Study of Stigmatization of People with Mental Illnesses among Young People

Statistics show ^{[1, 2, 3]} that the stigmatization of neurodifferent persons manifests itself in job refusals, often unjustified, in social isolation, avoidance and invasion of privacy (divorce, processing of personal data without a person's consent, forced hospitalization). In everyday life, there are often refusals from competent, in-depth diagnosis and timely therapy of mental disorders, in connection with which the problem worsens and leads to irreparable consequences (deterioration, isolation, in some cases suicide). In popular culture, stigmatization is also manifested in the activities of the media (including humorous TV shows ridiculing the problems of people with mental disorders, projecting false attitudes, turning a diagnosis into an insult, etc.). Inadequate patient care and rude attitude towards them were revealed in psychiatric clinics. Stigmatization reduces the self-esteem, sense of self-worth and motivation of people with mental illness. For this reason, people in need of serious qualified help often refuse it in fear of putting a stigma label, a social "stigma" of a mentally ill person, since there is an erroneous attitude in the mass consciousness: "It is a shame to turn to psychiatrists."

The problem is deepening, but it continues to be silent and multiply the number of personal and social tragedies.

The stigmatization of persons with mental disorders is not limited to particular cases of inappropriate behavior of the patient, which led to devastating consequences for society: even with absolutely typical behavior for a healthy person, an individual can be bullied if there is one fact of a mental disorder, which leads to situations when initially adapted in society psychiatric clinic patients are oppressed regardless of his actions, since the very name of the diagnosis can cause alertness and hostility in his environment. The attitude of society towards people with mental disorders has undergone changes with the change of historical epochs. In societies where religion played a decisive role, neurodifferent individuals were often associated with saints, with people with superpowers, they were called "blessed", in this case fear was intertwined with awe and awe. Madness was perceived in some societies as a gift from God, in others as devilish tricks, but in both cases it had a sacred basis. Over time, stigmatization began to take on an increasingly negative connotation. There is no need to talk about the dual nature of stigmatization in modern society: people with mental illnesses are perceived as undesirable social elements, they are sought to hide, at best - to ignore, at worst – to destroy. The category of persons with mental disabilities, despite the extraordinary attitude towards it, is actually part of the whole society, accordingly, requires a sociological study of its interaction with the social system, the consequences of this interaction and the attitude of society to this category.

The analysis of the attitude towards persons with mental illnesses among the representatives of the student environment in this case is important because of its professional potential, through which it will influence society and in many ways form public opinion as an intellectual elite. The attitude towards such people on the part of society as a whole largely depends on what attitudes students will broadcast on this issue, how, in their understanding, it is necessary to treat and interact with people with mental disorders. A number of areas of the university are directly related to psychology, sociology, pedagogy and social work, respectively, interaction with neurodifferent personalities in the future is quite likely in the work of students (kindergartens, schools, medical institutions, prisons, etc.). The strategy of working with them and the consequences of this work for society depend on their attitude to this category.

Theoretical aspects of the sociological study of the formation of the mechanism of stigmatization (mentally ill)Sociology considers mental health within the framework of social institutions and phenomena, it is appropriate to speak here not about a healthy and sick individual, but about society as a whole, together with its functions, dysfunctions and social pathologies.

First of all, let us recall the theory of Michel Foucault's disciplinary society ^[4]. It is important to note the work of psychiatric clinics here, their functioning is considered along with prisons. Like criminals, patients are taken into custody, isolated and monitored, appealing to the term "violent". Punishments in psychiatric hospitals were similar to prison ones, the so-called "punitive psychiatry" is considered by Foucault in the work "The History of Insanity in the Classical Era", when medicine turns into justice, and treatment into a measure of punishment. The patients were monitored as dangerous criminals, making them feel vulnerable and guilty of their illness all the time. If previously people with visible defects, for example, patients with leprosy or plague, were stigmatized, then in modern times similar measures are applied to people with mental disorders.

