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Martin Cadwell

Outline stigma and stereotypes relating to mental health illness

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Edited by Martin Cadwell, Thursday, 10 Oct 2024, 06:06

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A scattering of evocative words that can be perceived to be arising from applying stigma, stereotypical perceptions and behaviour can easily offend someone. Usually, a person will be silently offended, but the wound is still injurious to their health. Expressions such as ‘wonky mental health’, ‘mental aberration’, or phrases such as, ‘Perhaps then, it is only myself that will see a ‘fixed mindset’ as being something that must be quickly shoved aside by those with a ‘growth mindset’, can always be considered to be indicative of contempt, dislike or misunderstanding and bigotry. Indeed, if I heard someone describe an individual as having wonky mental health I would be inclined to reflect on my own attitudes to persons with mental ill-health. Sometimes, though, there is a desire to illuminate precarious subject material in a less dark format. Perhaps, it is my own take on highlighting the prevalence of mental health by speaking in the vernacular.

Certainly, I do not need to write using any slang, idioms, colloquialisms, or with analogies and metaphors. Technical writing, with the exception of Wiley’s series of ‘…..for Dummies’ books, are particular in the prevalence of phrases and words that are colourful, descriptive, and thought-provoking. Many people will not study a STEM subject precisely because there is no fluid knowledge allowed in the subject text.

So, how does a person in a conversation with another person appeal to the other person except through the use of shared language, including expletives, when both persons are ultimately seeking approval? Of course, there are many people who are morally correct with coming across as self-serving or self-righteous. These people will have their own preferred group of friends and acquaintances and does not include individuals who have strong views on mental ill-health and the sufferers of mental-ill-health, and never the twain shall meet. Methinks, they do protest too much; you know, Smoke-fire; kettle, pot, black.

In passing, I told a psychiatrist that I have been tested as having an IQ of 130 and also tested to have an IQ of 70, and then went on to remind him that dogs have an IQ of 70, to which he replied that some dogs have a higher IQ than that. We know that the bell curve for Intelligence Quotient includes outliers that are quite distant from the average 100 (103 in latter years), so there is a tendency to rope all individuals with mental ill-health into a group as being intelligence-poor; ‘normal’ people as being those who watch television; take holidays abroad once a year for which they save up for; own a car; and expect to retire at the age specified by the Government of the time; while people with higher or lower than usual IQs are ‘weird’; ‘mavericks’; and ‘misfits’.

Clearly, there is a correlation between diminished mental acuity and detectable mental ill-health. Would we expect a depressed person who is contemplating their own permanent demise  to score highly in an IQ test at the time of their wish to stop thinking? Of course not. The person experiencing emotional distress will, of course, be distracted by their perceived situation, such that they will find concentration and focus on a task very difficult.

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It is fair to say then, that we all undergo differing degrees of mental acuity and this is due to the time of day, levels of energy, and degrees of our mental freedom. It is not a measure of my high IQ test that is relevant since it only realistically reflects that I was unaffected by ANY mental ill-health on the day and at that precise time. It is not a metric which should have any lasting impression on myself or anyone else.

In any case, we are what we eat and mental acuity is facilitated by a good diet, so none of us can accurately assess someone else’s mental capacity and capabilities without first knowing whether their physical and nutritional needs are being adequately met. The only real use of attaining a high level of intelligence quotient is that it acts as something that should be a reminder that it should not be marred by excessive living and works as a goad to force a better, and more considered, presentation of one’s aptitudes.

Misconceptions arise from inductive reasoning. which is most people’s preferred method of making some sense of their world, because they can use heuristics to speed up a decision. Stigma, which is a word most often used by people who present as being different to the ‘norm’ and is a perception of potential negative stereotypical behaviour towards them that applies to their difference. However, just like the words ‘skeptical’ and ‘dubious’ being misused (One can be skeptical about a dubious offer – one cannot be dubious about a skeptical offer – even when there is a skeptical offer from a skeptical person who has a dubious life-story). We should be clear that ‘a stigma is a mark of disgrace that sets a person apart from others’.

