Philosophy Discussion Forums | A Humans-Only Club for Open-Minded Discussion & Debate

[JackDaydream]

In raising the topic I am thinking of the role plays in the development of mental illness and, likewise the stigma of mental illness as a source for prejudice and harassment. My own working definition of bullying is that it is forms of intimidation, including both physical violence as well as verbal abuse, as well as forms of prejudice. I have put this in the ethics section because an underlying question is the idea of its wrongfulness and why is it wrong?

The issue of bullying as a source of mental illness may involve the way in which it is a form of trauma. It may be a core basis for 'wounding', especially in childhood, alongside childhood sexual abuse. Also, in adulthood, the experience of bullying, such as bullying at work is a source for stress and people becoming unwell at work.

In his book, 'Stigma', Erving Goffman spoke of aspects of a person's presentation can lead to overall assumptions, especially prejudice. These include aspects of one's physical appearance and other factors in which features or characteristics become overriding ones in the way a person is perceived and treated.

I am thinking that the current current cultural backlash against 'tolerance' involves stigma and a rise in the current trend to bullying, whether it is for being a Jew, disabilities or mental illness. In this thread topic, I am thinking of the particular discrimination against those who are diagnosed or perceived as mentally ill. It can lead to outright discrimination and marginalisation, or underlying ideas of fear. For example, stereotypes depicted in the news of schizophrenia have been a problem historically in leading to such people being shunned.

There has been a lot of demystification of ideas of 'mental illness'. In mental health care there have been moves towards the value of 'user' involvement in services, including employing such people in mental health care. However, to what extent is there still a lot of prejudice and bullying of those perceived as having 'mental health problems'?

[Pattern-chaser]

However, to what extent is there still a lot of prejudice and bullying of those perceived as having 'mental health problems'?

Bullying is a perennial issue. It's been around seemingly forever. It is a form of assault or violence, though its proponents will often dispute this. They often claim that the victims of bullying should 'toughen up'. And maybe they're right (although I personally don't think they are; I think they're 'victim-blaming' to deflect responsibility/shame for their own bullying-violence).

But bullying does harm, and there are some in our communities who are not robust enough to tolerate it without suffering, as you say. I am surprised that this observation, supported as it is by empirical evidence, is not enough to stop all bullying, forever. But that's just me. Others seem to take a more indifferent view.

[JackDaydream]

However, to what extent is there still a lot of prejudice and bullying of those perceived as having 'mental health problems'?

Bullying is a perennial issue. It's been around seemingly forever. It is a form of assault or violence, though its proponents will often dispute this. They often claim that the victims of bullying should 'toughen up'. And maybe they're right (although I personally don't think they are; I think they're 'victim-blaming' to deflect responsibility/shame for their own bullying-violence).

But bullying does harm, and there are some in our communities who are not robust enough to tolerate it without suffering, as you say. I am surprised that this observation, supported as it is by empirical evidence, is not enough to stop all bullying, forever. But that's just me. Others seem to take a more indifferent view.

I don't know if it was related subconsciously to my thread but I just had someone try to beat me up on a bus, throwing my glasses on the ground. I am not hurt and have managed to get home. It felt like an 'attack' and I am wondering if I should report it to the police, but it may appear vague. I don't know why a man was aggressive towards me on the bus and this may be the problem of understandibg bullying and, even the way in which it may be dismissed. Sometimes, it may be subtle as opposed to physical, which is why I wonder if someone pushing and pulling me was a consequence of me writing this thread topic.

[JackDaydream]

However, to what extent is there still a lot of prejudice and bullying of those perceived as having 'mental health problems'?

Bullying is a perennial issue. It's been around seemingly forever. It is a form of assault or violence, though its proponents will often dispute this. They often claim that the victims of bullying should 'toughen up'. And maybe they're right (although I personally don't think they are; I think they're 'victim-blaming' to deflect responsibility/shame for their own bullying-violence).

But bullying does harm, and there are some in our communities who are not robust enough to tolerate it without suffering, as you say. I am surprised that this observation, supported as it is by empirical evidence, is not enough to stop all bullying, forever. But that's just me. Others seem to take a more indifferent view.

Beyond the experience I spoke of earlier, when you say that some take an 'indifferent view', I wonder if this involves bullying seeming justifiable as an aspect of the sentiments of the herd. The harm of psychological, rather than mere physical bullying, may be overlooked and dismissed by some as being psychological. It is possible that even a thread on bullying may be seen as trivial, and beyond the interest and scope of philosophical concern.

