people with the illness in a negative way. Researchers have found three broad categories of stigma against people with mental illness: that they are dangerous and should be kept out of our communities; that they are irresponsible and others should make decisions for them; and that they are incompetent and need to be cared for as if they were children. (Corrigan and Lundin, 2001, p. 20) I would add, that in the media, both news and entertainment, there is an erasure of positive, realistic portrayals of people with psychosis. The vast majority of people with psychosis that are covered in the news or portrayed in movie/book/video game stories are negative. I joke with my clients sometimes about how the news would never air a story like, “Local woman takes her meds, symptoms are stable, enjoys her job, going to her grandchildren’s sports events, and playing the piano.” These are many of the people with a psychotic disorder, but for the layperson, people with psychosis are all scary or incompetent. Fortunately, as the video game discussed above shows, the public is slowly starting to be aware of people with psychosis in a more realistic way. Flawed, sure, like any person, but not a one-dimensional caricature.
This series of blog posts aims to 1. take a close look at stigma and how it affects those with schizophrenia, their families, and the public at large, 2. Study how stigma hurts society, and 3. Examine how all of us can fight stigma and move forward in the progression of understanding and helping people with psychosis have enjoyable lives and bring as much positivity to the world as they can. We are early on in the journey, but when it occurs to large video game companies to try to present a hero with psychosis as the main character in the game, this gives me heart. We are moving forward.


Corrigan, Patrick, and Lundin, Robert. (2001). Don’t Call Me Nuts! Coping with the Stigma of Mental Illness. Champaign, Illinois. Abana Press.

Torrey, E. Fuller. (2013). Surviving Schizophrenia: a Family Manual. New York. HarperCollins Publishers.

The Science Museum of Minnesota Now Has a Mental Health Exhibit!


The Science Museum in St. Paul, Minnesota, in having this traveling exhibit show through January 2019, is aiming to #MakeItOk to talk about mental health. Mental health is often seen as an unimportant or “taboo” topic, something that should be avoided entirely. This has led to understandable but significant ignorance among people about what mental health and mental illness is, the effectiveness of treatment, and most importantly for people with schizophrenia-spectrum disorders, how “normal” people with these illnesses often are.


I attended the exhibit recently, and was very impressed by it. The most common mental health disorders all have displays, including schizophrenia. The information presented was clear, comprehensive, and understandable to people with any level of education or experience with mental illness. The exhibit does not shy away from the history of many of our horrific ways of treating mental illness, and highlights current treatments and how consumers experience them. There are also interactive exhibits, like the one where you can try to do some math puzzles while speakers play taunting voices from several different directions, mimicking the experience of hearing voices. Other exhibits involve a warped mirror to help one experience Body Dysmorphic Disorder (having an unrealistically negative view of one’s body) and writing down one’s worries and shredding them. I especially liked the booths running videos of interviews with people with various mental health disorders. The people in the videos talked about their experiences with their symptoms before they got treatment, how those symptoms changed after getting treatment, and about their lives since treatment, in general and about how they’re coping. These videos presented the interviewees as regular people, not as “mental patients,” and showed the real human side of people struggling with and managing mental illness.


I’ve had some clients attend this exhibit, and heard positive things from them as well. They found it was accurate, easy to comprehend, and most importantly, treated people with mental illness with dignity and respect. In addition, in order to encourage lower-income people to attend, the Science Museum offers a reduced-price ($3.00) admission ticket if one can present evidence of being lower-income (GA/MA/EBT/SSI/SSDI card). I would highly recommend this exhibit to anyone. I hope it continues to travel around the U.S., exhibits like these are so beneficial. Check it out!

Ways to Learn More About Schizophrenia

girl-3195810_1920Once someone hears the word “schizophrenia” from a doctor as a possible diagnosis, they and/or their family often want to learn as much as possible about the illness. Which is wise, since there is significant misinformation and misunderstanding of schizophrenia. Over the years, I’ve compiled a list of various ways you can learn more.

General Resources: Offers some very specific advice not always found in other guides. A very comprehensive guide, addresses all the typical information plus issues like debt, depression, and mental health care for people who are caregivers of a person with schizophrenia.  A helpful online booklet about schizophrenia in printable form. Another helpful online booklet, has a PDF you can download. Personal stories by family members about what they saw happening to their loved one as they began to develop schizophrenia and what they recommend if you think you or one of your loved ones may be developing the illness.

  • Free information: NAMI has brochures and fact sheets on the illnesses, adult mental health system, data practices laws, dealing – with a crisis and understanding the criminal justice system.
  • Classes:  NAMI has classes and programs that may be of interest to the families of your clients. Hope for Recovery, Family-to-Family, and Children’s Challenging Behaviors.
  • Support Groups: NAMI has support groups for families and for persons living with a mental illness.
  • Help Line: NAMI provides information on locating resources and navigating the mental health system.
  • Educational Conferences: NAMI hosts educational conferences with great speakers and information for providers, families and persons with a mental illness.
    • Special Topics: NAMI holds workshops on retaining custody when seeking residential services for a child, Evidence-Based Practices (EBP), and dealing with a crisis.

