How quick it has gone by! We are nearing the end of the program, and I am finding myself sad to leave. I have really enjoyed my co-workers and clients, and as I am putting together my final presentation, I find that I have learned a great deal of things. One of my greatest experiences is learning how to work with the mentally ill. While preparing for the big move next store, social services was cleaning out their stuff and gave me one of the journals–the January 2007, Volume of Social Work–which has information about working with the mentally ill, and the stigma that is attached. It was interesting to read about studies that have shown that the clinical diagnosis of the mental ill may exacerbate the stigma of mental illness. Stigma can create barriers that further deter progress in client’s lives, such as active label avoidance, blocked life goals and self-stigma.

Outward behavior of label avoidance is often seen when they are unwilling to follow their treatment plan. Commonly, they do not follow through on treatment because they want to avoid being called a “mental patient.” It is not so much to avoid any shame or hurt to their ego, but as to avoid the prejudice and discrimination that comes along with being mentally disabled. Another way you may see this label avoidance of the mentally disabled, is through public benefits they may receive. My co-worker, Stacey, has had multiple conversations with RepPayee clients about the special bus passes they use. One RepPayee client calls regularly, having noticed that her bus pass looks different than others, and refuses to use hers because she feels like the public will know she is mentally ill. Stacey explains that this is not true, and that she may have access to this pass for a back problem, or any other number of disabilities, and that people would never know that it is because she has a mental disability. Nevertheless, the disabled are conscious and worried about the prejudices that come with their disability.

These prejudices can be very hampering to the disabled. A blocked life goal is a prevalent experience of the mentally ill. At Bread, the RepPayee program works with their clients in hope that one day they will be able to manage their own money. A common goal of most services is to help the client develop their own independence, which is challenging because of their serious mental illness. As services look to promote progress, they find that the general public does not understand the extent of their client’s capability. Landlords, employers, and even medical caregivers are some of the public personas whose prejudice severely hampers client’s opportunities.

The last effect of clinical diagnosis on the mentally ill was the one I noticed the least in Bread’s clients. Environmental stigma is often internalized by clients–as shown by the conscious worry in the earlier client story– and can become so engrained in their psyche that the mentally disabled devalue themselves. The idea is that they basically “buy into the stereotypes,” which leads to a very negative self-image. Although I have heard some clients express worry about whether others know about their disability, or how they are sometimes embarrassed that they cannot perform normal functions, the clients I have come into contact with are very optimistic. This was particularly true at the client achievement award where the honoree of the night was both mentally and physically disabled. He had the most spirit of anyone there. By the end of his speech (which he wrote and then we read aloud), it was clear that while we were there to honor his accomplishments, he was grateful that the staff at Bread had been so adamant about getting him what he deserves. He said he was glad to have people there who were not frustrated with the challenges of his condition. Another one of my co-workers, Hannah, works as a case manager for some of our clients, but her service is ending in august. She shared with me that one of her clients, who she feels she never got particularly close with, started crying when Hannah told her she was leaving. Hannah said she was surprised, and asked her “what are the tears about” to find out that her client was sad she was leaving. She told Hannah, “it is nice to have someone who listens and who doesn’t act like your stupid when you talk.”

It is clear that the people who work for this organization genuinely care about their clients, and have the gift of compassion and patience that is so necessary to be successful in the kind of work. I think this is why the clients in the RepPayee program, or clients with disabilities in general, do not have strong self-stigma behavior. On the other hand, perhaps this difference from the clients at Bread compared to the general disabled populous shows how much the individuals at Bread care about their clients, and how wildly successful they are at what they do. I am so excited to come back and visit this agency to find out how they have expanded, and what aspect of Poverty they are tackling next.

Corrigan, Patrick W. “How Clinical Diagnosis Might Exacerbate the Stigma of Mental Illness.” Social Work 52.1 (2007): 31-39. Print.