Can Friends Overcome Stigma? by Violet Bilodeau

This short story by Violet Bilodeau explores the ways that stigma surrounding mental health disorders persists in a high school environment. With the aim of showcasing the causes and solutions to this stigma, Violet creates a relatable narrative that can be valuable to young adults and health care professionals alike.

 

Can Friends Overcome Stigma?

 

Jack’s stomach twists painfully as he scans the school hallway wondering where Bryson is. Jack takes a deep breath in an attempt to stop worrying about how his best friend will react to the news he was about to share. I want to be understood and accepted, so I must tell him.

“Hey, Bryson, how are you?”

“Fine. You?” Bryson says with a smile as he turns from his locker. 

Bryson’s smile fades when he sees Jack’s face.

“I’m ok, but there’s something I want to tell you.”

“Go ahead. You know I got your back, bro.”

“Thanks, and I’ve got yours.” Hope brightens Jack’s face.

They fist bump then Jack continues. 

“The other day I was diagnosed with schizophrenia which explains why it has been difficult to think straight.”

Despair hugs Jack as Bryson looks at him sideways.

 “Well, you are still you. Why don’t you come over on Saturday? I just got a new video game you’re going to love.”

“That sounds great!” 

Disappointment fills Jack. It was obvious to him that Bryson didn’t understand. Without understanding, Bryson can never fully accept Jack. As long as their friendship remains Bryson accepting Jack is a possibility.

***

Ava, Samantha, Paisley, and Olivia discuss the latest fashion trends. Ava’s mind wanders as her friends cheerily chat. 

Paisley turns to Ava. “I recall you mentioning a doctor’s appointment. How’d it go?”

“He said I have depression and prescribed some pills.” 

Olivia gives Ava a look of concern.

It doesn’t make any sense to give someone who is hopeless pills that take months to kick in and they may not even work.

 “I hope that fixes you cause I can’t wait to have the fun Ava back,” Samantha says while texting.

“Yes! Then we can all go shopping,” Paisley exclaims while putting her arms around Samantha and Ava.

“Ya!” Olivia raises her fist excitedly. 

For her friends’ sake, Ava cheerfully agrees.

“I can’t wait!”

Ya right. It’s hopeless. I’m not going to get better. Life just sucks.

The bell rings ending the girls’ conversation.

***

Later that day.

Olivia enters the gym and sits beside Ava.

“Are you ok, Ava?”

Ava shrugs. 

Silence prevails as they watch the remaining students file in.

Mr. Clark, the principal steps onto a temporary stage.

“For today’s assembly, we have a guest speaker. She’s here to talk to you about mental disorder stigma. Please join me in welcoming Evelyn.”

A tall, young, brunette steps onto the stage. The male students appear captivated by her beauty, while Olivia is eager to learn about mental disorders.

Evelyn describes the stigma around mental disorders and explains biological and genetic reasons for mental disorders. 

“I hope you will think about people with mental disorders and treat them the same as everyone else. An easy way to reduce stigma is to include people with mental disorders,” Evelyn concludes her speech.

Evelyn relinquishes the stage to Mr. Clark. 

“Thank you, Evelyn.” Mr. Clark pauses allowing applause to fill the gym. “That is the end of this assembly. Enjoy your lunch break.” 

Ava leaves without a word.

Olivia passes students conversing with friends as she approaches Evelyn. 

“Can I ask you a question?”

“Hello. Sure, go ahead.”

“Surely most people have heard these biological explanations of mental disorders, so why does mental disorder stigma still exist?” 

I want us all to get along. How can I convince Samantha and Paisley to include Ava even if she isn’t feeling well?

“Well, there are a few reasons why mental disorder stigma exists. People believe the media’s inaccurate portrayal of mental disorders. Sometimes people with untreated serious mental disorders commit violent crimes which puts everyone with a mental disorder in a bad light. When people with mental disorders are thought to be different, people who are uncomfortable with different, treat people with mental disorders poorly. Other times people treat people with mental disorders worse to increase their own popularity. Not everyone with a mental disorder recovers so they may need to be in an inpatient home, yet this may increase stigma. 

Then there is debate about whether there should be a distinction between mild and serious mental disorders. Some people think the distinction will lessen stigma while others think the distinction worsens stigma. So, there is a lot of confusion about how to be rid of mental disorder stigma,” Evelyn informs.

