Stigma can be an impediment to seeking treatment for mental illness and addiction, and may result in prejudice and discrimination against the affected individuals.
Anti-stigma programs have developed methods to assess both attitudes and behavioral intentions (e.g., the Opening Minds Youth Opinion Survey and psychometrically tested scales used by health care providers and journalists). Many initiatives also partnered with university researchers in order to conduct evaluations of their programming.
Identifying Stigma
Stigma can be an obstacle for people seeking mental health treatment, as it may alter how people respond to symptoms of their illness, such as when they choose not to seek help or don't take medications as prescribed. Stigma may lead to discrimination that prevents access to jobs, housing or other opportunities - it may also result in bullying from social groups and even violence being directed toward these individuals.
Education and awareness efforts can play a key role in combatting stigma against mental illness, as can people willing to openly discuss their personal struggles with it. By doing this, fewer people will feel they need to suffer alone in silence. People willing to openly discuss mental illness can have a significant positive effect on those around them and can have a direct positive effect.
People may find courage by witnessing others being open about their struggles, and many organizations provide resources and support to encourage this type of open dialogue about mental illness. Programs include those dedicated to decreasing stigma in the workplace while others aim to increase family conversations around mental health issues.
Stigma can result from a lack of understanding and fear, often instilled by false or negative information in the media about mental illness. When this type of content appears on social media or elsewhere, it's essential to set the record straight by reporting examples to SANE StigmaWatch.
Stigma against mental illness can be pervasive in certain cultures, making it hard for those seeking assistance and diagnosis with mental health conditions. Some cultures believe mental illness stems from demon possession - therefore understanding a person with mental illness's culture and addressing any potential sources of their distress are both key steps towards treatment success.
Self-stigma
Some individuals with mental illnesses avoid seeking help due to fear of stigma. They worry that others will discriminate against them or treat them negatively, leading them to feel like an inconvenience for loved ones and becoming depressed as a result. This can result in withdrawal from social activities and isolation - increasing the odds for severe symptoms or suicidal thoughts.
Good news is there are things you can do to reduce self-stigma. Talking to a therapist or other mental health professionals for support and guidance may help. Additionally, joining a mental health advocacy organization may allow you to meet others who share similar experiences while sharing coping strategies, plus providing resources for educating friends and family members.
Studies have demonstrated that decreasing self-stigma can enhance help-seeking attitudes and treatment adherence; as well as improve quality of life and reduce shame and distress. Interventions targeting both aspects are often combined in one program because these two concepts overlap considerably.
One example of a societal-level approach to reducing self-stigma is the "In Our Own Voice" program created by the National Alliance on Mental Illness in the US. This manualized group-based program uses testimonials of people living with mental illness to educate community members about mental health issues. This can be tailored for any audience from healthcare professionals to church congregations.
Though research on this type of intervention has been encouraging, it's important to keep in mind that previous studies lacked statistical power, had unreliable outcome measures and presented high risks of bias. More research needs to be conducted on the effectiveness of interventions aimed at reducing self-stigma, particularly their effect on outcomes such as help-seeking attitudes, treatment adherence and quality of life. Language should also be chosen carefully when discussing mental health, as certain terms can provoke more adverse responses and feelings than others. For example, using "commit" to refer to suicide can reinforce its stigmatizing associations while creating feelings of guilt or shame for its perpetrator.
Public Stigma
Stigma surrounding mental illness can result in discrimination against those living with it, such as being denied jobs, housing and services; relationship disruption between family, friends and coworkers; or even prevent treatment for their illness altogether. One cause of stigmatization can be ignorance about mental illness; another may come in the form of negative attitudes and beliefs aimed at harming people with mental health conditions such as fear, hatred and prejudice.
Anti-stigma initiatives aim to decrease stigma against mental health and foster more positive attitudes. Activities under this initiative range from awareness raising, education and community involvement - one effective strategy is providing public information, training mental health care providers and teaching students about mental illness.
Promoting open conversations about mental health struggles and experiences can also help break the silence around mental illness, encouraging others to seek assistance and bring Change to Mind founded by actress Glenn Close as an organization which facilitates this.
Studies suggest that decreasing self-stigma may help mitigate public stigma; however, other research indicates it alone cannot produce improvement for people living with mental illnesses in low and middle income countries where stigmatizing behavior could prevent access to treatment or resources.
However, even though these countries provide less funding and services dedicated to mental healthcare than other health providers, many individuals suffering from mental illnesses still face stigmatisation and discrimination.
Education and community outreach remain the best ways to reduce stigma. This can include school programs, community meetings and media campaigns; advocates may also reach out to government agencies for equal treatment of those living with mental health challenges - for example the Equal Employment Opportunity Commission offers information about reporting discrimination related to mental illness at work.
Institutional Stigma
Stigma refers to negative attitudes, beliefs and prejudices held against groups or people by society at large. Stigma may be used to advance one ideology over another or exploit others for personal gain. Misconceptions often stem from ignorance or misinformation and are affected by cultural, social and family factors. Attribute discrimination reflects how society values certain behaviors while undervaluing others. Stigma associated with mental illness can discourage individuals from seeking treatment and can cause discrimination in employment, education, housing and relationships. Stigma contributes to feelings of shame and self-blame among those living with psychiatric conditions as well as poorer hospital outcomes and decreased quality of life for these people.
Although medical experts have confirmed mental illness is real, many people hold negative opinions of people with mental health problems. Some of this negativity stems from stereotypes and assumptions reinforced by media such as portraying depression sufferers as lazy while those with schizophrenia as dangerous - this often results in inadequate public support for mental health services.
Studies have demonstrated that stigma disproportionately impacts individuals with mental health conditions at work. This may lead to lower attendance rates at employee assistance programs (EAPs) and less support from colleagues, as well as influences perceptions of mental health professionals which ultimately lower quality care received by patients.
Mental health stigma not only disempowers its victims and deters them from seeking assistance, but can also diminish its efficacy of promotion. A study published in Psychiatric Services showed that patients exposed to stigma were less likely to believe they could recover from their symptoms; additionally they were less likely to take medications according to prescription and engage in healthy behavior such as taking them regularly and engaging in other healthy practices.
As part of efforts to combat mental health stigma, it is crucial for people with mental illness and their allies to educate the public on its realities. Educators may use traditional or social media, mass events like marathons or festivals and inspiring recovery stories from those living with the disorder themselves in order to show that mental illness needn't prevent people from leading meaningful and satisfying lives and provide hope to people concerned about themselves or loved ones' futures.
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