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Combating Stigma

June 1, 2009
by Douglas J. Edwards, Editor-in-Chief
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Last month I came across stories about “Psycho Donuts,” a business in Campbell, California, selling treats with names such as “massive head trauma,” “bipolar,” and “cereal killer” (the latter topped with Froot Loops).1 Employees wear lab coats or nursing outfits, and the store has a straightjacket, padded booth, and “group therapy” area.2 The place is a hit, selling out every day with the line out the door on weekends.3

While it's easy for the public to dismiss this business's marketing plan as just a gimmick, we know that making fun of behavioral health disorders can have serious consequences, ultimately leading people with these problems to feel shame, experience discrimination, and avoid treatment. I don't blame the owners for trying to make a buck in a tough economy, but there must be a better way to sell donuts than playing off misconceptions of people with health problems. While such activities might seem innocuous at first, over hundreds of years this stigma has helped to devalue mental health and substance use problems and their treatments. So perhaps it's no surprise that in a recent study that asked Americans to rate 27 health services and products from a personal financial decision-making perspective, psychiatric services, vocational rehabilitation, and services for mental retardation and substance abuse were the least valued.4

Yet in the last century the field has made tremendous progress in combating stigma, and places like Psycho Donuts don't go unchallenged. Advocates recently gathered outside to protest the concept.1 They reminded me of Clifford Beers, the founder of what we now know as Mental Health America. One hundred years ago he spoke out about his bipolar disorder and helped start a movement to change how the country treats people with mental illness, and in this issue we examine the association's history and vision.

As the nation begins discussions on healthcare reform, mental health and substance use treatment are not lawmakers' highest priority. But at perhaps no other time in our country's history has this field been so visible and empowered. We have strong advocates on the national scene and local citizens determined to make the world a better place for people with behavioral health problems. While we probably won't achieve all we would hope for in the current healthcare debate (Consider how the parity fight was won in incremental steps), I am optimistic that our concerns won't be ignored. One hundred years ago, they may have been, but not today.

Douglas J. Edwards, Editor-in-Chief


  1. Donut shop's name angers mental health advocates. Updated May 18, 2009. Accessed May 19, 2009.
  2. Preuitt L.Campbell's Psycho Donuts driving some crazy. Updated May 12, 2009. Accessed May 19, 2009.
  3. Fisher P. Fisher:‘Kinda crazy’ doughnuts not so funny. Mercury News. Updated April 8, 2009. Accessed May 19, 2009.
  4. Access to care leads Americans’ priorities in first-ever public study of health value [press release]. Washington, D.C.:Spectrum Health.May 12, 2009.
Behavioral Healthcare 2009 June;29(6):9