While the writer has presented different perspectives on the labelling of schizophrenia, the title and highlights imply that the validity of the diagnosis is questionable. The case cited more appropriately depicts a scenario before the advent of new m edication in the 1990s. This can create confusion in the minds of lay people.

For more than a decade and a half there has been a sea change in the management of schizophrenia. New medicines have made the disorder more treatable than ever before. Today up to 80 per cent of the cases can be effectively treated, and a large number of people with schizophrenia are leading active, accomplished lives without institutionalisation and disabling side effects.

A document by the World Economic Forum states: “The stigma and discrimination against people infected with tuberculosis have a devastating social and psychological impact. Such attitudes obstruct healthcare providers in delivering effective treatment. Stigma often prevents people from seeking healthcare attention, which constitutes a direct public health threat to the community. Even when patients attend treatment, social disapproval of their family or community members decreases compliance with treatment.” Does this mean we should not make a diagnosis of tuberculosis or that we must turn our backs on the label of tuberculosis and its conventional treatments?

Stigma stems from misrepresentation of the illness. A joint study by Indiana and Columbia Universities found that nearly half of the people surveyed said they are unwilling to interact with a person with schizophrenia and 37 per cent said they would avoid someone with major depression. Another poll found that 59 per cent of the respondents would be “very comfortable” when meeting someone in a wheelchair, but only 19 per cent would be so when meeting someone with a mental illness.

Several studies have shown that the incidence of violence in individuals with mental disorder is not greater than that in population at large. Violence is limited to just a small minority of those suffering from mental illnesses — particularly those who have a high intensity of untreated psychotic symptoms and those who are also abusing alcohol and street drugs. In real life, individuals with a mental illness are far more likely to be victims of crimes rather than criminals.

Negative conceptions in the minds of people are reinforced by inaccurate images in the media. A study by Temple University, U.S., found that over 60 per cent of characters depicted as mentally ill on the screen were portrayed as violent and dangerous.

Those suffering from mental illness have personalities that are separate and apart from the illness itself, just as do those with physical disabilities. They can be smart, obstinate, sweet, whatever — just like anyone else. But because of pervasive stereotyping, they often get pigeonholed by others so that everything they say and do is seen through the filter of other people’s bias about mental illness. For example, what may be interpreted as garden-variety anger in a “normal” person may be seen as “out of control behaviour” in someone known to have schizophrenia.

While ethnic and racial slurs are no longer considered publicly acceptable, cracks and derogatory comments about mental illness abound. People with psychiatric problems often emerge from treatment, already in a vulnerable mental state, only to be confronted by the prejudice of others. Because of such preconception — whether subtly or overtly conveyed — the efforts of those with schizophrenia to re-engage socially may face insurmountable barriers.

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