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I am a consumer and a volunteer at the helpline of the National Alliance for the Mentally Ill in New York City, which is a referral and information service conducted by volunteers. I have had a few calls from consumers complaining about the stigma attached to mental illness and asking what is being done to combat and diminish the social, moral, and personal implications of stigma.

One of the most frequent dilemmas regarding stigma is disclosure of mental illness at the work place. Consensus among mental health consumers is that disclosure only exacerbates discrimination. In 1984 I was fired from Rehabilitation International, the umbrella organization for disabilities with over 170 affiliates throughout the world and a consultant to the United Nations. The incident occurred just after my fifth year anniversary on the job. I became manic and lost control and as a consequence was briefly hospitalized. When I tried to return to work I was told that my position had been dissolved due to lack of funds. I found it ironic at the time that the international organization covering every disability so unscrupulously terminated me.

In retrospect, I think it is despicable that one is so totally cut off without any recourse due to a mental illness, although his/her history of employment is successful for a long period of time. Personal experience also illustrates the fear of mental illness that the "normal" members of society have, hence, their inability to be open to discussing it, as though dismissal of mental illness renders it nonexistent.

My employed peers disguise the results of episodes by justifying time taken off from their jobs, invoking physical ailments requiring batteries of tests necessitating lots of time and necessary bed rests. They would resort to any plausible lie lest they would endure the discriminating attitudes of their colleagues and supervisors and the drastic consequence of losing their job. Health-wise, many of us are afraid of being diagnosed because of how family and friends may treat us.

Socially, stigma is perpetuated by the mass media and the entertainment industries, although the recent movie "A Beautiful Mind" made a breakthrough in the myths associated with the occasional chemical imbalances of psychotic disorders, which are treated with medications in the same way physical ailments are.

Strides in the mental health field are being made to reduce the impact of stigma. Last year the Fogarty International Center for Advanced Studies in the Health Sciences, which is part of the National Institute of Health (NIH), held a conference on stigma. In August, they announced a new research program with 11 NIH partners and the Canadian Institutes of Health Research to support international collaborations to study stigma and global health. Societal negative responses to mental illness such as disapproval, rejection, exclusion, and ultimately discrimination would be studied in order to develop interventions against stigma throughout the world.

This year, such a research program cost $2.75 million and the total support will be around $11 million over the next five years. Please contact Jennifer Cube at (301) 496-2075 for information on ongoing programs. We consumers are the most influential segment of society in the combat against stigma through our daily struggles, self-advocacy as well as outstanding accomplishments and need to be at the forefront of the battle.