One in four people
in the United States meet the criteria for a diagnosable mental illness in any given year. About half will develop a mental illness sometime in their life. Allen Frances, editor in chief of DSM-IV
wants fewer people, only those with the most serious illness, to be diagnosed to spare them the stigma of the diagnosis. The chief mechanism to achieve his goal would be to change the DSM criteria, so that fewer people qualify.
This series began by introducing Dr. Frances
, whose work has inspired it. It continues to address the topic of stigma
, what it means, where it comes from, how to respond. Last week
I defined terms, adding one that expands our frame. Briefly, Merriam-Webster says that stigma
is a mark of shame or discredit
; while prejudice
is injury or damage resulting from some judgment or action of another in disregard of one's rights
I think it is important to distinguish between the two. To do so, one has to clarify the context. Stigma
, when used by somebody who is the object of stigma, is the internalization of somebody else's prejudice
. When it is used by somebody else, stigma is a mechanism of diversion that calls on the object of one's own prejudice to bear the responsibility of that prejudice
So is Allen Frances trying to protect those whom he calls the worried well
from being marked with shame or discredit? Or is he creating a diversion that calls on people who are suffering to bear the responsibility for somebody else's prejudice?