Hope For Recovery Workshops (held Saturdays from 9:00 to 3:00 unless noted; call NAMI-MN, 651-645-2948.)


Resources for Families:

Forums for family members of people with schizophrenia to talk to each other about how to help their loved ones or get support and advice


Blogs written by people with schizophrenia disorders

Vlogs on YouTube by people with schizophrenia disorders

  • Rachel Withers


Resources for people with schizophrenia:

Forums where people with schizophrenia talk to each other online


Books about Schizophrenia:

The Complete Family Guide to Schizophrenia: Helping Your Loved One Get the Most Out of Life, by Kim T. Mueser, PhD and Susan Gingerich, MSW, 2006, The Guilford Press—a very thorough, practical, and easy-to-read guide, highly recommended

I Am Not Sick, I Don’t Need Help! Helping the Seriously Mentally Ill Accept Treatment: A practical guide for families and therapists, by Xavier Amador, 2011, Vida Press

Surviving Schizophrenia: A Manual for Families, Patients, and Providers, by E. Fuller Torrey, M.D., 5th edition copyright 2006, HarperCollins Publishers–an excellent resource, covers the nature, causes, symptoms, and treatment of schizophrenia, as well as how people and their families survive this illness

Diagnosis Schizophrenia: A Comprehensive Resource, by Rachel Miller and Susan E. Mason, 2002 Columbia University Press–a great resource, includes many first-person accounts by people with schizophrenia, as well as chapters by professionals on a wide range of issues from hospitalization to rehabilitation

The Everything Health Guide to Schizophrenia, by Dean Haycock, 2009, Adams Media–an excellent resource with straightforward and easy to understand explanations

The Center Cannot Hold: My Journey Through Madness, by Elyn R. Saks, 2007, Hyperion Books–an excellent memoir about living with schizophrenia


National Resources for Schizophrenia/Mental Illness:

American Psychiatric Association

1000 Wilson Blvd, Suite 1825

Arlington, VA  22209



Mental Health America (formerly NMHA)

2000 N.  Beauregard St.

6th Floor

Alexandria, VA  22311

1-800-969-NMHA (6642)


National Alliance for Research on Schizophrenia and Depression (NARSAD)

60 Cutter Mill Road, suite 404

Great Neck, NY  11021



National Institute of Mental Health (NIMH)

Public Information Branch

6001 Executive Boulevard, Room 8184, MSC 9663

Bethesda, MD  20892

Early Psychosis: Learning to Recognize Psychosis Early On and What to Do About It

For schizophrenia, symptoms like psychosis can often start in the mid-to-late teen years. Sometimes no one realizes that the person is having psychosis, which means they don’t get treatment as quickly.

For several years now, one focus in schizophrenia research and treatment has been identifying and treating people with psychosis (and possibly schizophrenia) early on in the course of their illness. It is thought that, in general, the earlier a person gets treatment, the better they will do overall. (JAMA. 2013;310(7):689-690. doi:10.1001/jama.2013.8804)

There are a lot of signs that sometimes point to someone starting to have psychosis, including sudden drop in school or work performance, trouble concentrating, not trusting others all of a sudden, not taking care of appearance or hygiene like they used to, having strong, inappropriate emotions or no emotions at all, and spending way more time alone than is typical for the person. However, these signs can also just be signs of typical teen/young adult behavior, or signs of other issues (other mental illness, drug and alcohol abuse), so it’s critical to get the opinion of a professional, preferably a mental health professional with some experience with people with psychosis.

Recently, the National Alliance on Mental Illness (NAMI), a nationwide non-profit organization, posted a thorough article on how to identify psychosis early on, what it is, what you can do, helping people with psychosis get the help they need, and working with school staff to work with the person with early psychosis. They include how to recognize early signs of psychosis, different treatments, therapies, resources, and support programs for people with the psychosis and for their families.

Sometimes, a person who’s beginning to have psychosis may not understand that they have psychosis, or may not want to get help. Here is a helpful tip sheet posted in the NAMI article above that addresses ways to engage a person in treatment and things to avoid.

For information about your local NAMI chapter, look on their national webpage for a search window based on what state you live in (halfway down the page, on the left), or call their national hotline at 800-950-6264.

Here in Minnesota, there is a Youth Psychosis program at the University of Minnesota, which provides consultation with psychiatrists about medications, therapy, school consultations, and education with the family of the person with psychosis. For questions or to set up an appointment, call 612.273.8710.

The group I run, called Living with Schizophrenia, can accept people new to the disorder as well, but the focus is not specifically on early psychosis, but rather on skills and support for people at any stage of the illness. However, I do have a packet of information about schizophrenia and related illnesses as well as about how to access available resources in the Twin Cities. Contact me for a copy of the packet if you’d like one.