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Stigma and Psychiatric/Mental Health Nursing

Generally when we think of stigma in relationship to mental health, we are thinking of the stigma attached to people with mental health problems or a psychiatric diagnosis. However, several scholars have noted recently, that we might consider those of us in the disciplines of psychiatry and mental health nursing as recipients of stigma—by the public, the media and others in the health professions (De Carlo, 2007; Gouthro, 2009; Moller-Leimkuhler, Moller, Maier, Gaebel, & Falkai, 2016; Schulze, 2009; Sercu, Ayala, & Bracke, 2015). This was far from my thoughts when I became a clinical nurse specialist (CNS) in psychiatric/mental health (PMH) nursing. In fact, an internal medicine physician at my university remarked to me at the time that all the smartest nurses went into mental health. But thinking back on it, I was becoming aware of a different attitude. Several years ago when I was having lunch with a friend, he made a reference to those of us who choose psychiatry as a specialty and said “everyone thinks there’s something wrong with people who go into psych.” As an example, he then told me about a psychiatrist he had observed walking across the parking lot each night after work on the way to his car, picking up trash along the way and putting it in a waste can. He thought this was obsessivecompulsive behavior. (Today this might be considered environmentally responsible behavior). But earlier in the meal he had told me about two colleagues in his residency program who had committed suicide during the stress of taking their board exams. I felt somewhat offended by his remarks about those of us in the mental health professions, especially given the situation with his residency colleagues who had obvious emotional disturbances. Over the years, I became aware that his attitude might not be uncommon—sometimes when asked what my clinical specialty was, I noticed strange grins when I said “community mental health.” I guess I had not thought of this reaction as stigmatizing at the time but rather that it showed a lack of knowledge, or discomfort with mental illness on the part of the questioner. However digging into the literature on this topic reveals a