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Stigma in Mental Health: Understanding the Definition and Impact of the Stigma around Mental Illness

Written by:
Rabia Khaliq
MSc in Applied Psychology
Reviewer:
Chelsea Ozigboh
NP

In the United States, more than one in five adults [1*] face a mental illness, and approximately one in 25 U.S. adults suffer from severe mental disorders like schizophrenia, bipolar disorder, or major depression. Around 8% [2*] of adults are affected by feelings of worry, nervousness, or anxiety while 8,3% [3*] had at least one depressive episode.

Despite the importance of addressing mental health, there is often a stigma surrounding mental health issues. A shocking 62% of Americans [4*] experience shame and stigma in relation to mental health problems.

Many people, even those facing fair or poor mental health, hesitate to discuss their struggles, whether to preserve their privacy or to avoid societal judgment. Moreover, challenges in accessing mental healthcare, including insurance coverage disparities and limited provider availability, further compound these issues.

In this environment, there is still a critical need for open, supportive conversations and improved access to mental health services. Let’s embark on this pivotal topic together, fostering understanding, empathy, and positive change. Below, we define stigmas in mental health, providing instructions on how to deal with it to eliminate its consequences.

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What Is a Mental Health Stigma?

According to Erving Goffman, stigma acts like a label, making a person seem less normal and less valuable in the eyes of others. It turns them into someone who is seen as flawed. As described by James Dudley based on Goffman’s ideas, stigma is when people are negatively judged or labeled because they do things or have qualities that differ from what society considers normal.

Mental health stigma [5*] pertains to the societal disapproval and stigmatization faced by people living with mental illnesses or those who seek assistance for emotional distress, encompassing conditions such as anxiety, depression, bipolar disorder, or post-traumatic stress disorder (PTSD).

This stigma can mainly come from family, friends, coworkers, and society. It can stop people with mental illnesses from getting help and hinder their ability to lead fulfilling lives, as many are afraid of being called “crazy” just for seeking support from a therapist.

The impact of mental health stigmas is not uniform and can vary significantly depending on the specific characteristics of the stigma and the context in which it operates. There are six identified dimensions that are generally linked to the stigma:

  • Concealability: This dimension explores whether a condition is visible or can be kept hidden from others.
  • Course: It looks at how the illness is expected to progress over time.
  • Disruptiveness: This dimension considers whether the condition interferes with daily life and interactions with other people.
  • Aesthetic qualities: It focuses on whether the illness is visually or aesthetically displeasing.
  • Origin: This dimension relates to the cause of the disorder and where it comes from.
  • Peril: It assesses whether the disorder poses a danger to the person with the condition or others.

This awareness underscores the importance of addressing and reducing the stigma surrounding mental illness in all its complexity. Let’s now look at the types of stigma people with mental conditions face.

Types and Common Examples of Stigma Related to Mental Health

The stigma surrounding mental health can lead to discrimination, manifesting differently. It can be direct like someone openly making hurtful comments about your mental health. Or, it can be subtle, like someone avoiding you because they have misconceptions about mental illness. Sometimes, you might even judge yourself due to these stigmas.

The literature identifies various forms of stigmas regarding mental health, including public stigma, self-stigma, professional stigma, and institutional stigma. These four types represent various societal and personal barriers hindering mental health awareness and support. Study the table below to briefly explore each type.

Type

Description

Example

Public stigma

Negative attitudes and discrimination are directed at people with mental illness, resulting in unfair stereotypes, prejudice, and misconceptions. This may include viewing them as threats, unreliable, incapable, or responsible for their condition.

It leads to unequal access to services and biased policies, including challenges in finding housing.

Self-stigma

People with mental health conditions internalize and accept society’s perceptions of them, believing they are responsible for their challenges, leading to experiencing guilt and shame.

People become hesitant to discuss their condition with others, which affects their self-esteem and makes it harder to seek help or support.

Professional stigma

Some healthcare providers hold stigmatizing views about their patients, often stemming from misconceptions or fears about mental conditions.

Health professionals with such views may desire more social distance from clients with mental illnesses and could be less willing to offer essential services.

Institutional stigma

Legal structures, public policies, and professional practices often reinforce an organization holding negative views about people with mental health issues.

It may cause a workplace to refuse reasonable accommodations for employees with mental health conditions, creating a hostile and unsupportive environment.