That makes sense but it doesn’t solve anything. Evelyn looks proud like she explained a great mystery yet in reality she created more questions.

“Ok, thanks,” Olivia says with a polite smile before leaving, her curiosity intact.

***

After lunch, Olivia has English class with Mrs. Roberts.

“Alright, class, your next assignment is a research paper,” Mrs. Roberts announces.

The class groans in dismay.

“This one will be exciting because you get to choose the topic. You have the rest of class to brainstorm ideas. Once I have approved your topic you may leave class early.”

The sound of rustling paper and scratching pencils fills the classroom as students get to work, eager to leave class early.

Olivia still burning with curiosity about mental disorder stigma, writes about why does mental disorder stigma persist? Satisfied with her topic Olivia brings her paper to Mrs. Roberts for approval.

“Excellent choice, Olivia. I can see that today’s assembly has you thinking.” Mrs. Roberts initials Olivia’s page, with her red pen.

Olivia’s next period is a study block, so she heads to the library to start her research paper. She sits in front of a computer and opens her notebook.

  • Articles that repeat Evelyn’s answer
    • Media
    • Untreated mental disorders and violence
    • Us vs. them mentality
  • Criminalizing mental disorders perpetrates stigma
  • The concept of continuum beliefs could be used to combat the us vs. them belief
  • Historically people with mental disorders were contained in asylums and treated terribly
  • Too much familiarity with people with mental disorders may increase stigma
  • Biogenetic explanations don’t decrease stigma but rather may increase stigma
  • Psychosocial causal explanations may be better for reducing stigma, than biogenetic explanations.

That bit about biogenetic explanations making stigma worse can’t be right otherwise why did Evelyn present biogenetic explanations of mental disorders. Although it would explain why Samantha and Paisley are distancing themselves from Ava.

The bell rings. 

Olivia saves her list of URLs, grabs her notebook, and heads to her next class.

***

After school Ava passes Samantha and Paisley.

Will they call out to me? Can our friendship be mended?

Samantha and Paisley continue conversing excitedly, without acknowledging Ava’s presence.

 Ava trudges home dejectedly. 

Ava’s mom eagerly greets Ava as soon as she opens the door to their home. “Welcome home sweety. How was school today?”

“Fine.”

“Did you learn anything interesting?”

“Yep, depression is caused by genetics so I will be depressed for the rest of my life.”

“Aw, honey I’m sure you’ll get better. My ray of sunshine named Ava won’t be hidden behind the clouds forever. You just have to hold on a little longer, until the medication starts working. Do you want to watch a movie and eat ice cream? I bought your favorite, chocolate chip cookie dough.”

“You couldn’t save Dad. Why do you think you can save me?”

Ava’s words cut deep. Her mom’s smile shatters as tears stream down her face.

Good, now she’ll leave me alone.

Ava drags her body upstairs and collapses on her bed. She rests for a few moments then 

pulls out her journal.

March 29

During today’s school assembly it was said that depression is caused by genetics and other biological factors. 

Life sucks. I am always miserable or just not interested in anything anymore. My friends, Samantha and Paisley, don’t understand or they just don’t care. Mom thinks it’s just a bump in the road and that things will magically get better on their own. I did see a doctor 

months ago, but these antidepressants are useless. I am not a lab rat to wait in a cage while a doctor tries every possible drug in an attempt to cure me. I am done. I can’t pretend much longer. I can barely do anything anymore. I don’t want to do anything. 

Can this end?

Since genetics and biology just are and cannot be changed. Then the only way for this hell to end is for me to end it. 

The other day I searched for how to end it. I saw suffocation, poisoning, shooting, jumping, cutting, stabbing, drowning, dehydration, electrocution, fire…

Suffocation – by a bag, hanging, or breathing in helium or some other gases I don’t have access to. Hanging seems a little complicated. Any poison seems to be extremely painful. Also, poison runs the risk of someone finding me unconscious and pumping my stomach.

Failing would make me even more miserable. 

No gun. Maybe jumping, would need to find a suitable building. Cutting/stabbing would be painful and could easily fail. Drowning… Dehydration or starvation are just asking someone to stop me. Electrocution seems like I have equal odds of becoming a vegetable as dying. Fire… Burning to death would be horrific, maybe smoke inhalation. The internet said 2-10 minutes of smoke inhalation could kill a person. How/where could/would there be fire though.