It is worth considering Irwin Hoffman's theory of stigma ^[5]. According to this theory, society forms ways of classifying individuals and identifies a set of properties and qualities that in this environment will be considered normal and natural, and which will not. It is worth noting that these attitudes are often subjective and relative, but are taken for granted by society.  Each society has its own criteria and may differ, but most are united by a first impression-based attitude towards an unfamiliar individual. Stigma can form already at this stage if an unhealthy member of society shows signs that are not accepted as normal in the team. Further, the stigma is fixed by appropriate actions and a label is already attached to the individual, which is almost impossible to get rid of, since the environment is already forming a so-called "virtual identity" - a complex of artificially constructed expectations. It is important to note that virtual identity often does not correspond to real social identity, but over time the boundary between them blurs, forcing the individual to adapt to the label attached to him. The danger of this phenomenon lies in the fact that a stigmatized individual, in the discourse of this work a person with a mental illness, is considered by society as "not quite a person", as something dangerous and unpredictable, which leads to unfair discrimination and a decrease in the quality of existence of such an individual in society. This tendency leads to the formation of an attitude that a mental disorder is an insult, a reason for neglect, avoidance and even attack. An individual can try to correct the defect in a timely manner (contact a specialist, suppress undesirable qualities in himself, as far as possible in his situation), in this case there is an effect of "victimization", when trying to improve the situation, a person encounters unqualified specialists, is deceived, etc., which in turn leads to a hit the individual in the role of victim, aggravation of the painful condition. There is also a hypercompensation scenario: the patient can find himself in certain areas of life, for example, in science or creativity, which will help him to rehabilitate himself in the eyes of society, improve self-esteem and attitude towards him. The worst case scenario implies an attempt by the stigmatized person to escape from reality in any way available to him, including destructive, which can eventually lead to tragedy. Hoffman uses the terms "own" and "understanding" to denote:

A) a category of positive-minded individuals, often with the same or similar stigma

B) people close to the individual who sympathize with his problem

Thus, these categories may try to convey to society the "cry for help" of a stigmatized person, but with the exception of interaction with the above groups, the integration of such an individual into society will continue to be difficult.

In considering this problem, it is also appropriate to rely on the theory of social pathology, which draws an analogy between the social and biological world. The focus of attention is the idea of a "healthy society". According to adherents of the concept of social pathology, a healthy society is a society of full-fledged individuals who are able to function adequately and harmoniously in this society. Social pathologies in this case are the consequences of the activities of defective individuals, as well as their groups. Thus, some defective cells multiply others, which is why unhealthy patterns of behavior in society are layered and consolidated, which leads to social problems. The ways to effectively solve this problem, according to the ideologists of the concept, are: either partial and complete isolation of defective individuals from society, or their competent rehabilitation with the help of various types of influence.

A number of theories of deviant behavior ^{[6, 7, 8, 9]} consider mental illness - a deviation from normal behavior as a consequence of the action of social barriers, in which an individual through his illness demonstrates a protest against the existing social framework. Since society functions through interactions between individuals and groups based on different expectations, when a member of such a society has a mental disorder known to society, a system of expectations is formed from him as a deviant, antisocial, dangerous behavior, which leads to a deepening of stigmatization. Receiving the label "psycho", the victim begins to adapt to the social stereotype. This phenomenon occurs at different levels, both in formal and informal social circles. Friends, family members and others can act as social agents who hang a label. Indirectly, the question of the causes of the phenomenon of deviant behavior is answered by Emile Durkheim's theory of anomie, ^[10] which contains the thesis that anomie is the moral instability of society and the lack of clear norms and frameworks of behavior is observed if, for some reason, the old world order has collapsed, and the new one has not yet been formed, social instability increases at times, it generates an increase in the number of deviations (in particular, suicides, which are largely the result of mental disorders caused by the precariousness of the situation in society) Thus, the concept of deviance is considered through the prism of a socially accepted normal model of behavior and the willingness of society to recognize a deviant from this norm as a deviant with all the ensuing consequences.

