Must balance openness, risk of stigma
By Patricia Wen
(JOANNE RATHE/GLOBE STAFF)
Chandra Watts helps youths cope with being open about mental health issues.
More than any previous group of American youth, Chandra Watts and her peers grew up hearing about ADHD, bipolar, and Prozac.
As a generation, they were more psychologically attuned — and diagnosed — than any other. Mental disorders, they were told, should be viewed no differently from physical illnesses, and cause no shame.
So when Watts was 15 and hospitalized in the midst of severe mood swings, she thought she could safely confide in a good friend. But that friend ended up telling someone else, who told someone else, and then word got out. Watts was devastated.
“I became known as the School Crazy,” said Watts, now 25 and attending community college in Worcester.
JOANNE RATHE/GLOBE STAFF
Chandra Watts is part of a program called Strategic Sharing, which helps young people who have struggled with mental health issues talk about their past in selective ways.
Seasoned by that experience, but undaunted, Watts is among a growing number of young people wrestling with a political and personal dilemma: They want to lead efforts to curb long-held prejudices against people with mental illness, but must carefully consider what they say publicly to protect their image as they enter the adult world. They also face challenges not confronted by previous generations: The Internet and social networking sites can turn casual remarks into permanent records, easily searched by college admissions officers and potential employers.
‘The majority of people are judgmental.’
Several national efforts are underway to help young people with this problem. YouthMOVE Massachusetts, part of a national group focused on youth mental health issues, is sponsoring a program next month called Strategic Sharing, in which Watts and others will learn when and how to filter what they say, depending on the situation. This program, created by Casey Family Programs, counsels young people with mental illness how to promote awareness of psychiatric issues but not share too much that might hurt them on the job or in new relationships.
A program called LETS (Let’s Erase The Stigma), launched two years ago in Southern California, has drawn several thousand teenagers to form school chapters to increase understanding and acceptance of mental illness, said Phil Fontilea, the founder and a former business executive with his own history of depression.
The organization also helps youth talk about mental disorders in a way that emphasizes treatment and recovery.
Mental health clinicians and advocates say they are careful in tapping the idealism and energy of youth, realizing that many Americans still hold deep prejudices, often out of ignorance or unfamiliarity.
Mark Picciotto, a psychologist who runs McLean Hospital’s residential program for teens with mental illness in Brockton, said the nonjudgmental attitude that is so encouraged among today’s young “is not guaranteed in the real world.”
This generation does not necessarily suffer from more mental health problems than previous ones, but they are diagnosed with conditions such as attention-deficit hyperactivity disorder (ADHD), depression, and anxiety at a far higher rate, said Kathleen Merikangas, a senior investigator for the National Institute of Mental Health.
During the past 20 years, roughly 1 in 10 children under age 18 have exhibited behaviors that qualify for a diagnosis of a serious behavioral, emotional or mental disorder — however, two decades ago, only about 10 percent of these children were diagnosed and treated, compared with roughly 50 percent today, she said.
One teenage girl from Southeastern Massachusetts said she knows mental diagnoses are more common in her generation, but she still believes many of her peers shun those with mental issues.
“The majority of people are judgmental,” said the high school student, who suffers from depression and anxiety and has experienced suicidal thoughts.
The teenager said she wishes she could be more open and spur societal changes in attitudes toward mental illness.
But after once telling a friend privately a couple years ago that she was hospitalized for mental health treatment, she learned that that confidence was betrayed, and she started feeling stigmatized by others.
“I was embarrassed,” the teenager said.
Now, she said, only about 10 friends know “the real story,” and the rest of the people are simply led to believe a physical ailment causes her to miss school sometimes. When classmates joke, “I want to kill myself,” after getting a bad test result, she doesn’t find it funny — and it only affirms her decision to keep much of her struggles with depression a secret. Though she didn’t want to be named for the article to protect her privacy, she said she wanted to be interviewed, to let teens with similar problems know “they aren’t the only ones.”
McLean’s Picciotto said he finds that young people whose mental issues surfaced through self-destructive behaviors, such as binge drinking, often more readily reveal that they are undergoing treatment to emphasize their commitment to change. Other youths, such as those who were victims of sexual assault or parental neglect, often are more private.
Eric Lulow, a national spokesman for YouthMOVE, said the digital media age makes it even harder for young people to know how much to reveal, even if they want to help promote greater understanding of mental heath issues.
Lulow told a recent gathering in Massachusetts about how he was shocked after a woman he was dating admitted knowing about his physical abuse as a child. She learned about it reading a 2009 interview he gave to a Maryland newspaper, available on the Internet.
“If you Google me now, you’ll find it,” he told the annual conference of the Parent/Professional Advocacy League, a mental health advocacy group in Massachusetts.
He said young people have to weigh the benefits of sharing psychological struggles, such as enabling people to “get you” better and helping to dispel negative stereotypes about mental illness, against the risks, including affecting your public image and triggering painful memories.
Meanwhile, mental health advocates applaud signs that young people want to play a role in ending stereotypes and fears about those with psychiatric issues.
Earlier this year, a nonprofit organization, Bring Change 2 Mind, founded by actress Glenn Close to fight the stigma of mental illness, was flooded with online testimonials from teenagers and young adults after its public-service video aired on “American Idol.”
The television show’s producers requested the video, produced by director Ron Howard, after a 17-year-old contestant admitted on air that she had been diagnosed with bipolar disorder, said the nonprofit’s executive director, Pamela Harrington.
Next month, Watts, the Worcester college student, is undergoing training in Strategic Sharing, and hopes to use those skills to teach other young people.
She said that though she was diagnosed with bipolar disorder as a teen, her therapists say she now has generalized anxiety disorder and she is now off her daily psychotropic medications.