[Lagayascienza]

Bullying: To What Extent is it a Trigger for Mental Illness and Mental Illness a Source of Prejudice?

I’ll break this down into two stand-alone questions:

1. Can bullying trigger mental illness?
2. Is there prejudice against the mentally ill?

I’d say the answer to both of these question would be Yes.

On the first question, I have looked at a couple of studies that indicate that there is a connection between bullying and mental illness. And, interestingly, the connection seems to be strongest in those who are both bullied and who also bully others.

On the question of whether there is discrimination against the mentally ill, the couple of studies I have looked at indicate that there is. I don’t know, but I suspect, that bullies may be attracted to people with mental health problems because a person suffering from a mental illness may be quiet and withdrawn and so bullies may see them as easy targets.

I doubt your recent experience of aggression on the bus is the result of you starting this thread. How would anyone who read what you wrote know who you are and where to find you? And what you wrote was not offensive so I doubt it would have prompted anger against you.

[JackDaydream]

Bullying: To What Extent is it a Trigger for Mental Illness and Mental Illness a Source of Prejudice?

I’ll break this down into two stand-alone questions:

1. Can bullying trigger mental illness?
2. Is there prejudice against the mentally ill?

I’d say the answer to both of these question would be Yes.

On the first question, I have looked at a couple of studies that indicate that there is a connection between bullying and mental illness. And, interestingly, the connection seems to be strongest in those who are both bullied and who also bully others.

On the question of whether there is discrimination against the mentally ill, the couple of studies I have looked at indicate that there is. I don’t know, but I suspect, that bullies may be attracted to people with mental health problems because a person suffering from a mental illness may be quiet and withdrawn and so bullies may see them as easy targets.

I doubt your recent experience of aggression on the bus is the result of you starting this thread. How would anyone who read what you wrote know who you are and where to find you? And what you wrote was not offensive so I doubt it would have prompted anger against you.

When I said that my experience on the bus may have been experienced as a result of me writing this thread, I did not mean a direct effect, because it is not known beyond the site. I meant more of an aspect of my own subconscious life and its role in the attraction of experiences.

Your break down of analysis of my thread question is useful, because it may be that my question will appear confusing. What I would say is that I think bullying is becoming seen as more justifiable, especially towards the mentally ill.

I have worked in mental health care but also experience depression and do feel that in many ways receive prejudice on that basis, especially in seeking employment.

I am looking for work because in the UK there is now a policy that no one should be written off as sick on such a basis. However, probably because I have gaps in my CV I find it almost impossible to find work. Despite the emphasis that people with depression are meant to be able to work full-time, I got an interview for a voluntary job in a charity shop and felt discriminated against. That is because the person interviewing me asked if I had an occupational health certificate to prove that I was fit for work as I hadn't worked for 3 years. I explained that I was not under any occupational health services as I didn't have a job. It is almost a week ago since the interview and I have not had heard from the charity, so it is likely that I am rejected.

Generally, from what I see the mentally ill are becoming marginalised increasingly. Some gain support but others are just ignored and in England so many people who are homeless, sleeping on the street may have underlying mental health issues. But, in a competitive and brutal society, unless people have some kind of supportive network, many are excluded. If anything, those who are seen as having a risk to others may be the ones who have better service provision than others who suffer alone.

[Lagayascienza]

Depression sucks! I know. It sucks the color out of the world and makes it difficult to do anything. Depression is hard even if one has adequate financial resources and I cannot imagine how difficult it is for those who don't. I imagine that, for those with schizophrenia and other disorders, it is equally difficult. I think you are correct in saying that those who are seen as being a risk to others may be the ones who have better service provision than others who suffer alone. Mental health should be more about prevention, maintenance and management rather than just about dealing with those in crisis.

The closure of state run mental hospitals in the late 20th Century in the UK, Australia and other western countries saved a heap of money for governments but made things doubly difficult for people with mental health issues. They face discrimination, marginalization, find it difficult to access treatment and find work, and they are often poorly housed or on the streets where they face real danger on a daily basis.

There were problems with the old government run psychiatric institutions, but the large scale closure of hospitals, euphemistically termed "deinstitutionalization", has been a disaster.

I think governments should reopen some of them and, after providing appropriate training, employ more people in mental health who have experienced mental health problems but who are currently well. They could also be employed in outpatient services. Who could understand mental health issues better than those who have experienced them?

