BlueTooth May Help Destigmatize Serious Mental Illness

I was standing on a street corner, waiting to cross on my way to a meeting at a large public hospital. A man in his 40s walked down the sidewalk behind me, staring straight ahead. He was alone, but was carrying on an animated conversation about the government’s failings.

The lights changed and I started to walk across the street. In the crosswalk coming toward me was a woman in her 30s, also staring into the middle distance and taking no notice of me. She was alone, but was carrying on an animated conversation about how the big banks are ruining the country.

As I said, neither took any notice of me, but I knew them both. One works as a cashier at the pharmacy I use and the other is a long-term psychiatric patient with schizophrenia. One had on a barely visible Bluetooth, the other has been engaged in discussions with imagined others long before the technology was invented.

But without my prior contacts with these two people, I would never have known that one of them had a serious mental illness. These fortuitous encounters make me wonder if these new technologies have an unintended but welcome destigmatizing function. Where before people might have shunned a mentally ill person who seemed to be talking to himself, today they usually assume that he’s just chatting on a BlueTooth or similar device.

Author: Keith Humphreys

Keith Humphreys is the Esther Ting Memorial Professor of Psychiatry at Stanford University and an Honorary Professor of Psychiatry at Kings College London. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans, drugs, crime and correctional systems. Professor Humphreys' over 300 scholarly articles, monographs and books have been cited over thirteen thousand times by scientific colleagues. He is a regular contributor to Washington Post and has also written for the New York Times, Wall Street Journal, Washington Monthly, San Francisco Chronicle, The Guardian (UK), The Telegraph (UK), Times Higher Education (UK), Crossbow (UK) and other media outlets.

34 thoughts on “BlueTooth May Help Destigmatize Serious Mental Illness”

  1. In the near future, good luck with distinguishing between someone having hallucinations or watching A My Children on their contacts.

  2. A co-worker was an early adopter of bluetooth technology. When someone would enter the room and see him talking away to apparently no-one, they would often ask “who’s he talking to”. I would answer “God”. Always good for a laugh.

  3. Correct: When I see someone blathering on alone I assume it is Bluetooth. But you are wrong about the shunning: I willfully separate myself from bluetooth users. I realize that we are trending towards a world in which public bluetooth shouters will not be obnoxious. Just as we have entered a world in which tattoos are not obnoxious. Be that as it may, I will continue to discriminate according to my own sense of decency.

    1. I agree with this. What we’re doing is not really destigmatizing, merely downgrading the putative diagnosis from schizophrenia or advanced psychosis to pathological narcissism.

      This is going to get even more interesting as the conversations stop being with other people and become predominantly with Siri and other digital-assistant software thingies.

    2. Just because large segments of society are accepting obnoxious behavior as “normal” doesn’t make it any less obnoxious.

      1. Just because small segments of society are denouncing trivial behavior as obnoxious, doesn’t make it obnoxious.

  4. Bluetooth won’t de-stigmatize serious mental illness. But it will buy people who talk to themselves some space because during that particular moment of public contact, no-one can know whether there is someone real at the other end of the conversation or not.

    1. I think there’s a confusion of issues here. To the extent that someone’s mental illness consists of NOTHING but them talking to themselves, perhaps they will blend in more.

      But I think at least part of the stigma of mental illness has to do with the unpredictability of the ill person; on every dimension from how they move to when they talk to what they say, they can’t be predicted, and that makes them scary. BT isn’t going to change that, not least because BT users are still predictable and so non-threatening.

  5. It was Scandinavian patriotism that led to the attribution of the technology to Norse King Harald Bluetooth (935-985 AD). The specific rationale is unclear. Wikipedia suggests it was “ostensibly due to his abilities to make diverse factions communicate with each other.” The fragmentary record does not really confirm he was a peacemaker; though he didn’t have the reputation that won Harald Hardrada his sobriquet - “the ruthless” - which took some doing in 11th-century politics, cf. Fulk Nerra of Anjou. However, Bluetooth did practice high public spending, with five large ring forts scattered across his wide domains.

