A problem you should think about before con­sulting a mental health profession­al, or encourag­ing or forcing some­one else to do so, is the stigma of having received the so-called therapy.  If you seek coun­seling or "thera­py" from a psychiatrist or psychol­o­gist, how are you going to answer questions on applications for occupational or professional licenses, a driver's license, applica­tions for health or life insurance, and school and college applications, such as "Have you ever had psychiat­ric or psycho­logical therapy?" When you apply for a job or occupa­tional license or a driver's license or apply for an insurance policy or admis­sion to an education­al program you will often be required to answer this or a similar ques­tion. When you answer such questions candidly and admit having received psychi­at­ric or psycho­logical "help", the result often will be loss of important oppor­tuni­ties: Answering "yes" to such ques­tions often re­sults in rejection for em­ploy­ment or licensure or admis­sion to col­lege or other educa­tional pro­gram or denial of insur­ance cover­age. Some­times you will be forced to ask your "thera­pist" to breach the confidenti­ality of your com­muni­cations with him or her by mak­ing a report on you in order for you to get a job, license, insur­ance coverage, or admis­sion to school. If you conceal your experi­ence of psychi­atric or psycho­logical "therapy" by answer­ing "no", thereaf­ter you will have to be careful to watch what you say and to whom, and you may with good reason worry about being found out-since you run the risk of being fired from a job or expelled from school or suffer­ing revoca­tion of licen­sure if your decep­tion is ever discov­ered. You may eventual­ly find the insur­ance policy you have been paying pre­miums on for many years is value­less because of what you con­cealed on the appli­ca­tion for the policy several years earlier.
          In his book The Powers of Psychia­try, Jonas Robitscher, J.D., M.D., Professor of Law and Be­hav­ioral Sciences at Emory University's Schools of Law and Medicine, pointed out that "Appli­cants for the state of Georgia bar examina­tion, like appli­cants in many other states, are re­quired to state ... whether they have ever re­ceived diagno­sis of ... emotion­al disturbance, ner­vous or mental disor­der, or re­ceived regular treatment for any of these condi­tions. Although there is no known instance of this informa­tion having been used to keep an appli­cant from taking the exami­nation or being admitted to the Georgia bar, there are instanc­es of denying appli­cants in other juris­dic­tions" (Houghton Mifflin Co. 1980, p. 234).
          In the same book Dr. Robitscher described the case of a medi­cal school appli­cant who had graduated from college magna cum laude, who was admitted to Phi Beta Kappa, and who scored in the upper ninety-ninth percentile in the Medi­cal Col­lege Admission Test—but who was denied admis­sion to medical school because she had sought psychiatric treatment (pp. 238-239). He said this is typical of "prejudi­cial policies of not admitting or readmitting students who have had or are undergo­ing psy­cho­therapy" (p. 239).
          An airline pilot told me he was grounded for seven months by the Federal Aviation Ad­minis­tration because he revealed he had been seeing a psychiatrist (for so-called outpa­tient psychothera­py) on the med­ical history question­naire he was required to fill out as part of his routine periodic medi­cal examina­tions required of airline pilots and which involved criminal penal­ties (a fine of up to $10,000 and/or up to five years impris­on­ment) for conceal­ing the requested infor­ma­tion. He told me he enjoyed seeing the psychia­trist but that the hassle which resulted from his doing so, because of the questions it created about his job qualifica­tions, out­weighed whatever benefit came from seeing the psychia­trist. He said that all factors considered, "It wasn't worth it."  When taking physical exami­nations, pilots in the United States are required to "List all visits in the last three years to a physician, physi­cian assis­tant, nurse practitioner, psy­cholo­gist, clinical social worker, or sub­stance abuse specialist for treat­ment, evalua­tion, or counsel­ing. Give date, name, ad­dress, and type of health professional con­sulted, and briefly state reason for consulta­tion. ... Routine den­tal, eye, and FAA peri­odic medical examina­tions may be ex­cluded" (FAA Form 8500-8, italics added). This suggests that, contrary to what some people think, anyone con­sulting a psycholo­gist or clinical social work­er is considered suspect. That is, stigma attaches to anyone consult­ing not only psychi­atrists, but also psychologists or social workers. Routine dental or eye examina­tions involve no stigma or suspi­cion of disqualifi­cation and therefore are not required to be reported.