[JackDaydream]

Depression sucks! I know. It sucks the color out of the world and makes it difficult to do anything. Depression is hard even if one has adequate financial resources and I cannot imagine how difficult it is for those who don't. I imagine that, for those with schizophrenia and other disorders, it is equally difficult. I think you are correct in saying that those who are seen as being a risk to others may be the ones who have better service provision than others who suffer alone. Mental health should be more about prevention, maintenance and management rather than just about dealing with those in crisis.

The closure of state run mental hospitals in the late 20th Century in the UK, Australia and other western countries saved a heap of money for governments but made things doubly difficult for people with mental health issues. They face discrimination, marginalization, find it difficult to access treatment and find work, and they are often poorly housed or on the streets where they face real danger on a daily basis.

There were problems with the old government run psychiatric institutions, but the large scale closure of hospitals, euphemistically termed "deinstitutionalization", has been a disaster.

I think governments should reopen some of them and, after providing appropriate training, employ more people in mental health who have experienced mental health problems but who are currently well. They could also be employed in outpatient services. Who could understand mental health issues better than those who have experienced them?

Depression definitely sucks. It is widespread and often GPs hand out antidepressants routinely, as the 'quick fix' solution. There is often an approach of 'pull yourself together' as if it is that simple.
There is a lot of discrimination against the issue and I did just get an email to reject me for the charity shop job. I read recently that it is better not to disclose mental health problems at interviews and the only reason why I did was because I was asked about health problems outrightly.

In the UK there are still many psychiatric hospitals and I used to work in one. However, it is difficult to get admitted for depression unless one makes a severe suicide attempt. Some people are admitted for not being able to get out of bed, eat and drink or wash. However, that is usually dependent on family members' concerns. If a person lives alone it is fairly likely that it will not come to medical attention.

There is the possibility of therapy for depression but managing to access it can be difficult, as there are often long waiting lists. There is a move towards online therapy but it is questionable whether this is anywhere near equal to having a person to talk to. The online therapies are based on cognitive behavioral approach and do lend some basic ideas for coping with depression and one idea which I do find helpful is that of becoming one's own therapist, which may incorporate the philosophy of knowing oneself.

[Lagayascienza]

Yes, in the end, I think all people who recover from depression become, to some extent, their own best therapist. They remain at risk of depression but, through recovery, they learn skills that will help them to manage depression if it strikes again.

SSRI's help some people to a limited extent. ECT and TCMS can sometimes be effective, too. Online CBT can help people who are well enough to be able to think half straight. But often people are not that well and, when all else fails, they need to see a therapist in person or, if they are so bad they cannot look after themselves or even get out of bed, then they need hospital treatment.

Ideally, people with depression would not deteriorate to that extent before being able to access care. But it does often happen that people with depression are voluntarily or involuntarily taken into hospital care. And sometimes that is the best solution because, as well as getting treatment that can resolve the depression, they gain skills that will help them cope with future bouts so that they may not need hospitalisation in future.

The lucky ones are those who have heath insurance or who live in countries with universal health care. Without these, prospects are bleak.

[LuckyR]

There are definitely individuals who are more (and others who are less) vulnerable to personalizing the slings and arrows of life and therefore magnifying the negative impact of such events on their psyche.

In addition bullying, in my experience comes from two broad sources. One is to attack others to acquire some external benefit (power, money and other tangible benefits, prestige etc). The other is to acquire internal validation especially for the internally insecure. The schoolyard is known for the latter and the office is known for the former.

[JackDaydream]

Yes, in the end, I think all people who recover from depression become, to some extent, their own best therapist. They remain at risk of depression but, through recovery, they learn skills that will help them to manage depression if it strikes again.

SSRI's help some people to a limited extent. ECT and TCMS can sometimes be effective, too. Online CBT can help people who are well enough to be able to think half straight. But often people are not that well and, when all else fails, they need to see a therapist in person or, if they are so bad they cannot look after themselves or even get out of bed, then they need hospital treatment.

Ideally, people with depression would not deteriorate to that extent before being able to access care. But it does often happen that people with depression are voluntarily or involuntarily taken into hospital care. And sometimes that is the best solution because, as well as getting treatment that can resolve the depression, they gain skills that will help them cope with future bouts so that they may not need hospitalisation in future.

The lucky ones are those who have heath insurance or who live in countries with universal health care. Without these, prospects are bleak.

