Why did this happen? Cultural stigmatization of mental illness and the public understanding of it provide some answers. For many years people with persistent, severe psychiatric disorders were considered the only ones to have real mental illness and the accepted treatment was to sequester them in state hospitals. People who were depressed, anxious, grieving, or otherwise stressed were not seen as having mental disorders but rather problems of living. Much of this attitude continues today. In an individualistic society that places a high value on self-reliance and independence, the burden of normality is selfmastery
and sufficiency. Normal people must live with, work through, and master their problems of living. Independence and self-reliance are virtues; dependence on mental health professionals is seen as a weakness. The legitimacy of sequestering the severely ill, the denial of mental disorder among the nonpsychotic, the social norm of self-mastery, the devaluing of seeking help for psychological problems, and skepticism about available therapies served to justify the distinction between medical and mental health care in insurance reimbursement (Teitleman, 2002).