          The 1988 Democratic Party Presi­dential nominee, Massachusetts Governor Michael Dukakis, in the words of Newsweek, "was ac­cused of having received psychiatric treatment" ("The High Velocity Rumor Mill", Newsweek, August 15, 1988, p. 22. See also, Andrew Rosenthal, "Dukakis Releases Medical Details To Stop Rumors on Mental Health", The New York Times, Au­gust 4, 1988, p. 1). The accusations proved to be false, but the impression given by the news reports about this story is that Duka­kis' presi­dential campaign would have been doomed by this one fact alone if the claim he had ever consulted a psychiatrist or psychol­ogist had proven to be true. In 1972 U.S. Senator Thomas Eagleton was nomi­nated for Vice‑President of the United States at the Demo­cratic Na­tional Convention but subse­quent­ly was removed from the ticket by the Democratic Na­tion­al Commit­tee when it became known he had undergone psychi­atric treatment, including hospi­tal­ization and electric shock treatment.
          Bruce Ennis, an American Civil Liberties Union (ACLU) attorney who has repre­sented people de­prived of employ­ment because of psychiatric stigma, argues that "In the job mar­ket, it is better to be an ex-convict than an ex-mental patient." He says "very few em­ployers will know­ingly hire an ex-mental pa­tient."  He points out that "Almost all public employers and most large compa­nies ask job applicants if they have ever been hospi­talized for men­tal ill­ness" and that "If the answer is yes, the applicant will almost certainly not get the job". Mr. Ennis also points out that "if the appli­cant lies and says no, he runs the risk of eventual discov­ery". On this basis Mr. Ennis argues that "It is time for psychi­atrists and judges to face the brutal facts. When they commit a person to a mental hospital, they are taking away not only his liberty, but also any chance he might have for a decent life in the future." On the basis of his expe­rience as an attor­ney for people saddled with psychiatric stigma he observes that "Even voluntary hospital­ization creates so many prob­lems and closes so many doors that an old joke takes on new truth—a person has to be crazy to sign himself into a mental hospi­tal" (Bruce J. Ennis, Prisoners of Psychiatry: Mental Patients, Psychiatrists, and the Law, Harcourt Brace Jovano­vich 1972, pp. 143-144). Mr. Ennis wrote those remarks in 1972, but if anyone is inclined to think psychiat­ric stigma substantially diminished during the 1970s and 1980s, consider once again the reac­tion of the press and public in 1988 to the appar­ently false allegation that presidential candidate Governor Michael Dukakis had previously consulted a psychia­trist. That it should be such a headline grabbing issue shows how stigmatizing is any experi­ence as a psychiat­ric "patient". This public reaction is particu­larly notewor­thy in light of the fact that Governor Duka­kis was accused only of consult­ing a psychi­a­trist in his office, not psychi­atric hospital­iza­tion.
          The presumption of unreliability, untrust­worthiness, and emotional instability which flows from having ever sought psychi­atric or psycho­logical "therapy" doesn't haunt only people with responsi­bilities like doctors, lawyers, airline pilots, and Presidential or Vice‑Presi­dential candi­dates: In his book, Prisoners of Psychiatry, ACLU attorney Bruce Ennis reports many cases of people who have been denied taxi driver licenses because of past psychiat­ric treatment even though "Most of them had never been hospitalized" and had never done anything to suggest they were dangerous (p. 160).
          In a book she wrote, Eileen Walken­stein, M.D., a psychia­trist, says "A psychi­atric diagno­sis is like a jail sentence, a permanent mark on your record that follows you wher­ever you go" (Don't Shrink To Fit! A Con­frontation with Dehu­maniza­tion in Psychiatry and Psycholo­gy, Grove Press 1975, p. 22). If you con­sult a mental health profes­sional, you will probably get some kind of "diagno­sis", particularly if health insurance is paying for the consultation or "therapy", since the psychiatrist or psychologist will probably be required to provide a "diagnosis" to the insurance company to get paid for whatever (supposed) service is provided. In at least some states, professional licensing laws require mental health professionals, includ­ing psychologists, to keep a written record of "diagno­sis" and "treat­ment".
