Mental Health Stigma

Key takeaways

• Mental health stigma describes negative perceptions, attitudes and beliefs about mental illness and the people who struggle with it

• Stigma has several negative impacts on people living with mental illness, including discouraging some from seeking treatment

• Everyone can work to combat stigma by adjusting their attitudes and behavior to be more open, accepting, and understanding of people with mental health challenges

What is mental health stigma?

Mental health stigma describes negative attitudes, beliefs and perceptions against mental illness and the people living with these conditions. Stigma adds another layer of suffering for people living with mental illnesses by causing them to worry that others will judge or discriminate against them based on their diagnosis.^[1][2]

While collective attitudes and perceptions of mental health issues have shifted in a positive way in recent decades, certain biases still exist, especially for people diagnosed with certain disorders.^[4] For example, there is a significant stigma against people struggling with addictive disorders, as well as those with more severe forms of mental illness like schizophrenia or bipolar. These include stereotypes and inaccurate beliefs that people with these disorders are dangerous, unstable, or unable to function normally in society.^[1]

In some instances, stigma can cause people with mental illness to avoid admitting to or seeking help for their condition.^[3][5] They may be concerned that doing so will cause them to be labeled in ways that affect or limit their abilities to get or keep a job or access other resources, services, or opportunities. Unfortunately, there is some truth to these concerns, as having a mental health diagnosis can prevent someone from joining the military or getting certain types of jobs.

Stigma does not have one single culprit or cause. Instead, it describes a variety of negative perceptions and attitudes that can be traced back to several sources within a society. In many cases, stigmas are fueled by harmful stereotypes that depict people with mental illness in ways that spark fear in other people.^[1][2]

Public stigma

Public stigma describes stigmas that exist in the greater public, and show up as collectively held beliefs, biases, and perceptions of people with mental illness.^[1][2] These beliefs can lead to prejudices and discriminatory treatment of people who struggle with certain types of mental illness. While not everyone in a society will hold the same negative perceptions, public stigmas are common enough to be recognized as perceptions held by large numbers of people in a society or group.

Here are some examples of common public stigmas against people with mental health issues:

• The belief that people with addictions are lazy, selfish, or lacking in willpower

• The belief that taking mental health medications is a weak or lazy choice

• The belief that depression or anxiety is a choice

• The belief that people who have a mental illness are dangerous or unstable

• The belief that mental health problems are not as serious as medical problems

Self stigma

Self stigma is when a person with a mental illness internalizes negative beliefs and perceptions that others hold. This can result in feelings of guilt, shame, and lowered self-esteem.^[1][2] Self stigma sometimes happens when a person receives negative messages from people in their social circle, but it can also occur even when they have a lot of social support.

Here are some common examples of self stigmatization in people struggling with mental health issues:

• Feeling ashamed of a diagnosis, symptoms or mental health challenges

• Feeling guilty for seeking help for issues they ‘should’ be able to handle themselves

• Feeling weak, broken, or defective because of having mental health issues

• Expecting others to judge, criticize or reject them because of mental health issues

• Minimizing their symptoms or distress because they feel like their problems ‘aren’t real’

Institutional stigma

Institutional stigma describes policies and systemic responses to mental health challenges that demonstrate a prejudiced or discriminatory attitude towards mental illness. Institutional stigma can show up in the policies, funding, or processes that directly affect people with mental health diagnoses.^[1][2] In some cases, institutional stigma can result in lower access to opportunities, resources, and services.

Here are some examples of institutional stigmas that affect people living with mental health conditions:

• Employment policies that restrict people with mental illness from getting certain jobs or promotions

• Insurance companies that have less coverage for mental health services than for medical services

• Military application denial based on having a diagnosed mental health condition

• Lack of educational and vocational support for people living with mental illnesses

• Lack of funding from governments or organizations for resources and programs that support mental health needs vs medical needs

What causes mental health stigma?

There is no singular cause of mental health stigma. Stigma describes collectively held perceptions, attitudes, and beliefs which are continuously reinforced by the media, institutions, and individuals within a society.^[1][2] They are also reflected in the larger culture, and influence the way that current events and controversial topics are discussed.

