What is Mental Health Stigma?

Dr Laura

The latest reports on rates of mental health occurrences suggest that 20-25% of the world’s population will require support for a mental health condition (WHO, 2020). However, mental health stigma maintains itself as one of the largest societal and personal barriers to mental health services.

Fear of the unknown and misunderstanding are common triggers of anxiety and depression. They also limit us from understanding ourselves and others. Specifically, mental health stigma may cause us to avoid seeking treatment or express our disapproval for a loved one wishing to obtain services. At its worst, mental health stigma also causes a barrier to services that leads to discrimination towards those who require assistance.

Minimizing, hiding, or avoiding symptoms of anxiety, depression, and many other concerns ultimately leads to poorer outcomes, most notably: lack of hope for the future, low self-esteem, increased self-harm tendencies, lack of socialization and engagement in professional and personal life (Yanos, DeLuca, Roe, Lysaker, 2020).

“…you never really understand a person until you consider things from his point of view- until you climb into his skin and walk around in it.” Atticus Finch, To Kill a Mockingbird

What is mental health stigma?

Mental health stigma takes many forms and occurs at individual, group, and global levels. More specifically, mental health stigma occurs emotionally, cognitively, and behaviorally. It is also commonly viewed as a universal problem, impacting individuals from all walks of life (Rössler, 2016).

Ultimately, this stigma wrongly suggests that mental health issues are the reason behind a person’s ineptitude, risk, or ability to function properly in a given job or society.

Mental health stigma is commonly referred to as personal and public stigma.

Personal stigma relates to the internal view of our own mental health experiences. Internalized beliefs of how mental health concerns are addressed (or avoided, rejected) within our family, peer group, gender affiliation, culture, or religion are at the root of self-stigma.

Additionally, how one should express feelings or cope with the problems that we face throughout our lives also contributes to how we view ourselves, our internal world, and if we seek treatment. Issues of doubt, ability, shame, uncertainty, disbelief, repression, and invalidation are common regarding personal stigma.

Results of internalized personal mental health stigma may be lack of perceived ability, isolation, self-hatred and shame. Unfortunately, personal stigma has been found to greatly impact treatment outcomes, with many individuals not seeking treatment, dropping out prematurely, or delaying recovery (Oexle, et al., 2018).

Public stigma refers to how others (family, work, cultural/religious affiliation) view mental health concerns, including stereotyping and social norms. Many stereotypes of mental health concerns generalize treatment as something reserved for someone who is non-functioning, a danger to society or themselves.

Public mental health stigma often leads to inaccurately stereotyping mental health concerns (e.g. misinformation from the media, social networking) and marginalizing those that are viewed as experiencing mental health symptoms.

How to support yourself or someone else who is seeking help

Be aware of the information you are consuming

The media (e.g. the news, tv shows, movies, social media) has overwhelmingly characterized those with mental health diagnoses in extreme and inaccurate ways as afflicted, reactive, unpredictable. Often, the representation of certain diagnoses, such as schizophrenia and OCD are not realistic and thus perpetuate misunderstanding, generalization, and invalidation.

For example, schizophrenia is often the most misunderstood diagnosis (e.g. those with schizophrenia are dangerous, unable to operate in society) and OCD (everyday preferences of order constitute a diagnosis) is the most trivialized (Robinson, Turk, & Jilka, 2018).

Unfortunately, mental health diagnoses are often characterized as the primary identity of a person, rather than one facet. Fortunately, there are national campaigns and resources that are combating mental health stigma that assist in demystifying these issues and bringing accurate and supportive representation to the forefront. Those include:

Use supportive language to yourself and others when addressing mental health issues

The internal and external language we use often shapes our feelings and expectations. Using person-centered, supportive language is a large part of reducing mental health stigma. For example:

“A person living with a mental health condition” rather than “mentally ill”
Avoid labeling, generalizing, assuming other’s experiences
Perspective-take and use empathy
Use curiosity and educate yourself & others

Source: National Institute of Mental Health

If you or someone you know is in crisis, call 911 or contact the following resources for support:

References

Oexle N, Müller M, Kawohl W, Xu Z, Viering S, Wyss C, Vetter S, Rüsch N. Self-stigma as a barrier to recovery: a longitudinal study. Eur Arch Psychiatry Clin Neurosci. 2018 Mar;268(2):209-212. doi: 10.1007/s00406-017-0773-2. Epub 2017 Feb 10. PMID: 28188369.

Robinson, P., Turk, D., Jilka, S. et al. Measuring attitudes towards mental health using social media: investigating stigma and trivialisation. Soc Psychiatry Psychiatr Epidemiol 54, 51–58 (2019). https://doi.org/10.1007/s00127-018-1571-5

Rössler W. The stigma of mental disorders: A millennia-long history of social exclusion and prejudices. EMBO Rep. 2016 Sep;17(9):1250-3. doi: 10.15252/embr.201643041. Epub 2016 Jul 28. PMID: 27470237; PMCID: PMC5007563.

World Health Organization [WHO] Investing in mental health. Geneva, Switzerland: WHO; 2021.

Yanos, P. T., DeLuca, J.S., Roe, D., Lysaker, P. H. The impact of illness identity on recovery from severe mental illness: A review of the evidence, Psychiatry Research, Volume 288, 2020.