          In 1992, Commenting on the Ameri­cans with Disabilities Act (ADA), Peter Manhei­mer, chairperson of the Com­mission for the Advance­ment of the Physi­cally Handicapped, said "It is most appropri­ate that the ADA pro­tects recover­ing drug addicts, alcoholics, persons with AIDS, and persons who have mental and psychological disabil­ities, as they form the most misunder­stood and feared portion of the disability community. They suffer the greatest dis­crimi­nation" (Peter Manhei­mer, "Reporting on per­sons with disabili­ties", letter to the editor, Miami Herald, July 24, 1992, p. 16A-italics added).
          And "a study by the National Institute of Mental Health in 1993 found that even ex-convicts rank above former mental patients in social accep­tance" (Chi Chi Sileo, "Rip-offs De­press Mental Health Care", Insight magazine, January 24, 1994, p. 14.) This article quotes a psychiatric hospital patient saying "The stigma is incredible ... Forget telling an employer! Sometimes they find out anyway, and all of a sudden you're unfit to work there" (Id). In his autobiography, Kenneth Don­ald­son said after he had been commit­ted to a psychi­atric hospital, people "accepted a psychiatric diagno­sis which forever rent the fabric of my life. There­af­ter, not only society at large but members of my family would not see Ken the son and father and friend, but Ken the mental patient. From this would flow unimagined misery, a fog which would envelop all our lives. And our situation would be, of course, representative of millions. The fog would seep into my employ­ment, my relations with doc­tors, my access to lawyers and the courts. Every enterprise in which I would engage would be poi­soned by the label. It haunt­ed me and frightened others" (Insanity Inside Out, Crown Pub. 1976, p. 321).
          In an article published June 4, 2012, H. Steven Moffic, M.D., wrote "I don't think by today that there can be any question that there is significant discrimination and prejudice against those who are deemed to have some sort of significant mental problem. Many times, that has resulted in trying to keep such people out of mainstream society, whether that be hospitalization, not being able to live in certain neighborhoods, and not being hired for work. ... We have the continuing stigma against people who are called 'crazy'" ("Psychism: Defining Discrimination of Psychiatry", psychiatrictimes.com).
          In his book The Powers of Psychiatry, Emory University profes­sor Jonas Robit­scher, J.D., M.D., said this:
Psychi­atrists have been so criticized for the errors or vagueness in their labeling proce­dures because the label produces a new disability, which often re­mains as a burden long after the symptoms that led to the label have departed. ... A study of the attitudes in a small town indi­cates that fellow townspeople reject other members of the community in a direct rela­tionship to the pro­fessionalization and spe­cializa­tion of the source of help, with the least rejection when help is sought from a clergyman, increas­ing percentag­es of rejec­tion for those seeking psychiatric help from physi­cians and psychia­trists, and the most rejection for those who get mental hospital help. A study of work supervi­sors shows that the knowledge that an employee is seeing a psychia­trist would be likely to rule out a promotion even if the employee is doing good work...The harm and potential harm done to mental patients and former mental patients is not only confined to those who have had serious illness­es, those who have been hospitalized or who have had to inter­rupt careers or schooling. Psychi­atrists know that many people who consult them as outpa­tients are much less 'sick' than many or most of the general population. If these people had decided not to be patients but instead to be clients or parishioners and had taken their prob­lems to a social worker, a pastoral coun­sel­or, or a faith healer, they would have incurred no stigma. ... The ubiquitous ques­tionnaires that ask, 'Have you ever consulted a physician for a physical or emo­tional or mental condition?' do not take account of those who should have and haven't, or those who are able to answer no because they have taken their problems to an encounter group, a sensitivity-train­ing ses­sion, an est seminar, or a consciousness-raising group, and so have escaped the discrimina­tory effect of seeking help. [pp. 230, 232, 233]

          The difficulty of getting a health insur­ance policy after having sought psychi­atric or psycho­log­ical "therapy" or even marriage coun­selling was mentioned in the August 1990 issue of Con­sumer Reports in an article titled "The Crisis in Health Insur­ance": "Virtually no com­mercial carriers and only a handful of Blue Cross and Blue Shield plans will sell policies to anyone who has had heart dis­ease, internal cancer, diabe­tes, strokes, adrenal disorders, epilepsy, or ulcerative colitis. Treatment for alcohol and substance abuse, depression, or even visits to a marriage counselor can also mean a rejec­tion. If you have less serious conditions, you may get coverage, but on unfavorable terms" (p. 540, italics added). In the U.S.A., the Patient Protection and Affordable Care Act known as "Obamacare" contains a provision effective in 2014 prohibiting health insurance companies from rejecting applicants because of a pre-existing condition. Time will tell if repeal efforts that have passed the U.S. House of Representatives will ultimately succeed and whether insurance companies will limit their risk by finding ways to discriminate against people with pre-existing conditions including supposed mental illness.