I would presume that you are in a country where you have to pay to be im hospital from what you are saying. In England, hospital admissions are not charged at present, but it is hard to know what is coming. There are attempts to prevent hospital admissions though. I do take SSRIs but have never been in hospital for depression. What I have found is that having requested antidepressants and had some recurrent depression when I stopped them of my own accord, doctors seem to wish me to continue with them almost indefinitely. I don't wish to have to take them for the rest of my life, although I do notice some definite benefits from them. They are like some form of armoury against the downs in life, and I seem to have more downs than ups.

Cognitive behavioral therapy does enable a certain amount of reframing. It is more focused on the present than psychodynamic, which often digs up the past. From what I have seen ECT seems to be more effective in older adults and is given less to younger people now. In the past, it was given more to younger people and the biggest problem seemed to be noticable memory loss.

[JackDaydream]

There are definitely individuals who are more (and others who are less) vulnerable to personalizing the slings and arrows of life and therefore magnifying the negative impact of such events on their psyche.

In addition bullying, in my experience comes from two broad sources. One is to attack others to acquire some external benefit (power, money and other tangible benefits, prestige etc). The other is to acquire internal validation especially for the internally insecure. The schoolyard is known for the latter and the office is known for the former.

To some extent, vulnerability to personalizing experience is a related to narcissistic wounding and underlying solidity. It involves childhood development and core personality structure. Cognitive behavioral therapy can help with going a bit beyond personalizing. However, there are likely to be limits and having a good social network may be a factor too. Being alone too much may be a recipe for rumination.

I would say that childhood and adult bullying are different to some extent. You are right to speak of the way in which a lot of adult bullying is for secondary gain, such as monetary ends and prestige.

I think that another aspect is its depth. I found that as a child the people who bullied me at times were friends with me later rather than lifelong enemies. However, with the bullying of adulthood it seems to have a more fixed foundation. I was rather shocked to discover a few years ago that I had so many enemies. Also, I have found that some people can be pleasant superficially may still resort to backstabbing.

Adolescence may be a critical time as well, especially due to the turmoil of identity. This may be so much worse with cyberbullying. There have been teenagers, and people of other age groups committing suicide due to the experience of cyberbullying, although it is likely that other forms of bullying may lead to the same response.

[Lagayascienza]

Yes, in the end, I think all people who recover from depression become, to some extent, their own best therapist. They remain at risk of depression but, through recovery, they learn skills that will help them to manage depression if it strikes again.

SSRI's help some people to a limited extent. ECT and TCMS can sometimes be effective, too. Online CBT can help people who are well enough to be able to think half straight. But often people are not that well and, when all else fails, they need to see a therapist in person or, if they are so bad they cannot look after themselves or even get out of bed, then they need hospital treatment.

Ideally, people with depression would not deteriorate to that extent before being able to access care. But it does often happen that people with depression are voluntarily or involuntarily taken into hospital care. And sometimes that is the best solution because, as well as getting treatment that can resolve the depression, they gain skills that will help them cope with future bouts so that they may not need hospitalisation in future.

The lucky ones are those who have heath insurance or who live in countries with universal health care. Without these, prospects are bleak.

I would presume that you are in a country where you have to pay to be im hospital from what you are saying. In England, hospital admissions are not charged at present, but it is hard to know what is coming. There are attempts to prevent hospital admissions though. I do take SSRIs but have never been in hospital for depression. What I have found is that having requested antidepressants and had some recurrent depression when I stopped them of my own accord, doctors seem to wish me to continue with them almost indefinitely. I don't wish to have to take them for the rest of my life, although I do notice some definite benefits from them. They are like some form of armoury against the downs in life, and I seem to have more downs than ups.

Cognitive behavioral therapy does enable a certain amount of reframing. It is more focused on the present than psychodynamic, which often digs up the past. From what I have seen ECT seems to be more effective in older adults and is given less to younger people now. In the past, it was given more to younger people and the biggest problem seemed to be noticable memory loss.

In Australia we do have universal health care (Medicare) which covers public hospital expenses. But for many so called "elective" procedures such as knee replacement surgery there are waiting lists years long. However, if you have private health insurance these procedures are readily available. However, many people cannot afford private health insurance.