Public Stigma

Public or social stigma encompasses several elements, starting with stereotypes of mental health—these are negative beliefs about a specific group, often involving perceptions of dangerousness, incompetence, or character weakness. Prejudice takes this further, as it requires agreement with such beliefs and can lead to negative emotional reactions like anger or fear. Discrimination, the third component, manifests as actual behavioral responses stemming from prejudice. This can involve actions like avoiding, denying employment and housing opportunities, or refusing to provide assistance.

Social psychology and sociology are key disciplines in understanding stigma. Social psychology explores how stigma forms through cognitive, behavioral, and emotional processes, while sociology delves into labeling, stereotyping, separation, status loss, and discrimination as components of stigma. Even though social stigma affects the mental health of people and lives significantly, social work literature has yet to explore this topic thoroughly.

Self-stigma

Self-stigma is an internalized process where people turn these negative ideas inward, fostering stereotypes about themselves related to character weaknesses or incompetence. Different theories suggest that fearing labels or holding negative beliefs can trigger emotions like embarrassment, isolation, or anger in those dealing with mental health issues. However, how people internalize stigma can vary depending on their coping methods and self-esteem.

Prejudice in the context of self-stigma involves an agreement with these self-deprecating beliefs and can result in negative emotional reactions such as diminished self-esteem and self-efficacy. Ultimately, self-stigma can lead to discrimination against oneself, manifesting as a failure to pursue opportunities in areas like work or housing.

Professional Stigma

Health professionals, including social workers, can sometimes carry stigmatized beliefs about patients with mental or behavioral disorders despite the assumption that they wouldn’t.

The development of mental health stigma among health professionals is complex and can be influenced by personal experiences, such as their mental health struggles or those of their friends and family. Some studies [6*] suggest that mental health conditions and burnout are more common among helping professionals than the general public,

The COVID-19 pandemic increased attention to the stress and mental health challenges healthcare workers face, including the consequent rise in anxiety [7*] , depression, and insomnia in these professionals. New measures for burnout prevention and strategies to improve workplace culture can help both improve mental health and increase recognition of similar problems in patients.

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Stigma of mental health disorders

Institutional Stigma

Institutional stigma is a broader, systemic issue encompassing government and private organizations’ policies. This stigma can be intentional when specific policies deliberately discriminate against those with mental illnesses. It can also be unintentional when such policies inadvertently affect this group due to their prevalence in certain situations, like stricter crime policies.

Paradoxically, the social processes designed to control substance misuse may unintentionally encourage the stigma. They may intensify feelings of shame and amplify public and structural stigmatization against the population struggling with mental conditions. As a result, there might be unequal treatment of people with mental health challenges.

Why Do Mental Health Stigmas Exist?

Stigma often emerges from a lack of comprehension and fear, worsened by misleading media portrayals. Despite some public recognition of the medical or genetic aspects of mental health disorders and the need for treatment, a portion of society still holds negative views about individuals dealing with mental illness. This highlights that various factors shape society’s view on mental illness, each uniquely influencing our attitudes.

  • Knowledge: The depth of understanding regarding mental health disorders significantly impacts perceptions. Enhanced awareness reduces reliance on stereotypes or misconceptions.
  • Personal encounters: The extent of individuals’ direct involvement with those grappling with mental health disorders sculpts their beliefs. Face-to-face experiences can challenge preconceived notions.
  • Media: How the media portrays those with mental and substance use disorders, along with coverage of tragic events like gun violence and suicide, can sway public opinions. Sensationalism can distort reality.
  • Social norms: They dictate whether we attribute causes or blame to those with mental health issues and whether we perceive them as dangerous or unpredictable.
  • Cultural dynamics, including race, ethnicity, and cultural backgrounds: All this is embedded in social relationships and significantly shapes attitudes, beliefs, and behaviors concerning mental and substance use disorders.

Thus, insufficient awareness, limited education, skewed perceptions, and apprehension toward individuals dealing with mental illness can collectively intensify mental health stigma.

Harmful Effects of Stigma and Discrimination

As per CNN [8*] , despite a growing openness and the presence of shared stressors in society, a majority of adults experiencing fair or poor mental health still find it challenging to discuss their feelings with loved ones. Some choose to maintain their privacy, while others aim to avoid the shame and stigma often associated with mental health matters. Stigmatization of illness exerts its influence across a spectrum of aspects, from personal and societal relationships to professional opportunities.

Mental

Stigma may not always manifest in overt or conspicuous ways. It can lurk in the language people use to describe mental health conditions or those living with them. This may involve hurtful, offensive, or dismissive language, which can be deeply distressing.