There is a common misconception: Individuals with mental health conditions are violent, cannot work or function properly in society because they are unpredictable and unreliable, and they will never get better. Another, people with mental health conditions are weak or have character flaws and these people are rare. In summary then, we should run them out of society and make them live on a remote island where they can fend for themselves or die trying (Oh, sorry, the last bit is the plot from ‘Lord of the Flies’)

There certainly is a valid correlation between occasions of mental ill-health and violence. Violence comes from an inability to adequately control one’s behaviour and exhibits itself as having a lack of clarity of vocal expression to satisfy the degree that the pugilistic person wants to use to hurt the other person. The actual misconception is that individuals with mental health conditions are inherently violent and have short tempers, so will attack even when they are unprovoked.

There is a valid correlation between individuals with permanent mental health conditions and a landscape of insufficient support and help. Also, similar to string theory, because there is an observance of a phenomenon, there is a corresponding effect on the observed element or entity. In simpler terms, but slightly distinct from that similarity, if people have knowledge that someone in their street is an alcoholic, will that alcoholic ever be able to shake off the stigma of being an alcoholic when they have not been intoxicated for decades, if they do not move home? That ex-alcoholic will be forced into a diminished mental state by vicarious influence, and not necessarily influenced by the thoughts that the alcoholic originally had.

‘Positive relationships make employees feel supported and generate an improved attitude towards the organisation and work. They will feel happier and have better mental health, which will make them more resilient in the face of problems and stressful situations both in the workplace and outside it. It will lead to fewer workplace absences and a happier, more productive workplace.’

There is a valid correlation between mental ill-health and weakness or character flaws. If negative stereotypical behaviour is directed towards an individual who is different, that individual will need support from a group of either, mental health workers, or a group of like-minded or similar people. Because we use the word ‘resilient’ as a descriptor of good mental health, when we perceive mental ill-health we use the antonym of the synonym to ‘resilient’. The opposite of strong (resilient) is weak. This can be explained away as not being a negatively stereotypical word as much as it is a lack of clarity of expression. What is the direct antonym to resilient, and why do we use ‘resilient’ to describe an aspect of good mental health, when we know that the working antonym is ‘weak’?

When a mental health condition is so apparent that it becomes a subject of interest to others there must be an attendant display of behaviour that has been perceived to be a correlation to the individual’s mental stability or health. We would be silly to think that in order to be predictable or reliable we must first have mental good health. We know that none of us are predictable and all of us are unreliable. Yet, it is also true that unpredictability and unreliable behaviour is one of the first indicators of mental ill-health when it is taken in the context of a work setting, otherwise the individual is entirely fit to continue in their work role and does not require immediate attention from support workers unless the individual is actually perceived to show other signs of distress, or volunteers such information.

People who exhibit mental ill-health or profess to suffer, or live with, mental ill-health are rare only because their mental ill-health has exacerbated to a detectable degree. Just imagine if the majority of people do present with detectable mental ill-health conditions that surpass the threshold that society places on adequate funtionality in the public environment; would you, like Wonko the Sane in Douglas Adams’ book ‘So long and thanks for all the fish’, consider that you were living in a asylum for mentally-ill people?

Despite there being an idea, that is quite widely promulgated, that one in four people will experience mental ill-health conditions at some point in their life; this is quite untrue. There are periods of extreme anxiety in all our lives at some point. When a loved one dies; only a heartless person (someone who is accepted to have a mental ill-health condition) would not grieve for the newly departed and that sense of loss remains; and who has not been distraught and inconsolably cried when our first love dumped us, and been ever affected by that into cautious love?

Since we know that the seven stages of grief are the contra-wise scale of mental ill-health to that of the Mental Health Continuum, we can be sure that the reason that we are not told that all of us will suffer from a mental health condition is because we are not strong enough to deal with this information; in other words – we lack resilience in the face of reality.

I don’t think it helps to promote the idea that three-quarters of the population are in, and will consistently remain in, a position in which they feel safe to judge one quarter of the population as being different, (for difference read inferior); because if there is a minority there is an outlier from the norm; and which civilisation in history correctly perceived their foreign controlling masters, who were in the minority, as being superior to themselves. Thanks, and a doff of the hat to the empires that subjugated nations, for that idea, and the proven concept that the majority will ultimately prevail unless they are suitably hobbled in their attempts.

But, that hobbling is to prevent anarchy. Perhaps, like getting the digital point in the wrong place for the content of iron in spinach, the actual truth is that one in four of us is experiencing mental ill-health at any given time.