Often, stigmas come from stereotypes that provide reductionary views on mental illness. These stereotypes may show up in movies, television, and other forms of media that people are exposed to. Stigmas are also reflected in the larger culture and may be identified in prominent voices on social media, journalism, or podcasts.

On a smaller scale, people are introduced to stigmas within their local communities and regional subcultures. For example, a person may be exposed to negative sentiments about mental health issues within their churches, schools, or even within their own families. When stigmas are developed within these closer communities, they can be especially difficult to overcome.

Stigmas can also be selectively reinforced by personal experiences, and the ways that people choose to make sense of these experiences. For example, a person may have had a negative encounter with someone who has a mental illness which reinforced the perception that all people with mental illnesses are dangerous or unstable.

The impact of mental health stigma

Stigma against mental health can greatly exacerbate the suffering of people with mental illness by making them afraid to talk about or seek help for their conditions. This can have a wide range of negative effects on people with mental health challenges, including:^[1][2][3][5]

• Discouraging people from seeking professional treatment for fear of being labeled

• Worsened symptoms and outcomes because of a lack of treatment and support

• Lower levels of social support because of fear of disclosing mental health challenges

• Employment issues because of fear of seeking ADA accommodations for mental health

• Greater impairments in functioning and quality of life for people with mental health issues

• Increased risk of social isolation and loneliness, which negatively impacts mental health

• Increased risk of discriminatory treatment in educational, employment or institutions

• Increased reliance on unhealthy coping skills like alcohol or drugs because of lack of treatment or support

Overcoming mental health stigma

Overcoming mental health stigma is complicated, and requires consistent effort over the course of several generations. In our lifetime, there have already been significant efforts and progress made towards helping reduce mental health stigma.^[4]

For example, more people than ever before are educated about common mental health conditions like depression, anxiety, PTSD, OCD, and even addiction. Also, more people are willing to seek therapy, medication, and other treatments for their mental health conditions than in previous generations.^[4]

While there has been significant progress in reducing negative perceptions and biases about mental illness, there is still a lot of work that still needs to be done.^[4] This work will need to involve the participation of individuals within a society, as well as organizations and institutions that guide policies that affect people with mental illness. Here are some of the steps that individuals and institutions can take to help in the effort to overcome mental health stigma:^[1][2][5]

• Open conversations: Facilitate open dialogues about mental health in the workplace and other community spaces to create a safe space for people to share their experiences

• Advocacy efforts: Advocate on a local and state and institutional level for improved access to mental health treatment, information and resources

• Education and awareness: Participate in public health campaigns designed to educate the public about mental health-related topics and feature individuals with lived experiences

• Challenging stereotypes: Challenge inaccurate stereotypes that fuel stigma against people with mental health conditions by respectfully disagreeing or offering an alternative perspective

• Supporting others: Volunteer in places that provide resources or services to people with mental health conditions to increase your exposure and understanding

• Respect and compassion: Treat people struggling with mental health conditions in a respectful manner and extend understanding, empathy, and acceptance

How to cope with mental health stigma

If you are someone living with a mental health condition, the impacts of mental health stigma can feel very difficult and personal. The impacts may include worsened symptoms, lowered support from others, and stress and anxiety about being judged for your condition. While there is no magic cure for these impacts, here are some ways you can improve your ability to cope with the effects of stigma:^[1][2][5]

• Seek treatment from a professional therapist who can treat your symptoms while also helping you become more kind, understanding, and compassionate to yourself

• Educate yourself more about your diagnosis, its origin and factors that make your symptoms worse or better to take back power and control over yourself and life

• Join a support group or other community where people discuss challenges with mental health issues openly in a safe and supportive environment

• Find advocates, mentors or other voices that help you maintain a more positive view of yourself, your issues, and your circumstances

• Surround yourself with people who love you, support you, and show up for you when you’re struggling with your mental health

• Reframe your challenges with mental health as proof of your inherent strength, courage, and personal resilience

Additional resources and support

There are many organizations actively working to combat mental health stigma by raising awareness and educating the public. Here are some additional resources to continue learning about mental health stigma:

• American Psychiatric Association

• World Health Organization

• Centers for Disease Control and Prevention