These experiences can evoke feelings of isolation in people with mental health issues and the belief that nobody comprehends their struggles. Coping with the repercussions of prejudice and discrimination can be emotionally distressing and may even worsen mental illness. For some, challenging mental health stigma is often more daunting than dealing with mental illness itself.

Social

In recent years, there has been a notable increase in awareness and understanding of mental and substance use disorders. However, despite this progress, issues related to social exclusion continue to persist at significant levels.

Thus, the Mental Health Foundation in the United Kingdom has highlighted substantial disparities that individuals with mental health conditions face. These disparities extend to various aspects of their lives, including reduced opportunities for securing employment, difficulties in maintaining stable relationships, challenges in finding suitable housing and experiencing a lack of social acceptance.

Professional

Diminished self-esteem, reduced self-efficacy, and the psychologically distressing emotions of embarrassment and shame are the mental consequences of the stigma. When both self-esteem and self-efficacy decline, it can trigger what Corrigan terms the “why try” phenomenon [9*] . This suggests that people may question why they should endeavor to lead independent lives or engage in work if they perceive themselves as undervalued.

How to Overcome Mental Health Stigma

To navigate and mitigate this negative stigma, it’s necessary to cultivate self-acceptance and gain insight into the strategies required for effective self-management and treatment. Below, we provide some effective coping mechanisms for successfully dealing with mental health stigma for those who are hesitant about seeking help.

  • Don’t contribute to the stigma of mental health treatment: If you are uncertain about your mental health condition, consider seeking professional guidance including online consultation to understand and address your concerns. Explore the MEDvidi blog to find valuable tips on how to locate the right specialist for your needs and how to leverage the benefits of telehealth services. Mental health conditions are as real as physical ones, and professional help in the form of therapy or pharmacological treatment can be effective.
  • Don’t take your mental health condition personally: It’s common to think that mental illness reflects weakness, leading you to believe that you or someone facing it should manage without assistance. Such beliefs can result in self-criticism or harsh treatment of others. However, seeking counseling, educating yourself, practicing self-compassion, and connecting with people who share similar experiences can be pivotal in building positive, stigma-free life.
  • Educate yourself: Take the initiative to educate yourself, drawing from reputable sources, about mental illnesses, their symptoms, and available treatments. Being well-informed constitutes the crucial first step toward receiving the appropriate treatment required for emotional well-being.
  • Use words meaningfully: Words have a profound impact, and choosing them with compassion can be a significant part of the healing process. Thus, instead of saying, “I’m anxious,” say, “I cope with anxiety,” or “I’m dealing with mental illness,” or “I’ve been diagnosed with anxiety.” This shift in language helps distinguish the person from the illness, emphasizing that no one is defined by their condition. We all encompass multiple facets of ourselves; if diagnosed with a mental illness, it’s just one part of who we are.
  • Combat negative stereotypes and misinformation: Extend this education to others, emphasizing that mental illness is amenable to treatment, just like any other medical condition. Equip them with accurate information to counteract the stigma of mental health disorders.
  • Tell your story: For yourself or your loved ones, create an open dialogue about the illness and the daily challenges faced. Sharing the journey and recovery process can foster understanding and empathy in others.
  • Join a support group: Isolation can intensify the challenges associated with mental illness. When people hide their struggles, it becomes difficult for anyone to provide support. Fortunately, in-person and online support groups offer a wealth of programs and resources. They aim to reduce stigmas and promote empowerment and recovery.

By doing so, you can shift your focus towards what truly matters: your well-being, your health, and nurturing your relationships with loved ones.

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How to Mitigate Mental Healthcare Stigma

To effectively combat stigma in mental healthcare, a multi-level approach is needed. This approach targets various levels within healthcare facilities. At the individual level, these interventions involve participatory training for all health facility staff, both clinical and non-clinical, as anyone with client contact can potentially contribute to stigma.