Analysis of research on the topic: interaction of the mentally ill with societyIn different historical epochs, society has considered deviation from different sides.

Through the religious paradigm, deviation from the norm was considered (and is considered) a sin, in the discourse of secular ethics, deviation is called a crime (in a milder form, a misdemeanor), and in medical circles it is considered a disease. Thus, the latter served as a prerequisite for the formation of such a term as the medicalization of deviance, which was introduced by representatives of the sociology of psychiatry J.Schneider ^{[11, p. 363]} and P.Conrad ^{[12, p. 264]}. This term implies the translation of moral, ethical and legal deviations into the plane of medicine. Researchers pay special attention to the interaction of mentally ill individuals with a healthy society. It has been found that such people are subjected to isolation and neglect, as well as various measures of influence in order to rid society of persons with mental pathology.

It makes sense to recall the work of P.I. Karpov "Creativity of the mentally ill and its impact on the development of science, art and technology."  It was found that a more sensitive attitude on the part of the medical staff of psychiatric clinics, an individual approach and goodwill significantly improve the patient's condition. Stimulating, rather than prohibiting, the self-expression of neurodifferent persons through creative activity contributes to productive communication for both actors: the condition of patients improves significantly, and employees replenish the practical base, thereby contributing to the development of the system of assistance to such people. It is known that mental disorders among scientists and artists are not uncommon. In his work, P.I. Karpov ^[13] considers such people as "engines of progress", a category ahead of its time, paying for it with mental health.

Thus, people with mental illnesses make a tremendous contribution to the study of human society in all its manifestations.

 The results of the study of the level of stigmatization of people with mental illness among young people (students)By interviewing the respondents corresponding to the sample (120 people) using a questionnaire method.

for a pilot study), and after analyzing the data, we obtained the following conclusions about the attitude of young people to people with mental disorders:

The first question was asked about how the respondents understand what mental health is. According to the WHO formulation, mental health is "a state of well–being in which a person can realize his own potential, withstand the usual stresses of life, work productively and fruitfully, and contribute to the life of his community."

The most common answer was "Brain condition" (33%), the second most popular definition of mental health was the absence of any mental pathologies (21%), followed by theses about adequate reactions to circumstances and inner well-being (14%), a small part of respondents considered that mental health implies inner harmony (8%) and only 2% of respondents considered that this is a certain set of psychological characteristics (both positive and negative). Thus, 22% of respondents turned out to be the closest to the above formulation, which indicates a low level of understanding of the phenomenon of mental health.

The next question was asked in order to find out whether the respondents were aware of the symptoms of mental disorders and how much detail, in their opinion. Results:

The overwhelming majority of students (61%) claim to know about any symptoms, but only in general terms, 20% have, in their opinion, detailed knowledge in this area. Almost a fifth (17%) have heard about it somewhere, but did not go into details and 2% do not know anything about the symptoms of mental disorders.

In question No. 3, respondents were asked to assess the degree of agreement with judgments about people with mental illnesses. For a visual demonstration, we have reflected the results of the answers in the following four illustrations:

When analyzing this question, it was revealed that only 27% of respondents are afraid of mentally ill people, 63% of respondents do not feel fear next to them. The thesis that neurodifferent people should be isolated from society is shared by 14% of respondents (those who answered "completely agree" and "rather agree"), the vast majority (97%) believe that mentally ill people need help and understanding, and 53% of respondents agree to help if possible. Regarding the judgment that neurodifferent persons are in many ways better than healthy ones, no categorical conclusions were found, 43% of respondents refrained from an exact answer, 37% of respondents are ready to challenge this judgment, and only 20% agree with this thesis. Almost 90% of respondents agree that there are no completely mentally healthy people at all. Most of them believe that too little attention is paid to the problems of the mentally ill in society. Almost all respondents (97%) believe that attention to mental health is as important as to physical health. A quarter of respondents would not like to be near a mentally ill person, and 52% disagree with this. It was also found out that the presence of a mental diagnosis, according to respondents, is, after all, not just a reason to attract attention (70%), 75% of respondents agree that mentally ill people are the same people as themselves. Almost the absolute majority (92%) are not ready to leave a person after learning about the presence of a mental disorder. Regarding the legal issue, the majority (75%) he also does not believe that mentally ill people should be restricted in their rights. The idea of the judgment "mental illness is easy to control, and those who do not do it simply do not try enough" was shared by only 7% of respondents, while the majority of respondents do not agree with this. Slightly more than half (58%) do not believe that all serious crimes are committed only by mentally ill people. It was also revealed that between the neighborhood with a former prisoner and a person with a serious mental disorder, 40% would choose the latter, and 50% found it difficult to draw any conclusion. Only 10% of respondents are ready to choose the first one.

In the fourth question, respondents needed to note the level of intensity of associations between adjectives and the concept of "mentally ill person" using a semantic differential scale.

It was noted that, on average, respondents tend to positively evaluate people with mental disorders in general and do not have much fear of such people.

The fifth question was asked in order to find out whether the interviewees had encountered neurodifferent personalities directly:About half of the respondents (52%) had such an experience.

Next, the impression of those who encountered mentally ill people was analyzed.

In the course of the study of the answers to this question, we come to the following conclusions: 57% of respondents had a positive impression of neurodifferent people. A fifth of the respondents treated them neutrally, or considered that the presence of a diagnosis is not the criterion by which one can form an opinion about a person as a whole, and 23% admitted that the impression was negative, in this case, fright, misunderstanding and the desire to stop any contact with a person were often mentioned.

40% of respondents had the opportunity to help people with mental disorders on their own, 5% did it only out of necessity, while they had no desire for it. They did not provide assistance, but 32% of respondents would like to do it. Almost a quarter of the respondents (23%) had neither the opportunity nor the desire to help. Thus, it can be concluded that about 63% are ready for real help to mentally ill people.

Next, we examined how the respondents assess the level of development of the mental health education system in our country.

During the analysis of the answers to this question, it was revealed that 82% of respondents (those who answered "almost undeveloped" and absolutely undeveloped" together) believe that at the moment there are problems with psychological education (awareness of mental health and diseases, methods of assistance and self-help), 10% believe that that it is developed, but with a few comments. Those who believe that there are no problems with psychological education, and it is fully developed, did not turn out.

The overwhelming majority of respondents (95%) believe that there is a problem of insufficient assistance to people with mental disorders in our country. Among the ways to improve attitudes towards people with mental disorders, the most correct, according to respondents, was to improve the entire system of medical care for such people.

The connection is built as follows: the medical system is improving => specialists in the field of psychiatry are being treated more and more often, as the condition improves => this type of help is becoming more popular and legitimate for society, as a result, the installation of the benefits and normality of seeking psychiatric help and discussing such problems is being strengthened in society itself. The next most popular method among respondents was a request for the introduction of special classes in educational institutions on mental health issues (29%), approximately equal parts of respondents indicated that it was important to popularize this topic in the media and the inclusion system for neurodifferent persons.

ConclusionIn the course of a direct study of the opinion of students of the Siberian Federal University by conducting a pilot study on people with mental disorders in order to analyze the level of stigmatization of such people in the youth environment , the following results were obtained:

There is a fairly high level of interest in the student society to the topic of mental health in general, a relatively loyal attitude towards neurodifferent individuals. For people who treat mentally ill people less loyally, the main motive for stigmatization is fear, fear due to the "unpredictability" of the behavior of people with severe mental disorders. It is also important to note that a significant part of the respondents claim that in Russia the level of mental education, the quality of medical care and the level of support for people with mental illnesses, measures aimed at integrating such people into society are not of sufficient quality.