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"In some Asian populations, we know there are not even words for therapy or suicide," said Kristee Haggins, senior associate at the California Institute for Mental Health and one of a dozen or so exhibitors. Unwillingness and/or the inability to access care are common barriers across cultures, said Haggins. But there is an added layer of resistance among some ethnic groups. Members of these groups may prefer to access non-psychological resources and services, like church and spirituality, she told CT.

Fighting Stigma

"If you don't fight stigma in your own family, the rest of society and the church aren't going to fight stigma either," said Amy Simpson, author of Troubled Minds: Mental Illness and the Church's Mission. The message she heard from her community and church growing up was that her mother (who has schizophrenia) was to be feared and that she too was "infected," Simpson said.

One-fourth of Americans will suffer a mental illness this year, several speakers said. Sixty-five percent come to church first for help with their struggles, said Vann.

However, one-third of Americans and roughly half of evangelical, fundamentalist, and born-again Christians say that with prayer and Bible study alone, sufferers can overcome serious mental illness, a September 2013 LifeWay Research survey found.

"From my standpoint, the stigma that affects the members of the congregation is exactly the same stigma that affects any group of people," said Pitman at the press briefing.

"People don't want to admit to having a mental illness, because we all know what it looks like. It's either a psychopathic killer or somebody sitting in a corner, staring vacant-eyed and drooling.... That's not what it looks like. It looks like the people in this room," he said.

Stubbornly High Suicide Rate

Stigma is "a victim word," said Tom Insel, director of the National Institutes of Mental Health, in an email to CT after the conference. (Insel was not in attendance.)

"We need a word that empowers," he said. "Discrimination is a better term for framing the issue." Imprecise language can negatively influence the perceptions of caregivers, conflate the illness with a person who has it, and affect the person's self-perception, Insel said.

"One of the most difficult issues for people with depression is their self-loathing, that sense of hopelessness and helplessness that precludes getting the care they need. All of this is complicated but, for me, much more useful than talking about stigma," he said.

The issue that keeps Insel up at night is the nation's intractable suicide rate, he said. "The rate is remarkable — 38,000 a year – or about one every 15 minutes in this country — and no sign of a decrease over the past 20 years when mortality from traffic accidents, homicides, and AIDS [all now less than 38,000 per year] have gone down," said Insel.

Lack of integrated and equitable care contribute to mental illness mortality and morbidity rates, he said, but so does a lack of of good science about mental illness.

"We don't know enough," said Insel.

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