This may take more work than I thought. Is it worth it? What happens if I give up? Just stop participating in school, or just stop getting out of bed at all. 

Dad must have been serious. He hung himself in a building that was to be demolished.

I miss Dad, he knew how to cheer me up. I suppose that was meaningless though since he could not retain enough hope to live. 

Can anyone retain hope enough to live?

“Supper’s ready,” Mom calls.

Ava hides her journal and heads downstairs.

If I don’t eat, Mom will worry then she may interfere. I’ll try to eat.

***

“Hey,” Ava greets Samantha and Paisley, attempting to appear normal.

“I doubt you want to come but we’re going to the mall after school,” Samantha says. 

Ava lowers her head.

Of course, she doesn’t want me to come. I’m never going to get better.

Paisley tries a gentler approach. “What do you think? Can you get better?”

Ava shakes her head while avoiding eye contact, head lowered.

“Go home and sleep if you need to. We’ll be fine without you,” Samantha tells Ava.

Samantha leaves and Paisley meekly follows, not willing to risk her popularity for Ava.

Ava feels her desire for suicide strengthen as her heart shatters. 

Olivia was approaching in hopes of socializing when Ava was abandoned.

“Are you ok?” Olivia gently asks.

“No, but there is nothing that can be done.”

“Do you want to talk?”

“Not really.”

“Are you sure? I may be able to help,” Oliva offers.

“You know I have depression and as we saw from the talk yesterday there’s not much that can be done.”

Olivia is silent for a moment. 

She probably thinks I’ll never get better so why should she waste her time.

“I’m sorry. I don’t know how to help but I can be your friend and listen.”

“Ya, like that’ll do any good.” Ava blinks quickly and turns to the sanctuary of the washroom. Enclosed in a dark stall, Ava lets her tears flow.

***

In the school hallway.

In the school hallway.

 Jack returns his textbooks to his locker and Bryson saunters over.

“Hey, Jack, don’t bother coming over on Saturday.” Bryson takes a deep breath before continuing. “I can’t hang out with you anymore.”

“What happened? We were solid, weren’t we?”

“We were but I can’t be near someone with schizophrenia.”

“Yesterday you were fine with it. What changed?”

Bryson’s internal struggle is written across his face. “I can’t relax around you knowing that one day you’ll have a psychotic break. There is no cure for schizophrenia and since it’s genetic I doubt there ever will be.” 

Jack watches Bryson’s retreating form. 

How did this happen? Maybe he just needs time to process. I’ll talk to him tomorrow. Maybe he didn’t mean it.

***

The following day at school.

Jack grabs his homework from his locker before heading to the science lab. He sees Everett and Ben working on a lab assignment, Ava at the back of the room, and Bryson near the homework bin.

“Bryson! How are you today?”

I hope yesterday was a bad dream or a mistake. I don’t want to be alone.

Bryson does not react. Jack steps closer and places his hand on Bryson’s shoulder. 

“Hey—”

“Don’t touch me,” Bryson yells as he shoves Jack hard.

A table breaks Jack’s fall and the force knocks over a lit Bunsen burner. Jack’s homework catches on fire.

“What’s wrong with you Bryson? Why are you treating me like this?”

“Do I need to pound it into you to make you understand? We’re not friends. Come near me again and I will hurt you.”

This doesn’t make sense. Am I delusional?

“I don’t believe you. This must be a delusion.”

As Jack approaches Bryson the fire alarm goes off.

Real or not I’m not risking it.

Jack quickly follows the other students outside. Once they were at the assigned meeting place, Everett approaches Jack.

“Wow, I didn’t know Bryson was such a jerk. I’m Everett. Are you ok?”

“I’m Jack.” He takes a deep breath. “I will be ok, but it sucks to lose a friend.”

“Ha!” Everett’s hands fly up to cover his mouth. “Sorry I shouldn’t laugh but Bryson sucks. Based on the way he just acted he never was your friend.”

He has a point. Maybe I am better off without Bryson.

“We can be friends though,” Everett offers before calling into the crowd of students. 

“Hey, Ben, get over here.”

Ben walks over and leans on Everett’s shoulder.

“This is my friend, Jack. Can he come over to your birthday party on Friday?” Everett requests.

