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Mental Illness Awareness Week – What exactly is mental health stigma?

So this week (6th – 12th October) is Mental Illness Awareness Week. I thought in this post I could talk about one of the biggest issues for people living with mental health problems – the stigma surrounding it. I’ll be honest, I’ve never fully understood what the word ‘stigma’ actually means. I’ve assumed it is something to do with negative associations, but I’m curious to find out more. I thought I could add to the discussions this week by raising awareness of mental health stigma, what it is and the effect it has on the individuals whom it is directed towards. Hopefully others will find the information I uncover as insightful as I do.

The actual word stigma is derived from the greek word ‘stizein’. A stizein was known as a distinguishing mark that was branded into the flesh of slaves or criminals so that others would know who they were and that they were less-valued members of society (1). Because of the markings, these individuals were often avoided by others in public spaces (2).

A common definition provided by Erving Goffman in 1963 describes stigma as ‘an attribute that is deeply discrediting’ and reduces an individual ‘from a whole and usual person to a tainted, discounted one’ (2). Other researchers have built upon this initial work to define stigma as ‘stereotypes or negative views attributed to a person or groups of people when their characteristics or behaviours are viewed as different from or inferior to societal norms.’ (3).

Types of stigma

I found out that there are many different types of stigma when it comes to mental health. The main three being discussed were public stigma, self-stigma and label avoidance, although there are others.

Public stigma involves some individuals within the general population endorsing the stereotypes of mental illness they are presented with in their environment (this could be stereotypes presented from the media or from their peers). These individuals then act in a discriminatory manner towards the stigmatised, so an example would be an individual refusing to work with a person with mental illness because they think they might be dangerous.

Self-stigma is when an individual with mental illness discriminates against themselves. An individual can become aware of the stereotypes that others have attached to others with mental illnesses. They then start to agree with the stereotype and apply it to themselves. This type of stigma can lead to devastating effects on an individual’s self-esteem and self-efficacy, making them believe they aren’t good enough or worthy of what other people have (4).

Label avoidance refers to a type of stigma that results from an individual being publicly labeled through association. In the context of mental health an example would be if an individual was seen leaving a psychiatrist’s office, others may think she’s crazy. This type of stigma can have a negative impact on those suffering from mental health issues, as it may deter them from seeking the help that they need.

Effects of stigma for those with mental health issues

There are a number of ways that stigma can have an effect on individuals experiencing mental illness. Here are just a few I found:

Those with mental health issues may fall victim to prejudice, as others may make preconceived opinions on them that have no factual back-up. A study carried out found the top three misconceptions about mental health patients to be that they are dangerous and violent; that they have a low IQ or are developmentally handicapped and that they cannot function or hold a job (5). The strange thing is, studies have shown evidence to dispel these claims of violence and handicap, but people still have misconceptions.

As a result of these misconceptions, those with mental health conditions can fall victim to social distancing. This is where people are unwilling to associate with a person with mental illness. For example, others may turn down offers to meet up for a coffee with someone they believe to have a mental illness (6).

As a result of prejudice and social distancing, those with mental health issues may feel isolated from society. Sadly, the Queensland Alliance for Mental Health observed that people with mental health problems are “frequently the object of ridicule within the media” which does nothing to help the feelings of rejections individuals may feel from society (7). 

Stigma can also lead to internalised discrimination, where an individual suffering with their mental health starts to believe in the stereotypes and misconceptions placed upon them. This leads them to assume they are rejects socially and this has a massively negative impact on their perceived self-worth (8).

Although work is taking place to get rid of mental health stigma, there is still a long way to go. Unfortunately, we still live in a world where some people see having a mental illness as a sign of weakness. Personally, I think some of the strongest people I know are those who are able to live their day to day lives despite their mental health issues. Also, having a mental health issue does not make anyone less worthy or capable.

Have you ever experienced any mental health stigma during your life? Also what do you think can be done to help remove the current stigma?

References

  1. Arboleda-Flórez, J. (2003). Considerations on the stigma of mental illness.
  2. Goffman, E. (2009). Stigma: Notes on the management of spoiled identity. Simon and Schuster.
  3. Dudley, J. R. (2000). Confronting stigma within the services system. Social Work, 45(5), 449.
  4. Corrigan, P.W., Rafacz, J., Rüsch, N., (2011). Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Research 189, 339–343.
  5. Canadian Mental Health Association, Ontario Division. (1994) Final report. Mental health anti-stigma campaign public education strategy. 
  6. Corrigan P et al (2001) Prejudice, social distance, and familiarity with mental illness. Schizophrenia Bulletin; 27: 219-226.
  7. Queensland Alliance for Mental Health (2010) From Discrimination to Social Inclusion. A Review of the Literature on Anti Stigma Initiatives in Mental Health.
  8. Livingston JD, Boyd J (2010) Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science and Medicine; 7: 2150-2161.