At the structural level, these approaches aim to create and enforce anti-discrimination policies, provide necessary supplies for infection control, establish standard precaution infection control practices, and implement client complaint and compliment mechanisms. Here are several strategies and approaches to help achieve this goal:

  • Public education & awareness: Implementing major public campaigns through diverse media channels to combat mental health awareness stigma, the prevalence of such conditions, and the detrimental effects of stigma. It can help actively challenge stereotypes and misconceptions.
  • Healthcare provider training: Delivering thorough cultural competence and sensitivity training to healthcare providers, encompassing physicians, nurses, and mental health professionals, with a specific focus on equipping them to identify and address their personal biases and prejudices during patient interactions.
  • Anti-stigma programs: Incorporating anti-stigma initiatives within healthcare settings, emphasizing the reduction of stereotypes, prejudice, and discriminatory conduct among staff and patients, and continuously assessing and adapting these programs based on their effectiveness.
  • Inclusivity promotion: Ensuring physical and cultural accessibility for individuals from diverse backgrounds in mental health facilities and services while actively fostering inclusive and non-judgmental atmospheres within the healthcare sphere.
  • Legal protections: Encouraging enforcement of legal safeguards prohibiting discrimination on the grounds of mental health conditions and advocating for policies that secure equitable access to healthcare services for those with mental illnesses.
  • Mental health screening and early intervention: Fostering the widespread adoption of routine mental health screening and early intervention practices. It can help to proactively detect and manage mental health concerns before they worsen while combating mental health treatment stigma.
  • Support systems: Creating support groups for people with mental health conditions and their families, facilitating the exchange of experiences and coping strategies.

Bottom Line

While the consequences of mental health stigma can be substantial, we all can contribute to reducing mental illness’s burden on others and ourselves. Here at MEDvidi, we are dedicated to eliminating the stigma associated with mental health. By providing a safe space for expression, we are creating a world where seeking mental health care is met with empathy and compassion.

Don’t allow stigma to deter you from seeking professional care. Explore our mental health treatment services for more information.

FAQ

Mental health stigma is fueled by a complex interplay of factors that can vary across cultures and societies. A significant contributor is the lack of awareness about mental health conditions. Misconceptions, stereotypes, and myths persist due to this gap in understanding. Cultural and societal beliefs also play a substantial role, as sometimes mental health issues can be mistakenly perceived as signs of weakness or moral failings, leading to shame and discrimination. Media portrayals perpetuate stigma by often sensationalizing mental health issues or depicting individuals with mental illnesses as violent or unpredictable.

Stigma can significantly affect mental health professionals in various ways, impacting their personal well-being and ability to provide quality care to clients. They may experience heightened stress due to the specifics of their profession, which contributes to mental health challenges too. Personal stigma, or self-stigmatization, can also take place, leading to reluctance to seek help.

Healthcare workers are at higher risk for burnout [10*] , which can be a cause and a consequence of mental exhaustion simultaneously. Burnout can result in reduced job satisfaction, potentially impacting the quality of care provided to patients. Additionally, some professionals may feel isolated due to discrimination or skepticism from colleagues who do not fully grasp the significance of mental health care.

However, the modern world establishes new standards for healthcare, and mental health care becomes less stigmatized and more accessible than before. It’s important to not contribute to stigma but spread awareness and set an example by acknowledging mental health issues and seeking professional help when necessary.

The history of mental health stigma shows that almost any condition can be stigmatized, and it depends on a variety of factors instead of just the type of the disorder. For example, racial minorities face more stigma [11*] for common mental health conditions that develop in people of all races.

However, some studies show [12*] that schizophrenia is one of the most stigmatized mental health disorders while depression, OCD (obsessive-compulsive disorder), and GAD (generalized anxiety disorder) are less stigmatized. According to other findings, nearly 50% of people with schizophrenia [13*] face discrimination, and others try to keep a distance from a person with schizophrenia more often compared to those with depression.

Sources

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13 sources
  1. About Mental Health
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  2. Estimates of Mental Health Symptomatology, by Month of Interview: United States, 2019
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  3. Major Depression
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  4. 90% of US adults say the United States is experiencing a mental health crisis, CNN/KFF poll finds. (2022)
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  5. Mental Health Stigma: Society, Individuals, and the Profession. (2011)
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  6. Health Worker Mental Health
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  7. Psychiatric Issues Among Health Professionals. (2023)
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  8. 90% of US adults say the United States is experiencing a mental health crisis, CNN/KFF poll finds. (2022)
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  9. Understanding Stigma of Mental and Substance Use Disorders. (2016)
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  10. Occupational Burnout in Healthcare Workers, Stress and Other Symptoms of Work Overload during the COVID-19 Pandemic in Poland. (2023)
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  11. Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis. (2020)
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  12. Creating a hierarchy of mental health stigma: testing the effect of psychiatric diagnosis on stigma. (2022)
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  13. The stigma of mental disorders. (2016)
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Written by:
Rabia Khaliq
MSc in Applied Psychology
Reviewer:
Chelsea Ozigboh
NP
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This article contains scientific references. The numbers
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