So, these misconceptions that derive from heuristics and result in negative stereotyping when a stigma is encountered, are validated by being in the proverbial majority of ‘unfettered’ thinkers.

Finally, let me examine the misuse of the word ‘resilient’ when applying it to be something to aspire to, or be a metric of mental good health. A story of an Eastern mystic comes to mind. Stereo-typically, they give good advice. The mystic said that we should be like a sapling in a great wind; it bends with the wind and returns to its shape when the storm has passed. 'Do not be like the strong Oak tree', he went on, 'which is firm and stiff and breaks in the wind and cannot return to its shape when the storm has passed'.

We find that the sapling survives because it is malleable and the mature oak tree breaks because it is immutable in its nature. When we say ‘resilience’ we are egregiously conflating the nature of a sapling with a mature oak because we think they are both resilient to force, they are, but different types of force.

How have we drifted away from understanding that the expression ‘You can’t teach an old dog, new tricks’ means that a young dog’s thinking is mutable and an old dog’s thinking is immutable? Very small children are far better at recovering from emotional trauma than mature adults, because small children are resilient due to their mutability. Resilient to change, means immutable or inert. ‘Adaptable to change’ means mutable.

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Martin Cadwell

Helping with or without permission or assistance

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Edited by Martin Cadwell, Thursday, 10 Oct 2024, 06:11

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Return to work:

When people return to work from any kind of illness, there is a general conception that because the individual is back then they must be cured, or at least functional. However, someone in the organisation should make it their responsibility to welcome back the recently deteriorated person who has been restored to an acceptable level of capacity and capability to operate sufficiently in the work/learning environment. The newly rendered person needs to be updated with information that pertains to their responsibilities, changes in the work environment, its structure and policies, and any other details that may be considered to be initially confusing to the stripped-back individual. Customising of the individual needs to replace any details that were erroneously deleted during the recovery process while they were absent from the primary work operations they are to be assigned to. This may be a re-assignment in keeping with the level of deterioration and restoration of the individual that was previously required.


Like an old and restored car, if someone cannot pass an emissions test, it is best to make sure they are not in a room that does not allow the other workers to freely escape from. Vocal expressions from an individual, may not be quite finalised in their adjustment to a work environment that has been influenced by its conspicuous employees. An organisation should be aware that any new or absent employee will not be up to speed on conversation within a group and they should support the returning individual for a few days with conversation. Although not advisable for the self-respecting person, hiding in a toilet cubicle could assist an assigned supervisor or mentor in discovering whether the returning individual is soliloquising safely or quietly crying. Otherwise, monitoring could include conversations and an open-door policy for help. For the social media hungry people, asking to take selfies with them might make them feel either included or less weird than the mentor/supervisor making the requests. Social acceptance, however, does not yet allow sneaking around to gather information when one might actually be caught for it.


Define the term person-centred

A person-centred approach is directed attention on an individual, which takes an holistic method of application. This means that it is not just the results or outcome and its attendant difficulties of mental ill-health that are focused on. Rather, the whole of an individual’s life and current lifestyle is considered and there are drives into achieving positive changes in the individual’s life that are made to bring about a stable position which encompass personal security, sociability, work, and any other aspects of a person’s life. Advice on debt and finance is sometimes available.


Describe the importance of a person-centred approach for mental health

People feel that they are important and are thus self-centred (self-absorbed?). When mental health assistance is given with a person-centred approach the individual is given some control over their route to wellness. If they are dragged from their dwelling kicking and shouting and railing against mistreatment they will likely rebel against any indoctrination. However, if they are gently persuaded and given the opportunity to engage in mental reassignment they will embrace the concepts and new lifestyle as being through their own decisions and actions. 

Richard Thaler came up with ‘Nudge Theory’ some years ago. Nudge Theory is used by Governments to assist job-seekers to find their own way back into employment. Sometimes though, the reluctant job-seeker will find themselves on a mandatory program that extends from the DWP work coaches’ capacities yet gives the moaning job-seeker a chance to shape their job search and believe they have found a job to suit them.

A person-centred approach to mental health has the same result in satisfying the individual as to the degree of control they have over their mental health recovery and how to stabilise it to attain a plateau of wellness that can be reached through differing conduits while stopping and refreshing at different platforms along the route. It is important because the journey is a voluntary one that the individual, with a travel guide, can manipulate to suit their capacity to positively change.


