By Lakshmi Mahadevan, Ph.D.
What is mental health stigma? Are there different types of mental health stigmas? Are you aware of the specific type of mental health stigma you experience and its potential impact on you?
Kalichman (2019) defines mental health stigma as “the disgrace, social disapproval, or social discrediting of individuals with a mental health problem.” Additionally, research has identified four types of mental health-related stigma (Subu et al., 2021):
- Self-stigma – Often referred to as internalized stigma, self-stigma encompasses negative attitudes towards one’s own mental health or illness which may lead to a lack of self-efficacy with coping or perceived ability to recover; a hesitancy to access treatment or help; and feelings of powerlessness or general lack of control when experiencing a mental health challenge.
- Public stigma – Public stigma or perceived stigma is negative attitudes demonstrated by the community or public towards individuals with mental illness or challenges. Stemming from fear or misunderstanding, public stigma can lead to negative outcomes at home and beyond.
- Professional stigma – Particularly worrisome, professional stigma occurs among healthcare professionals who hold stigmatizing attitudes towards their patients with mental illness-related symptoms thus negatively impacting integrated care and treatment services. Professional stigma may also arise towards those healthcare professionals who provide mental health services to patients.
- Institutional stigma – Institutional stigma refers to an organization’s policies or culture of negative attitudes and beliefs toward individuals who present with mental health problems. These negative attitudes are further reinforced or deepened by legal frameworks, public policy, and professional practices (Livingston, 2013).
It is important to take stigmas into consideration because they are known to impact:
- the ways in which one talks about their own or others’ mental health,
- the ways in which one seeks treatment or help to improve mental health, and
- the ways in which one seeks to cope with or recover from mental health challenges/crises in themselves or others.
Those Impacted by Mental Health Stigma
How do we know we are being impacted by mental health stigma? Has any of the below happened to you?
- You have heard someone say – “I have no patience with people’s mood changes. Just do your work and get over your issues” – public stigma
- You have seen a family member’s frustrations with her doctor who says “You are just experiencing hormonal issues – it will get better over time. Just be patient” – professional stigma
- You are hesitant to tell someone at work or at home that you are sad, unhappy, or frustrated for many days now for fear of looking weak or attention-seeking – self-stigma
- A colleague tells you that they are getting mental health therapy but “Please don’t tell anyone at work because you know they are going to lay me off”– institutional stigma
To better understand stigmas as they may apply to you:
- Begin with assessing your attitudes toward mental health.
- Are you ok with someone talking to you or asking for advice that is mental health-related?
- Are you ok with a family member telling you about their feelings and emotions?
- Are you ok with having a “personal” conversation with a colleague?
- Are you ok when you hear others self-disclose that they are getting help or therapy to improve their mental health?
- Are you ok when someone mentions they practice mindfulness or meditation or yoga to better manage their moods?
- Are you ok with talking about your own feelings with friends, family, or colleagues?
- Are you ok if someone talks to you about what they have perceived as your moods or behaviors at work or home?
- Are you ok with asking yourself – “I Feel or Think…what is going on?”
- Are you ok with telling yourself – “I can’t do this alone…I need help (professional or self-care)”
- Next, assess public stigma:
- Do you feel concerned about being perceived as “nuts,” “crazy” or weak or helpless by your community – friends, family, colleagues?
- Next, assess institutional stigma:
- Do you feel worried that you may get disciplined, medically labeled, or dismissed because of disclosing your mental health challenges at your workplace or another organization important to you?
We hope that you now have more clarity when it comes to mental health stigmas and how they may apply to you. Please note that this is the first in a series of blog posts addressing mental health stigmas. In future blog posts, we will address:
- Reducing self-stigma.
- Minimizing the Impact of Public Stigma.
- Coping with Institutional Stigma.
- Practicing nonjudgmental listening, thinking, and communicating to reduce stigma.
Kalichman S., (2019). Stigma and prejudice teaching tip sheet. In: American Psychological Association. 2019. https://www.apa.org/pi/aids/resources/education/stigma-prejudice.
Livingston, J.D. (2013) Mental illness-related structural stigma: The downward spiral of systemic exclusion Final Report: Mental Health Commission Canada.
Subu, M.A., Wati, D.F., Netrida, N. et al. (2021). Types of stigma experienced by patients with mental illness and mental health nurses in Indonesia: A qualitative content analysis. International Journal of Mental Health Systems 15 (77). https://doi.org/10.1186/s13033-021-00502-x
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