“Sure, the more the merrier,” Ben says with a warm smile.

“Thanks,” Jack says to his new friends.

A contended warmth fills Jack.

I won’t be alone.

***

Twenty minutes earlier.

Ava numbly observes Jack and Bryson fight. The Bunsen burner falls and the fire spreads quickly.

An opportunity has appeared.

Ava rests her head on folded arms on the table before her. 

I wish my misery would end.

Ava closes her eyes, as smoke fills the room.

***

Olivia anxiously shifts her weight from foot to foot as Mrs. Roberts takes attendance.

Where’s Ava?

“Ava,” Mrs. Roberts calls.

Silence.

“Ava,” Mrs. Roberts raises her voice.

Again, no response.

“Has anyone seen Ava?”

Olivia shakes her head.

Mrs. Roberts finishes calling attendance as panic gnaws on Olivia. 

While other teachers give Mr. Clark a thumbs up, Mrs. Roberts’ thumb points down.

This can’t be happening.

Olivia hums softly to soothe herself. After what felt like an eternity, she sees a fireman carry someone outside.

Ava!

Olivia runs to Ava’s side. Relief floods Olivia when Ava’s eyes open. 

“Even if my friendship doesn’t mean much to you, I’m really glad you’re alive, Ava.”

Ava smiles softly.

 

Note to Reader:

How Research Inspired the Short Story, Can Friends Overcome Stigma?

Can we rid the world of mental disorder stigma? Mental disorder stigmas prevent individuals from seeking professional help and may cause individuals to stop attending counseling or other programs that aid mental health. Stigma may prevent individuals from being vulnerable with others, thus isolating themselves and worsening their mental health. Many people, groups, and organizations attempt to diminish mental disorder stigmas, yet mental disorder stigmas are still prevalent. With research and this short story, I explored the causes and solutions to mental disorder stigma.

The primary audience for this creative project is young adults and the secondary audience is health care professionals. This project is a short story about high school students, their struggles with mental disorders, and the social repercussions. Many people enjoy reading and the primary audience, young adults can relate to high school students.

Mental disorder stigmas hurt people and diminish their quality of life. Many well-meaning people, groups, and organizations try to reduce mental disorder stigmas. Have they reduced mental disorder stigma and if not why? What is the most effective way to reduce mental disorder stigma? My curiosity about these questions and desire to help people are why I made this creative project.

In the story during a school assembly, Evelyn gives a speech about mental disorder stigmas, and she explains biological and genetic reasons for mental disorders which is generally inspired by all of my sources. Later Evelyn’s answer to Olivia about why mental disorder stigmas persist despite biological explanations being widely known is heavily influenced by my research. Evelyn mentions that people believe the media’s inaccurate portrayal of mental disorders (Benjamin & Pfluger, 2018), the connection between untreated serious mental disorders and violent crimes (Eide, 2020), contributes to people treating individuals with mental disorders worse simply because they are different (Levine, 2017; Peter et al., 2021; Shrivastava et al., 2012), people treat people with mental disorders worse to increase their own popularity (Kvaale & Haslam, 2016), inpatient homes being necessary and yet they increase stigma (Eide, 2020), and the debate about the distinction between mild and serious mental disorders (Eide, 2020; Levine, 2017).

In the narrative, Olivia researches why mental disorder stigma persists. She makes a list of what she finds: media (Benjamin & Pfluger, 2018), untreated mental disorders and violence (Eide, 2020), us vs. them mentality (Levine, 2017; Peter et al., 2021; Shrivastava et al., 2012), criminalizing mental disorders perpetrates stigma (Shrivastava et al., 2012), the concept of continuum beliefs could be used to combat the us vs. them belief (Peter et al., 2021), historically people with mental disorders were contained in asylums and treated terribly (Eide, 2020; Shrivastava et al., 2012), too much familiarity with people with mental disorders may increase stigma (Corrigan & Nieweglowski, 2019), biogenetic explanations don’t decrease stigma but rather may increase stigma (Doll et al., 2021; Kvaale et al., 2013; Kvaale & Haslam, 2016; Haslam & Kvaale, 2015; Levine, 2017), and psychosocial causal explanations may be better for reducing stigma, than biogenetic explanations (Doll et al., 2021; Levine, 2017). Olivia ponders how biogenetic explanations don’t decrease stigma and the implications.