          The stigma involved in obtain­ing psychi­atric "therapy" was dis­cussed in an article by columnist Darrell Sifford titled "Should You Lie About Psy­chi­atric Care?" appearing in The Char­lotte Observer (Char­lotte, N.C.) on June 10, 1990, page 4E. A mother wrote to Mr. Sifford asking whether her teenage son, who was about to apply for admission to college, should an­swer truthful­ly the questions about psychiat­ric treatment, which he had had at the age of 15. She wrote: "Many of these [college application] forms request infor­mation re­garding any psychiatric treatment. And once he is out in the real world, most job applica­tion forms ask for the same infor­mation ... Have we [by insisting he get psychiatric care] doomed him to a future of lying on application forms for fear of losing the posi­tion or college being applied for? What should we do?" The newspaper columnist realized the wo­man's question is what he called "a serious question. Very Serious." He shared the wo­man's letter with Paul Fink, imme­diate past president of the Ameri­can Psychiatric Asso­cia­tion. This was Dr. Fink's advice:
I would tell them to lie on the forms ... The stigma is there, and to deny it and sacrifice yourself by telling the truth makes no sense. ... With the public at large I work to de­crease stigma, but with individ­ual patients I impress on them how wide­spread and deeply rooted the stigma is. ... If two people who are equal in creden­tials apply for a job and one has had psychi­atric treatment, that per­son will be discrimi­nated against, and he'll be the loser in the competi­tion for the job. ... Even if the person with treatment had better credentials, he most likely still would lose out to the other per­son. That's how deeply rooted the stigma is. ... I will not encourage any­body to acknowledge that they had treat­ment.

Psychologist Paula Caplan, Ph.D., interviewed on February 11, 2012, said she maintains a web site called psychdiagnosis.net that includes true life stories showing "the whole huge array of the ways people's lives have been destroyed by getting a psychiatric label." In that same interview she said this ("MindFreedom (MF) Live Free Web Radio: Paul Caplan v. Psychiatric Labeling!", interviewed by David Oaks, archived at blogtalkradio.com):
There was a wonderful article in the New York Times Magazine some months ago by Ethan Waters, and he looked at the research showing, and this sounds really weird, but it makes total sense once you think about it, he found, or he talks about the research showing that, when there are campaigns against stigma, guess what happens to the level of stigma?!: It rises! Now, why is that? It's because the nature of these campaigns goes like this: Well yes, they're different from us, but don't hold it against them. So anything that increases the sense of there are those of us who are not mentally ill, and then there are those 'other people'" increases the prevalence and intensity of psychiatric stigma.

Campaigns against psychiatric stigma enhance awareness of so-called mental illness, thereby increasing discrimination against the supposedly mentally ill.
