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The Consequences of Mental Health Stigma

Imagine, for a second, living in a world where physical health is met with the same stigma as mental health:


You have a stable job, a loving partner, and a roof over your head. By every imaginable metric, life is good. And then one day, out of nowhere, you feel a minor ache in your abdomen. You think nothing of it, hoping it will go away with time. However, a week later, the pain seems to be intensifying. What at first seemed like a minor annoyance has turned into unbearable pain. Simple, everyday tasks have become nearly impossible.


While you know you can't bear this pain for much longer, you fear the consequences of seeking help. What if people start to think you are weak, unstable, or unreliable? What if seeking help impacts your social relationships? What if you lose your job? Unfortunately, these fears associated with stigma are not without precedent. While our understanding, knowledge, and awareness of mental health is better than it has ever been, the stigma associated with mental health persists. This stigma is not imagined, either. Disclosing your mental health disorder at work may impact your chances at upward mobility. Disclosing your mental health disorder with your family may change your relationships with them. Disclosing your mental health disorder with your friends may make them distance themselves.

One organization fighting hard to reduce the stigma associated with mental health to ensure everyone receives the help they deserve is Made of Millions. This article will explore multiple studies related to mental health stigma as well as ways to combat it. It also includes vital insight from Mary-Lyn Kieffer, the Canadian Director of Made of Millions.

Made of Millions is a mental health advocacy non-profit on a mission to change how the world perceives mental health. From May 10th - 23rd, 40% of all Andre Kan 'JACKYL' print sales are being donated to Made of Millions. Click to purchase.


MENTAL HEALTH STIGMA


Extracting the Stone of Madness  c.1494–1516, oil on panel by Hieronymus Bosch (c.1450–1516)

Negative perceptions of mental health have been around since time immemorial. Historically, mental health has been viewed as a form of religious punishment, demonic possession, or as the direct result of a physical ailment. Treatments for mental health disorders have included the use of amulets and charms imbued with magical powers, as well as primitive treatments like trepanning, which involved drilling or hammering a hole into the skull. 'Madness' has been known and feared by society throughout history.


Despite knowing more about mental health than at any other point in history, increased awareness and knowledge has not equated to a reduction in stigma. According to one study, while the public may accept the medical or genetic nature of a mental health disorder (as well as the need for treatment), many still maintain a negative view of mental health. In one survey, which included respondents from 27 countries, nearly 50% of persons with schizophrenia reported discrimination in their personal relationships, and up to 2/3 of these people anticipated discrimination while applying for work or looking for a close relationship.


To gain further insight into stigma, researchers have identified three different types: public stigma, self-stigma, and institutional stigma. Public stigma is the negative and discriminatory attitudes that others may have about mental health. This includes your family, friends, co-workers, and others. Self-stigma is the negative attitudes and internalized shame felt by those struggling with their mental health. This stigma is often informed by both public and institutional stigma. Institutional stigma is more systematic, involving the policies of private and government organizations that either intentionally or unintentionally limit opportunities for people struggling with their mental health.

The stigma associated with mental health is not culturally specific, either. According to a 2016 study on stigma, “There is no country, society or culture where people with mental illness have the same societal value as people without a mental illness.” This often means that those struggling with their mental health experience worsening symptoms and a reduced likelihood of getting treatment as a direct result of stigma. Some of the direct effects of ‘self-stigma’, as outlined above, can be:


- Lower self esteem

- Reduced hope

- Increased psychiatric symptoms

- Difficulties with social relationships

- Reduced likelihood of adhering to treatment

- Difficulties maintaining stable employment


The short-term impact of stigma can further isolate someone dealing with a mental health disorder. Being unable to speak openly about your experiences means that an individual may feel like they are carrying the weight of their disorder alone. Currently, more than half of people with a mental health disorder don't receive help or treatment. As Mary-Lyn Kieffer explains, "Despite the progress we're slowly making when it comes to awareness and education around mental health, there still remains a lot of stigma and shame."


Culturally, it takes time for people to adapt to changes in beliefs and perceptions (this is considered 'cultural lag'). Unfortunately, this might mean that even the people closest to us may make us feel ashamed for struggling with our mental health. Shame is not just 'perceived', it is also inflicted. As Mary-Lyn explains:

"People might experience this stigma internally, externally, or both. Unfortunately what ends up happening when people either internalize stigma, or feel the negative association externally, they may suffer in silence due to the feared consequences of reaching out for help. Alternatively, they simply might believe that they don't deserve, or need the help. As a result, people can potentially spend years suffering in silence."

Mary-Lyn explained that there are a lot of external stressors that impact people's mental health in a negative way––especially right now. She explained that whether it is technology, the pandemic, social unrest, financial instability, or discrimination, it can be very difficult for people to shut off all the noise, especially if they do not have the tools necessary to do so. She believes that both mental health education and improved access to treatment can improve our collective mental health.


OVERCOMING STIGMA


According to research, having direct contact with someone who struggles with their mental health is one of the best ways to reduce stigma. However, since having direct contact with an individual from every demographic is almost impossible, being able to connect with individuals online is a great alternative.


According to a 2020 study,"large numbers of teens and young adults experiencing moderate to severe symptoms of depression are turning to the internet for help, including researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent)". With more people than ever turning to resources online due to the pandemic, Mary-Lyn Kieffer believes that this is an important step towards creating greater understanding of mental health overall:

“The pandemic has definitely created a shift in how society looks at mental health. Universally, we are all being affected in one way or another, and so people naturally have become a lot more accepting and interested in the topic of mental health as we try to build resilience during these challenging times."

Mary-Lyn believes that we need to advocate for mental health first aid within companies, and empower people to speak up and reach out for help: "I think there's a misconception that one can only suffer with mental health challenges if they have a diagnosed disorder. The reality is that if you have a brain, you have mental health. Acute situations like financial strain, divorce, micro-aggressions, etc all can have a negative affect on our mental health. If we recognize this, we can hopefully begin to start realizing that mental health is a part of our overall well being, and something that we need to start taking care of from a very young age."


WHAT YOU CAN DO


“The National Alliance on Mental Illness (NAMI) offers some suggestions about what we can do as individuals to help reduce the stigma of mental illness:

  • Talk openly about mental health, such as sharing on social media.

  • Educate yourself and others – respond to misperceptions or negative comments by sharing facts and experiences.

  • Be conscious of language – remind people that words matter.

  • Encourage equality between physical and mental illness – draw comparisons to how they would treat someone with cancer or diabetes.

  • Show compassion for those with mental illness.

  • Be honest about treatment – normalize mental health treatment, just like other health care treatment.

  • Let the media know when they are using stigmatizing language presenting stories of mental illness in a stigmatizing way.

  • Choose empowerment over shame - "I fight stigma by choosing to live an empowered life. to me, that means owning my life and my story and refusing to allow others to dictate how I view myself or how I feel about myself." – Val Fletcher, responding on Facebook to the question, How do you fight stigma?

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