“Irre menschlich Hamburg” – An Example of a Bottom-Up Project

This chapter highlights the advantages and importance of bottom-up approaches in the fight against stigma. Where and how does stigmatization occur? Through uneducated neighbours, colleagues or psychiatric services itself? Does the diagnostic process unwillingly foster stigmatization by creating terminological barriers? Is it the case that today’s prejudices against psychiatry reflect its failure of the past? Which concepts of mental health problems can strengthen or weaken prejudices, and which concepts can foster tolerance and sensitivity? What does successful work against stigma look like and what are the necessary prerequisites for such work? How should a field of psychiatry be constituted that allows for the natural transition between life crises and mental health problems that do not reject experiences with alienating terminology and concepts, but instead supports the assimilation of alienating experiences? Questions regarding stigmatization and in opposite regarding tolerance, sensitivity, prevention and hope are profoundly connected with the understanding of health and mental health problems, as well as the proposed concepts of support systems. Stigmatization due to mental health problems is judged as more distressing compared to stigmatization due to innate features or a minority status, given that the stigmatized person often held similar prejudices prior to their mental health problems. Whether people are stigmatized depends on the concept of human being, not merely on the idiosyncrasies of the individual. If a society propagates the picture of a successful, dynamic, eternally youthful person as the unquestioned standard, then any deviation from this can be stigmatized. A field of psychiatry that diagnoses every “deviation from the norm” and that endlessly extends its diagnostic categories is substantially responsible for the expansion of stigmatization.