          Do you want to go through life with this kind of problem? How do you feel about lying on applica­tions for the rest of your life? If it is your rebel­lious ado­lescent or trou­bled spouse for whom you're considering psychiatric "treat­ment", ask yourself: Are you really upset enough with your rebellious teenager or spouse to impose this kind of prob­lem on him or her? Is it the right thing to do? The prob­lems motivat­ing you to impose so-called therapy on a member of your family are probably short-term, but psychiat­ric stigma lasts a lifetime.
          The U.S.A.'s Americans with Disabilities Act (ADA), enacted in 1990, prohibits questions about former psychiatric treatment on employment applications by employers with 15 or more employees. However, a complete employment history may be required, gaps in which may bring up questions, and as Jonas Robitscher, J.D., M.D., said in his book The Powers of Psychiatry prior to the enact­ment of the ADA: "The disclosure that one is or has been mentally ill can lead to rejec­tion, and other reasons for the rejection can al­ways be found. ... Forcing private em­ployers to hire the disabled would raise issues of invasion of privacy and problems of en­forcement. Stigmatization will continue to be a problem, and discrimination will contin­ue to exist" (p. 241-242). In areas covered by the ADA, avail­ing oneself of its protec­tion will probably require large amounts of time spent in litigation and a lot of money paid in lawyer's fees, with uncertain results.
          There also are many areas of stigmati­za­tion and dis­crimina­tion the ADA and other laws don't cover. One example is the effect of psychiatric stigma on personal relation­ships: Keep­ing secrets conceals parts of who you are and pre­vents emotional intimacy of the sort most people want with friends and espe­cially with one's spouse, but sharing this secret leaves you open to black­mail or similar kinds of pressure. Concealing psychiatric "treat­ment" from an employer (which may be necessary to get a job) but revealing it to one's spouse or a friend gives the spouse or friend knowl­edge that can be used against you if your relation­ship turns sour. Should you be put in a position where you must lie to your spouse or a friend to keep secret your history of so-called psychiatric or psy­chological "therapy" (e.g., if he or she should ask), you intro­duce decep­tion into a relationship that would be better if you could be honest and sincere. Even if you don't tell your spouse or someone you are thinking about marrying, divorce now occurs in close to half of marriag­es, and in a divorce—especially if you get into a dispute over child custo­dy or even visita­tion rights—your spouse's attor­ney will proba­bly ask you, under oath when you are subject to the penal­ties of perju­ry, if you have ever had psychi­atric or psycho­thera­peutic "treat­ment"—perhaps confront­ing you with the choice of commit­ting perjury or jeopar­dizing your employment by telling the truth. Whether you admit having had psychiatric or psy­chological "thera­py" or it is discov­ered some other way, the resulting stigma may result in losing your chil­dren in a custo­dy battle, and threats to reveal it to your employer may be used to pres­sure you to agree to property division or alimo­ny (or lack of it) or an amount of child support that is not appro­priate. You may have to consider these problems when contem­plating the wisdom of getting married or divorced—problems you could have avoided by simply avoiding psychiatric or psychological "therapy". You are likely to face a similar dilemma if you are ever called for jury duty, since during the jury selection phase of the trial potential jurors are often asked, under oath, if they have ever had psychiatric "treat­ment".  A Home Box Office (HBO) film, "Citizen U.S.A.: A 50 State Road Trip" says among the questions asked of persons seeking permanent residence in the U.S.A. are whether they have ever been convicted of a crime, been a prostitute, or confined in a mental institution.
          If the so‑called therapy helped enough, it might be worth the problems created by the stigma of having had psychi­atric or psychological "help". However, the benefit assumed to come from psychi­atric and psychological "therapy" (itself a ques­tionable assump­tion) is out­weighed by the stigma that comes from receiving it. The stigma that results from seeing psychi­atrists, psycholo­gists, or psy­chiatric social work­ers is a strong argument in favor of instead con­sulting friends, fami­ly, or non­pro­fes­sional coun­selors whose expertise comes from life rather than from "pro­fessional" training, or simply trying to solve your problems yourself.

copyright 2015
Permission to reproduce is granted
provided the reproduction is accurate
and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

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