Explain the importance of recognising one’s own responsibilities and limitations in relation to supporting the mental health of others

Managers with mental health training should follow the organisation’s policies for the reporting of mental ill-health and the support that should be given to the individual. This is important because any mishandling in this area can negatively impact on the individual, the position of the manager, and the organisation’s reputation. At this point, the manager has their own judgement and actions somewhat curtailed and a framework of assessment and action provides a guidance to the manager to alleviate the stress that the manager may experience on being responsible for support from their own, perhaps disjointed, approach. So, a good manager will have, in this way, realised the importance of recognising their own responsibilities and limitations.


Without a recognisance of limitations and an uneven or rugged approach to mental health support without following the organisation’s policies and procedures, respect and support of colleagues may be compromised and discrimination against individuals with mental ill-health may inadvertently occur. With this in mind (recognising one’s own responsibilities and limitations) it is important to know how to report a mental health issue in order that safeguards can be implemented and assistance from appropriate people and services can be sought and utilised.



Identify when it may be necessary to refer to others when supporting individuals with mental ill health. Include people you may refer to.


Without a recognisance of one’s own limitations and an uneven or rugged approach to mental health support without following the organisation’s policies and procedures, respect and support of colleagues may be compromised and discrimination against individuals with mental ill-health may inadvertently occur. With this in mind (recognising one’s own responsibilities and limitations) it is

important to know how to report a mental health issue in order that safeguards can be implemented and assistance from appropriate people and services can be sought and utilised.


Sometimes, mental ill-health has such control over an individual that psychosis will override the individual’s ‘normal’ perception of reality and will cause an individual to be unable to recognise their mental unruliness. In this case, this person would need to be persuaded to seek mental health adjustment services. Of course, this is not by injection, or by operant or classical conditioning (such as for Malcolm McDowell’s character in the film ‘A Clockwork Orange’, forced to watch gratuitous violence on a cinema screen while listening to music by Beethoven). 

This adjustment service is peopled with helpful and understanding persons. There is still, however, a mentality of ‘Keep Calm, and Carry on’ left over from wartime Britain in the 1940s that shrouds the prevalence of anxiety, stress, and other mental health issues. This is not helped by a sway among young people to move towards an attitude that has garnered the epithet ‘Snowflake’. Used in a derogatory way, it has, by dint of having a name, become a rallying point for people who are normally reasonable and fair-minded (a name being a shortcut or code for a whole person or concept). From which elevated position, a bit advanced from their normal resting position, they pour scorn on ‘weak’ people or people who perceive, rightly or wrongly, a bruised attitude in others. Hence. there is a concerted, though not necessarily co-ordinated, retreat from having mental ill-health brought up in a ‘normal’ conversation. By ‘normal’ I mean ‘safe’, or not complicated, such as not discussing religion and politics.


Referring someone to mental health services or persons may be the appropriate action where there is a failure in the individual to perceive their mental ill-health as treatable and especially when they seem to be a threat to themselves or others, notwithstanding that young people are in this group of people because they have unprotected sex, drink too much alcohol, and drive too fast.


Referral should be made when individuals present as psychotic and are not currently seeking mental health help or being seen by mental health persons, teams, or services; or are likely to harm themselves or others, including suicide (how can we know?); and doing something that could put someone else at risk through violence or aggression – but not, apparently, when they are drinking too much at a party, having unprotected sex with their friend’s girl/boy friend, and then driving home too fast full of bravado and high self-esteem that borders on delusional, with a subsequent drop into sorrow and anxiety the next morning when they remember what they did. (Sounds like this person should be arrested for being in possession of an offensive nature who is exhibiting three counts of self-harm, likely to endanger others through violent use of a car, and signs of a bi-polar mental health condition).


When to seek help in supporting an individual with mental ill-health largely depends on whether the manager or responding person is at work or is otherwise dealing with an employee of the organisation they work for. The organisation’s policies will guide the manager accordingly. Of course, if the manager encounters someone who does not work at their place or organisation they can ignore them and get on the nearest bus to escape – or just say ‘I don’t carry any change, sorry.’, or ‘While you are living under my roof you will do as I say. Get a job!’



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