Psych Unit Gangs: An Autoethnography

The stigma against people with mental illness is a well-worn subject; however, stigma between groups of people with different mental illnesses is rarely discussed. Within the context of a psychiatric hospital, hierarchies form among patients based on symptomatology and diagnosis. In this perspectives piece, I explore, how, in my experiences with being on the bottom of this hierarchy as a person with a schizophrenia-spectrum psychotic illness in a psychiatric hospital. I, and my fellow "psychotics," were stigmatized and outcasted by other groups of individuals who were diagnosed with mental illnesses that are considered less serious than psychosis. I explore how one stigmatized, outcasted group (people with substance use and mood disorders) construct power relationships over an even more highly stigmatized, marginalized group (people with psychotic disorders). Utilizing Goffmanian and Tajfel theories, the perspective explores stigma within a total institution, and the formation of in-groups and out-groups. I explore how people, upon entering the psychiatric hospital unit, know almost immediately whether they belong to the dominant group or the subordinate group, and I conclude with recommendations to reduce the stigma of psychotic disorders within popular culture.