Nearly three decades after the popular novel "One Flew over the Cuckoo's Nest" awakened the nation to the plight of the mentally ill, the stigma still lingers.
Stereotypes of psychiatric wards filled with schizophrenic men muttering garbled nonsense and severely depressed women huddled in a fetal position are so deeply entrenched that even relatives and friends of those suffering from a disorder can be reluctant to seek help.
"There's definitely a stigma that exists in mental health care," acknowledged Marshall Belaga, director of psychiatry at North Arundel Hospital. "It's a stigma we're working very hard at eliminating."
To combat the widespread misperceptions and offer the latest information on mental health issues, the Glen Burnie hospital is sponsoring four community awareness seminars this month. The hospital kicked off its month-long program with a workshop Monday night on locating psychiatric services in the county.
Many people don't realize they can receive help for common psychological problems by simply going to the emergency room, Belaga said. Doctors and nurses staffing the emergency room are trained to handle everything from a mild anxiety attack to a suicide attempt. They also refer patients to outpatient programs or recommend admitting them for treatment at North Arundel's psychiatric unit, he said.
"One doesn't have to be crazy -- and it's a term I deplore -- to be in need of psychiatric care," he told the more than 50 people who attended the seminar.
When a patient is admitted, either voluntarily or on the recommendation of a physician, to the hospital's 19-bed psychiatric facility, the doors swing shut on the outside world, said Mary Vogelsang, the unit's head nurse.
"A lot of people think we lock them in," she said. "We actually lock (the ward) to keep the family out because a lot of times the families are the stressers."
The hospital keeps strict confidentiality rules, only permitting visitors if the patient wants to see them and never giving out room phone numbers to callers, even if they are family members. Vogelsang said the confidentiality policy was developed to protect patients from discrimination "because a lot of people in the community still haven't accepted mental illness as an illness."
Patients typically only spend two weeks in the psychiatric unit "to get the treatment rolling," receive medication, be referred to an outpatient treatment program and "get back into the community as quickly as possible," she said. But they can continue to share their problems at a monthly support group run by the hospital the second Sunday of each month.
Since the hospital only admits patients after they turn 18, adolescents are referred to other medical centers or outpatient programs, such as the Glen Burnie Mental Health Clinic, Annapolis Day Treatment or Focus on Family, a Severna Park counseling service that specializes in treating addictions and family conflicts.
Both Belaga and Eldon Watts, a psychiatric social worker with the county Health Department, urged the audience to fight for more financial support from the county and state to strengthen and expand services. A number of planned prevention services, including an after-school program for children at risk of developing psychological disorders, failed to win enough financial backing and were scrapped in the last few years, they said.
"Your voice is heard a lot louder than ours," Belaga said. "If we speak up, they just think we're trying to line our pockets. If you speak up, they'll listen."
Several members in the audience, who said they were most interested in programs for children and teen-agers, promised to show up for next Monday's seminar, which will focus on suicide.