Social Stigma: Mentally Ill

[Pursuivant]

This variation of Social Stigma is very common and can be based on the Second Class Citizen, Minority Group, or Outlaw RAW variants.

Social Stigma (Mentally Ill)

-5, -10, or -15 points

You suffer from discrimination and social marginalization because you obviously have, or are widely though to have, a serious mental illness or intellectual disability. Depending on its severity, your stigma might cause anything from occasional inconvenience to regularly life-threatening situations.

It is worth -5 points if it is subtle enough that it only occasionally interferes with your life, such as limiting your ability to hold certain jobs, gain a security clearance, or marry into certain families.

For -10 points your problem is either so obvious that it's immediately noticeable or is "common knowledge" within your society. At this level few normal people accept you as a peer, bullies will target you and even well-meaning people unintentionally patronize you. You are forbidden from holding any sort of high-status or high-pressure jobs due to your perceived mental instability. Fellow mentally-ill people might react to you at +1, however, particularly if they believe that you suffer from a similar form of mental illness.

For -15 points, your mental illness makes you an outcast. All but the most tolerant people fear you, shun you, and try to drive you away. You are regularly persecuted by bullies and hassled by police. You might be considered incompetent to handle your own financial affairs or medical treatment, giving others the right to make major life decisions on your behalf even without your consent. You might be involuntarily jailed or committed to a psychiatric institution. If you are killed, or left to die of neglect, it is highly unlikely that those responsible will ever be brought to justice.

You can have a social stigma for mental illness in addition to any traits which justify it. In such cases, the mental traits which model the disadvantage only cover limitations on your personal behavior. If the trait carries a reaction penalty, your problem is still subtle enough that the penalty only applies to people who know you, who have seen you personally, or who have been directly affected by your problem. Adding a Social Stigma to the base traits means that your problem is immediately obvious and affects how you are treated by society at large.

It is different from an Odious Personal Habit in that you don't have to do anything to in order to draw a reaction penalty. You are are stigmatized based on what your represent or what people believe you might do. It is different than a bad Reputation because the stigma isn't based on anything you've done; you just fit into a clearly identifiable, traditionally marginalized group.

Most importantly, you don't have to have an actual problem to be perceived as being insane. For example, historically, repressive governments have stigmatized perfectly sane scientists and political activists as being mentally ill. In less sinister situations, people who suffered from acute, treatable mental problems have been permanently stigmatized as being mentally ill even after they were cured.

In some cases, a social stigma for being mentally ill can be partially offset by levels of Social Regard, usually Feared or Revered. Social Regard (Feared) is appropriate for reputedly insane people with formidable powers which makes them dangerous to cross, Social Regard (Revered) is suitable for mentally ill people who are seen as being harmless or charming (e.g., a charismatic crackpot) or who were previously well-respected members of their community, such as an elder suffering from dementia.

[David Johnston2]

I would suggest that you change it to "Social Stigma: Apparently Mentally Ill". It isn't needed when the character is actually mentally ill because actual mental illnesses already have disadvantages to represent them and those disadvantages come with social penalties. But it could represent people who aren't mentally ill but for example, have advantages like Medium or Precognition that make them look crazy because they can see things those around them can't.

[Sam Baughn]

If Criminal Record, Minority Group and Second-Class Citizen are fixed cost, I see no real reason why this should be variable. I'd simply use Second-Class Citizen, which nicely covers the restricted legal rights, and let reaction penalties from the disorder do the rest.

[SilvercatMoonpaw]

Originally Posted by David Johnston2

But it could represent people who aren't mentally but for example, have advantages like Medium or Precognition that make them look crazy because they can see things those around them can't.

Or people who are being labeled "mentally ill" because they won't conform to social norms.

[Pursuivant]

Originally Posted by Sam Baughn

If Criminal Record, Minority Group and Second-Class Citizen are fixed cost, I see no real reason why this should be variable. I'd simply use Second-Class Citizen, which nicely covers the restricted legal rights, and let reaction penalties from the disorder do the rest.

My proposed disad. is just a modification of Second Class Citizen, Minority Group, and Outlaw/Outcast, respectively. Degree of stigma depends on culture and degree of public perceptions, hence the three different costs.

The same idea holds for certain physical diseases, like Leprosy. Where lepers are feared and shunned, they're effectively Outcasts. Where they're not feared but blocked from full participation in society, they're a Minority Group or Second Class Citizen.

I proposed this disad. because a history of mental illness, or certain types of mental illness, can end careers, block access to a number of professions, or interfere with full social participation in the same way that being a member of a racial, religious, or sexual minority can. Even if a condition is misdiagnosed or properly treated, the stigma remains.

As David Johnson pointed out, it's also designed for people with supernatural powers that make them seem mentally ill to normal people. (E.g., if you can see and talk to invisible ghosts or faeries, normal people will assume that you're schizophrenic unless you make a point of carrying a cell phone or wearing a Bluetooth earpiece everywhere you go.)

As for mental disads which carry an inherent reaction penalty, it's GM's choice as to whether you can "double dip" by also taking a Social Stigma. For example, Chronic Depression doesn't carry a reaction penalty. With a high self-control roll, you might actually be able to retain a high-stress, high-profile career. A public stigma for mental illness due to Chronic Depression would turn a private problem into a social one.

Historically, the stigma of seeking psychiatric treatment prevented people from seeking treatment. Being involuntarily committed for an acute psychiatric problem created a stigma that followed patients for the rest of their lives and was used to justify all kinds of subsequent abuse. The fact that a public figure had sought routine treatment could be weaponized (e.g., Richard Nixon's agents burglarizing the offices of Daniel Ellsberg's pyschiatrist, to discredit Ellsberg after he leaked the Pentagon Papers). A public figure with a history or recurrent mental illness (e.g., King George III of England) would be pushed aside by rivals or possibly treated in ways that would never be justified otherwise if they hadn't been declared insane.

[Farmer]

Mental illness is indeed stigmatised beyond the equivalent physical illnesses at any given level, although that situation is improving in some parts of the world. How it plays in a given game world could be quite interesting. In some historical settings the person might even be revered for seeing spirits or something similar. I think the first thing to do is understand the cultural norm for the world and then you can assign points accordingly (disad or ad or neutral). Perk/quirk level "doesn't think badly of mental illness" might also be appropriate for a PC if it has some impact in the game world.

I would also caution that you check with players and GMs alike before gaming such things. The biggest issue with mental illness is that most people are unaware of those who may be dealing with them.

[Otaku]

Originally Posted by David Johnston2

I would suggest that you change it to "Social Stigma: Apparently Mentally Ill". It isn't needed when the character is actually mentally ill because actual mental illnesses already have disadvantages to represent them and those disadvantages come with social penalties. But it could represent people who aren't mentally but for example, have advantages like Medium or Precognition that make them look crazy because they can see things those around them can't.

I don't think that change is necessary, and may add unneeded clutter. I base this on the trait Delusions. While not apples to apples, you still have a trait that is largely based on how others perceive you, though it does also care about your actions.

However, it remains true that you can have Delusions but actually not be deluded. Maybe you're perfectly sane and just are mistaken as delusional by a society unaware of the truth... or maybe you're right but still crazy. ;) "Apparently Mentally Ill" makes it sound like we need an "Actually Mentally Ill" to go with it, if we're drawing such distinctions. So why not keep it simple, and let the character's other traits and backstory handle details like whether or not they're actually mentally ill?

Maybe it goes without saying, but I'd also allow this at the Quirk Level. Maybe I'm mistaken because of personal experience, but there are some forms of mental illness that carry only a minor stigma.