      1. It’s only Wikipedia! I’m just “a snapper-up of unconsidered trifles”, like Autolycus.

  6. … or perhaps the opposite. Maybe all those folks taking advantage of hands-off technology will be presumed to be whackos.

    In any case, Keith, it’s clear you are a man with a good heart.

  7. Way before any of this technology existed, back in the 60’s and fed on a steady diet of Harriet The Spy and Get Smart, I remember, in my innocence, understanding that the funny man at the bottom of my street was talking to his control…

  8. I recall years ago some comic suggesting giving old cell phones to the deranged and training them to hold them to their mouths as they walked for just this reason. Years before that, another suggested pairing them up (much like Tom Lehrer’s suggestion back in the 1960s, I think, for pairing sadists and masochists and voyeurs and exhibitionists).

  9. The person blathering on their phone via Bluetooth is a much more predictable and appropriate social creature than the person who may be arguing with command hallucinations due to a serious mental illness.

    If I couldn’t easily tell the difference between the two I would feel obligated to actively shun/avoid both of them in the interest of my own safety. Although no one questions the importance of destigmatizing mental illness, I’m not sure that obscuring behavioral differences that might be important to public safety is the best way to go.

    1. People with mental illnesses are no more likely to be violent than people without mental illnesses. They are, however, much more likely to be the victims of violent crime themselves.
      http://depts.washington.edu/mhreport/facts_violence.php

      People with substance abuse problems are more likely to be violent, but laregly towards friends and family members. Mentally ill people who also have substance abuse problems are more likely to be violent, again with family members. http://psychcentral.com/archives/violence.htmhttp://psychcentral.com/archives/violence.htm

      But, you have no reason to fear a mentally ill person who you don’t know more than a neurotypical person you don’t know; and you should fear a neurotypical substance abuser more than a mentally ill non-substance abuser.

      1. Yeah, right. People with specific mental illnesses can be up to 20 times more likely to commit acts of violence than the mentally healthy. (Though the majority still won’t.) OTOH, people with other forms of mental illness may be less likely. (If you’re huddled in the corner with clinical depression, you’re not going to be out mugging people.) No such blanket statement is appropriate; Mental illness is a heterogeneous classification, it both IS and ISN’T associated with violence.

  10. I feel this is somehow related but can’t figure out how:

    I recently read somewhere (grrh!) that many people seen walking down the street apparently absorbed by their smartphone are actually folks pretending to be absorbed because they are alone and feel the need to “look busy”. So they feel less awkward when they have something to concentrate on.

  11. Around a year ago I saw a beer (I think) commercial that got at the bluetooth problem. A guy walks into the store and stands against a refrigerator door trying to select one of the beers. To his surprise, the extremely beautiful looking woman next to him suddenly says “so, what are you doing tonight?” The average Joe quickly gets it together to offer some sort of cool sounding reply. The woman then says “so, do you want to hang out later tonight maybe?” The average Joe cannot believe his luck and starts to answer when the woman suddenly turns to him and gives him the milk-curdling glare. Only then does the BT piece in her ear become visible to us and to the victim.

  12. I was leaving my local library branch when I heard what sounded like an animated conversation about some political scandal of the hour. I looked around and saw a tall gentleman engaged in said conversation.

    I would have assumed a Bluetooth-aided phone conversation at the root of what I overheard, except the fellow had waist-length hair, had on both a baseball cap and a stetson hat, and was holding onto two separate shopping carts filled with plastic bags, aluminum cans, and several used books.

    For the moment at least, Bluetooth users who refrain from cavorting with the familiar accoutrements of the homeless will be judged only on their obnoxiousness, not on the possibility that they are also paranoid and delusional.

    1. Just a minor point, but still worth considering: People who talk to themselves aren’t always going to be paranoid or delusional. They may just lack somebody else to talk to, and talk to themselves to relieve the pressure that real conversations aren’t dealing with. The key question is, do they think they’re talking to somebody else?

      If they don’t, it’s not a sign of insanity, just a bad habit.

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