Stigma Case Study

Stigma Case Study

Frank Jones had been released from a provincial psychiatric
hospital after having been admitted recently for intense
psychotic symptoms. At the time of admission, Frank was
highly agitated, yelling that the police were going to harm
him because he’s the Boston Strangler’s brother. In the
emergency room, Frank told the on-call psychiatrist that he
was hearing voices of the devil preaching about his
murderous relatives.
This was Frank’s third hospitalization since he was first
diagnosed with Schizophrenia 12 years earlier at age 22.
Frank had made an excellent recovery from pervious
hospital stays: He had been working as a salesman at a hardware store for the past
six years, and lived nearby in a small but comfortable apartment. He visited a
psychiatrist at the community mental health centre for medication once a month.
He also met with a counsellor there to discuss strategies to cope with his mental
illness. Frank had several friends in the area and was fond of playing softball with
them in a community leagues. He had been dating a woman in the group for about
a year and reported that he was “getting serious”. Frank was also active in the local
Baptist Church where was co-leading Bible classes with pastor. The reappearance of
symptoms derailed his job, apartment and his social life.
Recuperating from this episode involved more than just
dealing with the symptoms of his illness. The reaction of
friends, family members and professionals also affected
what happened to Frank. The hardware store owner was
frightened by Frank’s “mental hospitalization”. The
owner had heard mentally ill people could be violent,
and worried that the stress of the job might lead to a
dangerous outburst in the shop. Frank’s mother had
other concerns. She worried the demands of living alone
was excessive: “ He’s pushing himself much too hard
trying to keep that apartment clean and do all of his
own cooking,” she thought. She feared Frank might
abandon his apartment and move to the streets, just
like other mentally ill people that she had seen.
Frank’s doctor was concerned his hospitalization signaled overall lack of stability.
His doctor believed schizophrenia was a progressively degenerative disease, a view
first promoted by a renowned psychiatrist in 1913. In this view, psychiatric
© Bow Valley College 2015
hospitalization indicated the disease was worsening. The doctor concluded Frank’s
ability to live independently would soon diminish; it was better to prepare for it now
rather than wait for the inevitable loss of independent functioning. So the doctor,
with the help of Frank’s mother and boss, talked him into leaving his job, giving up
his apartment and moving in with his mother. Frank was unable to meet with his
friends and soon dropped out of the community sports league. He stopped seeing
his girlfriend. In one month, he lost his job, apartment and friends.
Alice Johnson
Like Frank Jones, Alice Johnson had been
diagnosed with a significant and chronic disease:
diabetes. She had to carefully monitor her sugar
intake and self-administer insulin each day. She
watched her lifestyle closely for situations that
might aggravate her condition. Alice also met
regularly with a physician and dietitian to discuss
blood sugar, diet and exercise. Despite these
cautions, Alice had an active life. She was a 34-year-old clerk typist for a small
insurance broker. She belonged to a folk dancing club she attended at a nearby
secondary school. She was engaged to an accountant at the insurance company.
Despite carefully watching her illness, Alice suffered a few setbacks, the last
occurring about a month ago when she required a three-day hospitalization to
adjust her medication. The doctor recommended a twoweek break from work after her discharge, and referred her
to the dietitian to discuss appropriate changes in lifestyle.
Even though diabetes is a life-threatening disease (in her
most recent episode, Alice was near coma when she was
wheeled into the hospital), no one suggested she consider
institutional care where professionals could monitor her
blood sugar and intervene when needed. Nor did anyone
recommend Alice give up her job to avoid work-related
stressors that might throw off her blood sugar.