BOX 2-2: The Politics of Stigma

The public perception of an individual's stability, competence, and stamina is perhaps most important in the political arena. Indeed, the slightest hint of mental health problems can be the political kiss of death. Recent history shows that the stigma associated with mental illness is a formidable weapon when used to cast doubts on a candidate's fitness for political office. Although it was acknowledged among his peers that President Lincoln was plagued by "melancholy" throughout his life and his presidency, it wasn't until 1964 that a "mental illness" was first raised as a campaign issue. Since that attack on Republican presidential candidate Barry Goldwater's mental health, several other national candidates have had their mental stability attacked. A closer look at some of these political races corroborates the stigma of mental illness while hinting at an evolution in public attitudes.

The Political Kiss of Death

In October 1964, in an effort to discredit presidential nominee Barry Goldwater, the publisher of the now defunct "Fact" magazine published the results of a survey he had commissioned in which more than 1,189 of the 2,417 psychiatrists answered "no" to the question, "Is Barry Goldwater psychologically fit to be President of the United States?" The American Psychiatric Association (APA) and the American Medical Association assailed the survey as "yellow journalism," with the APA noting that:

By attaching the stigma of extreme political partisanship to
the psychiatric profession as a whole in the heated climate of the
current political campaign, Fact has in effect administered a low
blow to all who would advance the treatment and care of the
mentally ill of America.
Subsequently, the APA adopted what it called "the Goldwater Rule" which forbids doctors from offering a psychiatric opinion on a public figure unless the psychiatrist has personally treated the official and has authorization to break patient-doctor confidentiality. Although it is difficult to know with any certainty the effect of any one factor on a political campaign, it appears that the incident contributed to Mr. Goldwater's defeat in the presidential election. He did, however, successfully sue the magazine's publisher, becoming one of the few public figures to win such a libel suit.

Several days after Democratic presidential candidate George McGovern selected Senator Thomas Eagleton as his running mate, the national press revealed that Mr. Eagleton had withheld the fact that he had been hospitalized on three occasions for "nervous exhaustion and fatigue" and that he had undergone electroconvulsive therapy for depression on two of the three occasions. In this instance, the information was true. Mr. Eagleton had withheld the information from Mr. McGovern and his staff when asked if he had "any skeletons in the closet."

Perhaps Mr. Eagleton did not regard his medical history of depression as a "skeleton." It became clear, however, that the press and much of the public did. While some people praised Mr. Eagleton for his candor, most people criticized his judgment for failing to make the facts known before his nomination. Moreover, while some people found it reassuring that Mr. Eagleton recognized the need and sought treatment for depression and expressed confidence in his ability to be Vice President, others viewed him an unfit candidate for the office and urged him to withdraw from the race. After a painful and public debate, Mr. Eagleton was dropped from the ticket.

Sixteen years after Mr. Eagleton was forced to withdraw, rumors of mental illness were used against Michael Dukakis' bid for the presidency. During the 1988 presidential campaign, supporters of Lyndon LaRouche circulated the rumor that Michael Dukakis had been treated by a psychiatrist for depression. Initially, Mr. Dukakis dismissed the allegations with an assertion that there was no evidence to support the rumor and he refused to release his personal medical records. But then, President Reagan brought national attention to the rumor when he joked at a press conference that, "I am not going to pick on an invalid," when asked his opinion about Mr. Dukakis' refusal to release his medical records. Eventually, Mr. Dukakis' personal physician issued a statement assuring the public that the presidential candidate was in excellent health and had had no psychological symptoms, complaints, or treatment. While the ultimate outcome of the presidential race may not have hinged on this issue, it nonetheless underscores the potency of such allegations.


A New Age?

More recent experience suggests that voters' attitudes about mental illness may be changing. In 1990, former United States Senator Lawton Chiles had to deal with the mental health issue during his gubernatorial campaign in Florida. Mr. Chiles acknowledged that he was taking the widely prescribed drug Prozac for treatment of depression, which he had suffered since leaving the U.S. Senate, complaining of "burnout." During the gubernatorial primary campaign, his opponent's running mate suggested that Mr. Chiles could be suicidal. His allegation was based on newspaper accounts that the makers of Prozac were being sued because the drug induced suicidal tendencies.

Mr. Chiles was obliged to release medical records that said he did not contemplate suicide during his bouts with depression. The voters did not seem to consider Mr. Chiles' taking of Prozac to be a significant issue. Mr. Chiles said he thought the health issue was much more of a concern to the press and politicians than to average people. "I didn't realize how many people knew something about depression, had somebody in their family with it or whatever," he said. "People are always coming up to me, just kinda squeezing my arm and saying something." Mr. Chiles won the election.

Most recently, in 1992, Congresswoman Nydia Velazquez, former U.S. Secretary of the Department of Puerto Rican Community Affairs, won her bid to represent New York City's 12th Congressional District despite reports that she had attempted suicide in 1991. After hospital records revealing a bout with depression, pills, alcohol, and attempted suicide were anonymously leaked to news organizations, Ms. Velazquez held a news conference to assure voters that she had been receiving professional counseling that gave her "a whole new outlook on life." Apparently voters were convinced; she won the election with 77 percent of the votes.

The experience of candidates for public office reflects what people in all walks of life know: Mental disorders trigger stigmatizing perceptions of incompetence, personal turpitude and weakness, endangering job prospects. Thus, even with the suggestion of diminishing negative attitudes, people with psychiatric disabilities clearly need protection from discrimination offered by the ADA.


>SOURCES:

"Risks of Prying Into Mental Health Problems," CQ Researcher 2:346, 1992; J. Fuller, "Editorials Are Mixed on Eagleton," Washington Post, July 28, 1972, p. A13; J. LeMoyne, "Polls Show Chiles Leading in Florida," New York Times, Sept. 2, 1990, p. A24; "Is Barry Goldwater Psychologically Fit to be President of the United States?" advertisement in New York Times, Sept. 12, 1964, p. L26; "Doctors Deplore Goldwater Poll," New York Times, Oct. 2, 1964; New York Times, "The 1992 Election: New York State-- U.S. House Races: Green and Downey Lose as New York State Delegation Changes Dramatically," New York Times, Nov. 4, 1992, p. B11; C. Sandburg, Abraham Lincoln: The Prairie Years and The War Years (New York, NY: Harcourt, Brace, 1954); R. Toner, "Florida Governor Warily Fights Chiles Mystique," New York Times, Sept. 14, 1990, p. A14; "Ex- Senator Chiles Issues Health Data," Washington Post, Aug. 22, 1990, p. A3; "After Suicide Try, Candidate is `Truly' Living," Washington Post, Oct. 9, 1992.


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