The Problem of Mental Health Stigma
It’s sad that some folks still need to hear it: mental illness is real. Mental illness has consequences for ones well-being and the pain caused by it, both emotional and physical, takes a tragic toll. Addiction, broken relationships, lost opportunities, even physical harm are merely a few negative outcomes of living with mental illness. Recent years have seen an increase in diagnoses of certain mental disorders and a rising suicide rate. In a society where stigma surrounds mental health, it is sometimes difficult to get people the proper help. Even someone who is aware of their problem may resist acknowledging it.
The other night I was at my friends’ kitchen table talking as we do each weekend. This particular evening the topic went in a deeper direction than usual. I was shocked when someone very close to me admitted his suspicion that he may have severe anxiety and OCD (Obsessive Compulsive Disorder), but in the same breath claimed he “doesn’t believe” in seeing a psychologist or psychiatrist.
I asked, “You don’t believe in psychology or psychiatry?”
“I do,” he responded, “but I’m not going to see one because I don’t believe it would help me.”
At first I thought it preposterous. Wouldn’t someone with a broken leg seek medical attention? Wouldn’t someone with a disease want a doctor? It’s the same thing: there are doctors and treatments for people with mental illness and injury. If something is amiss why not correct it with tried and proven tools? My previous experiences with OCD and depression taught me reaching out for help can only do one thing: help.
Mental health stigma is an ingrained false notion that the mentally ill are inherently different, dangerous, or volatile. Unfavorable views towards those with psychiatric problems can be traced back to when the accepted diagnosis was demonic possession. Through the centuries populations developed undue suspicion of sufferers of mental illness, painting an entire group of people as undesirable. Although they have no basis in fact these attitudes still exist today. In modern times the harsh gaze of mental health stigma could be visited upon a sufferer by family, peers, coworkers, and even teachers. Sometimes it comes from the TV.
We live in a decade when media and society at large have begun softening their views on mental illness. This sadly was not always the case. For decades news media ran headlines depicting psychiatric patients as non-social or antisocial, dangerous, violent, and suicidal. Entertainment media like movies and TV shows did no better – they damagingly portrayed people with mental disorders as homicidal maniacs or neurotic recluses.
I wondered, could this be why my friend refuses treatment? A few sentences later he made it clear.
“People look at you differently, plus it’s a sign of weakness,” he explained.
There it was laid out explicitly. The reason he shunned professional help was fear of how others would look at him – and how he looked at himself.
Self-stigma is when a sufferer internalizes stigmatizing reactions towards them. In turn, they begin to see themselves that way. This will not only hinder treatment but it can lead to additional hardships. Some studies even show that doubts about one’s self can actually interfere with life goals. Stagnation and avoidance of discomfort is just one more blow dealt by mental health stigma, as in the case of my friend. Knowing he requires treatment would be a step towards conquering his condition, but would also spark an internal battle as he confronts his own self-stigma.
Stigma in the public must be rebuffed and is currently being fended off by organizations like The Carter Center and The National Alliance on Mental Illness. But as long as it exists, the problem of overcoming stigma inside one’s self is a top priority for maintaining quality of life.
So what could be done? The first step is to consider disclosing one’s condition to friends and family, and/or being somewhat open about it in general. This works to normalize it to the afflicted person, their loved ones, and peers.
Sometimes disclosure is trickier than it sounds. In certain cultures or environments, risks outweigh benefits if being known to have a mental illness would cause one to be ostracized or discriminated against. Thusly, there are levels of disclosure to be strategically deployed for individuals on a case by case basis. Methods of disclosure exist on a spectrum from complete social avoidance (keeping mental illness a total secret) which is obviously less productive, to the opposite: broadcasting (letting everyone know and trying to educate them on the subject). Here is a useful model of disclosure hierarchies:
Further steps towards empowerment can go many ways. Some choose to quietly better themselves while others go the path of active participation in the mental health community; there’s no wrong way as long as stigma is defeated in one’s own mind.
One way people overcome self-stigma is group sessions using cognitive behavioral techniques to counter self-stigmatizing thoughts. Of course private therapy sessions could also yield positive results. In addition there are co-op groups run by patients themselves offering various services which have been found to empower those experiencing self-stigma. [At the end of this article will be a collection of resources to help reduce mental health stigma]
Even in the United States we as a society have hard work ahead of us to end mental health stigma. Involved efforts to do so will no doubt expand tolerant views towards people with mental conditions and at the same time encourage those people to take control of their lives.
The friend with whom I spoke that night had at least taken the first fraction of a step. He said he believed he had a problem. Now it is up to him to take the next step. Just as society should do, I know I’ll continue to challenge negative and limiting views towards mental health problems – all the while encouraging those who need it to get treatment just like I did when I needed help.
Resources to help fight mental health stigma:
https://www.nami.org/Find-Support/NAMI-Programs/NAMI-In-Our-Own-Voice – One of the most comprehensive resources on mental health stigma, and part of the National Alliance on Mental Illness
https://dontstigmame.com/ – Takes a blogging approach to addressing many problems caused by mental health stigma.
http://www.dhi.health.nsw.gov.au/transcultural-mental-health-centre – Offers mental health resources in a wide variety of languages.
https://www.cartercenter.org/health/mental_health/index.html – One of the main goals of this program started by First Lady Rosalynn Carter is to “reduce stigma and discrimination against those with mental illnesses.”
Note: For assistance with behavioral health issues, contact us at 305-740-3340 or schedule an appointment with BregmanMD.
Corrigan, Patrick W. & Rao, Deepa (2012) On the Self-Stigma of Mental Illness: Stages, Disclosure, and Strategies for Change. Canadian Journal of Psychiatry, 57(8), 464-469. doi: 10.1177/070674371205700804
Davey, Graham C.L., Phd. (2013, August) Mental Health & Stigma. Psychology Today. Retrieved from: https://www.psychologytoday.com/us/blog/why-we-worry/201308/mental-health-stigma
Nutt, Amy Ellis. (2018, June) Suicide rates rise sharply across the United States, new report shows. The Washington Post. Retrieved from: https://www.washingtonpost.com/news/to-your-health/wp/2018/06/07/u-s-suicide-rates-rise-sharply-across-the-country-new-report-shows/?noredirect=on&utm_term=.6c566ec0df25