In the short story, Ava hears biogenetic explanations of mental disorders and loses hope of ever getting better (Haslam & Kvaale, 2015). Research shows that perceived dangerousness and increased desire for social distance increase when biogenetic explanations of mental disorders increase (Doll et al., 2021; Kvaale et al., 2013; Kvaale & Haslam, 2016). At a school assembly, a speech was given about biogenetic explanations of mental disorders. Later Samantha and Paisley socially distance themselves from Ava, who has depression. After hearing biogenetic explanations of mental disorders desire for social distance especially increases around people with schizophrenia (Kvaale et al., 2013). Bryson socially distances from Jack, who has schizophrenia, because Bryson fears Jack. Jack refuses to accept the sudden disintegration of their friendship, so Bryson shoves him and threatens violence if Jack doesn’t leave him alone.

During editing, I made sure Jack was not violent so as to not perpetuate mental disorder stigma (Eide, 2020). I was going to demonstrate how too much familiarity increases stigma (Corrigan & Nieweglowski, 2019) with Ava’s family but decided that would be too many characters and just too much to portray in a short story. The ending portrays the characters overcoming mental disorder stigma as both Jack and Ava have friends despite their mental disorders. Overall, my research generally informed my short story about mental disorder stigma.

In conclusion, research shows that biogenetic explanations of mental disorders do not reduce mental disorder stigma, but psychosocial causal explanations may. Together biogenetic explanations and psychosocial causal explanations may reduce mental disorder stigma, but more research is needed. Let’s help people with mental disorders by caring and not spreading false information about them.

References

Benjamin, J., Pfluger, B. (2018, May 8). The media still has a long way to go in portraying mental health accurately. The Big Issue. https://www.bigissue.com/life/health/the-media- still-has-a-long-way-to-go-in-portraying-mental-health-accurately/
Corrigan, P. W., & Nieweglowski, K. (2019). How does familiarity impact the stigma of mental illness? Clinical Psychology Review, 70, 40-50. https://doi.org/10.1016/j.cpr.2019.02.001
Doll, C. M., Michel, C., Betz, L. T., Schimmelmann, B. G., & Schultze-Lutter, F. (2021). Important Role of Stereotypes in the relation between Mental Health Literacy and Stigmatization of Depression and Psychosis in the Community. Community Mental
Health Journal 58, 474–486. https://doi.org/10.1007/s10597-021-00842-5
Eide, S. (2020, Winter). In Defense of Stigma. National Affairs. https://nationalaffairs.com/publications/detail/in-defense-of-stigma
Haslam, N., & Kvaale, E. P. (2015). Biogenetic Explanations of Mental Disorder: The Mixed-Blessings Model. Current Directions in Psychological Science, 24(5), 399–404. Retrieved March 11, 2022, from http://www.jstor.org/stable/44318903
Kvaale, E. P., Gottdiener, W. H., & Haslam, N. (2013). Biogenetic explanations and stigma: A meta-analytic review of associations among laypeople. Social Science & Medicine, 96, 95-103. https://doi.org/10.1016/j.socscimed.2013.07.017
Kvaale, E. P., & Haslam, N. (2016). Motivational orientations and psychiatric stigma: Social motives influence how causal explanations relate to stigmatizing attitudes. Personality and Individual Differences, 89, 111-116.
https://doi.org/10.1016/j.paid.2015.09.044
Levine, B. E. (2017, February 1). Killing “Schizophrenics”: Contemporary U.S. Psychiatry Versus Nazi Psychiatry. CounterPunch. https://www.counterpunch.org/2017/02/01/killing-schizophrenics-contemporary-u-s-psychiatry-versus-nazi-psychiatry/
Peter, L. J., Schindler, S., Sander, C., Schmidt, S., Muehlan, H., McLaren, T., Tomczyk, S.,
Speerforck, S., Schomerus, G. (2021). Continuum beliefs and mental illness stigma: A systematic review and meta-analysis of correlation and intervention studies. Psychological Medicine, 51(5), 716-726. http://dx.doi.org/10.1017/S0033291721000854
Shrivastava, A., Johnston, M., & Bureau, Y. (2012). Stigma of Mental Illness-1: Clinical reflections. Mens sana monographs, 10(1), 70–84. https://doi.org/10.4103/0973-1229.90181

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