The problem for people with mental illness in Australia is that the public mental health care system is inadequate and Medicare funded hospitalisation is only available for people in crisis - for example those experiencing psychosis or those with suicidal ideation. For people with less severe depression there are private hospitals but they are not covered by Medicare and so if you don't have private health insurance you are charged in the order of $1000 per day which is just not affordable for most people with depression. Most people with depression who are not sick enough to be hospitalised in the public system are referred to private psychiatrists or psychologists. This is expensive and only partly funded by Medicare so there are high out of pocket expenses for patients which many cannot afford. So those people get no help except perhaps a prescription for SSRIs from their GP.

I'm retired and have a reasonable private superannuation fund. I have to hope it lasts me until the end so I don't need to go on the aged pension. I'm lucky to have been able to keep up my private health insurance. I'd let a lot of things go before I let that go.

I imagine the situation is similar in the UK. Those who are wealthy can afford the best care and those who are poor don't and so will have poorer outcomes.

[JackDaydream]

Yes, in the end, I think all people who recover from depression become, to some extent, their own best therapist. They remain at risk of depression but, through recovery, they learn skills that will help them to manage depression if it strikes again.

SSRI's help some people to a limited extent. ECT and TCMS can sometimes be effective, too. Online CBT can help people who are well enough to be able to think half straight. But often people are not that well and, when all else fails, they need to see a therapist in person or, if they are so bad they cannot look after themselves or even get out of bed, then they need hospital treatment.

Ideally, people with depression would not deteriorate to that extent before being able to access care. But it does often happen that people with depression are voluntarily or involuntarily taken into hospital care. And sometimes that is the best solution because, as well as getting treatment that can resolve the depression, they gain skills that will help them cope with future bouts so that they may not need hospitalisation in future.

The lucky ones are those who have heath insurance or who live in countries with universal health care. Without these, prospects are bleak.

I would presume that you are in a country where you have to pay to be im hospital from what you are saying. In England, hospital admissions are not charged at present, but it is hard to know what is coming. There are attempts to prevent hospital admissions though. I do take SSRIs but have never been in hospital for depression. What I have found is that having requested antidepressants and had some recurrent depression when I stopped them of my own accord, doctors seem to wish me to continue with them almost indefinitely. I don't wish to have to take them for the rest of my life, although I do notice some definite benefits from them. They are like some form of armoury against the downs in life, and I seem to have more downs than ups.

Cognitive behavioral therapy does enable a certain amount of reframing. It is more focused on the present than psychodynamic, which often digs up the past. From what I have seen ECT seems to be more effective in older adults and is given less to younger people now. In the past, it was given more to younger people and the biggest problem seemed to be noticable memory loss.

In Australia we do have universal health care (Medicare) which covers public hospital expenses. But for many so called "elective" procedures such as knee replacement surgery there are waiting lists years long. However, if you have private health insurance these procedures are readily available. However, many people cannot afford private health insurance.

The problem for people with mental illness in Australia is that the public mental health care system is inadequate and Medicare funded hospitalisation is only available for people in crisis - for example those experiencing psychosis or those with suicidal ideation. For people with less severe depression there are private hospitals but they are not covered by Medicare and so if you don't have private health insurance you are charged in the order of $1000 per day which is just not affordable for most people with depression. Most people with depression who are not sick enough to be hospitalised in the public system are referred to private psychiatrists or psychologists. This is expensive and only partly funded by Medicare so there are high out of pocket expenses for patients which many cannot afford. So those people get no help except perhaps a prescription for SSRIs from their GP.

I'm retired and have a reasonable private superannuation fund. I have to hope it lasts me until the end so I don't need to go on the aged pension. I'm lucky to have been able to keep up my private health insurance. I'd let a lot of things go before I let that go.

I imagine the situation is similar in the UK. Those who are wealthy can afford the best care and those who are poor don't and so will have poorer outcomes.

It is interesting to know where you are based. England is in the similar situation of there not being adequate systems of care. Often, this means that the ones in crisis are the ones catered for, and others are left in the community, often struggling. The NHS in England is simply overwhelmed in so many respects and some wealthy people can go private, like popstars going into 'The Priory', which from what I have heard is a cross between a hospital and hotel for recuperation.

Mental health diagnoses seems to be on the rise. It is hard to know to what extent it is about people being more aware of such issues, or whether it is because life is becoming more stressful. The division between the wealthy and the poor, and the financial circumstances of life for many who struggling to meet basic, just as bullying can, may be a major factor in the development of mental illness. Life for many is brutal, as Hobbes suggested in his picture of human nature and life in the twentieth first century remains a competitive jungle in so many ways.