STIGMA Be Gone! – Shattering barriers to mental health

Even though good mental health is a fundamental component of overall well-being, it is often neglected or stigmatised. Mental health stigma can have serious consequences including discrimination, loneliness, and lack of support for those who may need it most. Nowadays, more people are realising the importance of mental health and are making significant adjustments in ensuring they do everything possible to use good mental health to improve their general well being and enhanced functionality.

What is Stigma?

Until the movement to deinstitutionalize mentally ill people became popular in the 1970s, isolation was the main method of dealing with psychological disorders(Santos, Barros and Santos, 2016). This leads to a fear of the unknown and lack of education regarding mental illness. The resulting discreditation, shunning and labelling as inferior, bad or different is called Stigma (Ahmedani, 2011)

Essentially stigma leads to someone having a ‘spoiled identity’ (Goffman, 1963) and subsequently they are treated differently and negatively stereotyped, a combination of factors which greatly influence the level of mental health support they receive. When it comes to mental health, stigma has been reported by the World Health Organization (WHO) as a major barrier to successful management and engagement with those seeking mental health care. (WHO 2001)

As a doctor providing mental health services, the consequences of stigma are evident when clients come in for a visit:

1. 1. They are apprehensive about seeking help: due to fear of being judged, even by healthcare professionals, this leads to treatment delays. Clients also stigmatise their own selves, and this internalised shame also causes a reluctance to getting the help they need. In fact nearly 40% of canadians needing medical help avoid it (CAMH, 2018)
   2. They are not adherent to treatment: because of the uncertainty that stigma carries with it, clients often harbour distrust for healthcare providers and often do not follow medical advice. Additionally, because they also fear discrimination, they rather not let anyone see or know that they are coming to you for care, and they may become inconsistent with their care routine (Kamaradova et al., 2016).
   3. They get worse over time: the stress of being stigmatised ultimately leads to negative consequences in all aspects of their life and  worsening mental health issues (Zäske, 2016)

Stigma can lead to a variety of negative mental health consequences, but affects other areas of your personal life. Low self-esteem, social isolation, lack of a support network, and difficulty in finding and maintaining employment all contribute to the negative impacts of stigma. This can be like a downward spiral that not only affects your ability to engage effectively in various activities but also potentially leads to higher healthcare costs and burden on support systems (Roehrig, 2016, Rüsch et al., 2010).

What Can Wellness Practitioners do?

Getting rid of stigma related to mental health has been challenging as even the campaigns against stigma have been known to cause more mental health problems in those who are already mentally unwell (Siegel et al., 2019). Nevertheless various methods to reduce stigma can be made (CAMH, 2018):

1. Keep communication open: being open to discussions surrounding mental health will create the safe space needed for individuals to feel comfortable about sharing their experiences and looking for help.
2. Education for everyone: taking part and even creating workshops, and other campaigns on mental health helps. When everyone understands mental health issues better it will foster empathy and consequently reduce stigma.
3. Make access easy: Social media link outs, hotlines, support groups and counselling services specifically for mental wellness should be easily accessible.

Combating mental health stigma is certainly needed if we want to promote overall well being. The discrimination, isolation and delays in seeking help that comes with stigma only causes a heavy burden on society as individuals facing stigma tend to get worse over time. If we use open communication, education on mental health topics and ensuring access to care is easy we can create a more supportive environment.

What are you doing to help reduce mental health stigma in your community? Share your thoughts and join the conversation!

References

Ahmedani, B.K. (2011). Mental health stigma: Society, individuals, and the profession. Journal of Social Work Values and Ethics, [online] 8(2), pp.41–416. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248273/ [Accessed 25 Jul. 2024].

Centre for Addiction and Mental Health (2018). Addressing Stigma. [online] CAMH. Available at: https://www.camh.ca/en/driving-change/addressing-stigma [Accessed 26 Jul. 2024].

Kamaradova, D., Latalova, K., Prasko, J., Kubinek, R., Vrbova, K., Krnacova, B., Cinculova, A., Ociskova, M., Holubova, M., Smoldasova, J. and Tichackova, A. (2016). Connection between self-stigma, adherence to treatment, and discontinuation of medication. Patient Preference and Adherence, [online] Volume 10, pp.1289–1298. doi:https://doi.org/10.2147/ppa.s99136.

Rüsch, N., Corrigan, P.W., Todd, A.R. and Bodenhausen, G.V. (2010). Implicit Self-Stigma in People With Mental Illness. The Journal of Nervous and Mental Disease, 198(2), pp.150–153. doi:https://doi.org/10.1097/nmd.0b013e3181cc43b5.

Santos, J.C., Barros, S. and Santos, I.M.M. (2016). Stigma. Global Qualitative Nursing Research, [online] 3, p.233339361667044. doi:https://doi.org/10.1177/2333393616670442.

Siegel, J.T., Flores-Medel, E., Martinez, D.A. and Berger, D.E. (2019). Can Mental Health Anti-stigma Messages Have Untoward Effects on Some People with Depression?: An Exploratory Study. Journal of Health Communication, [online] 24(11), pp.821–828. doi:https://doi.org/10.1080/10810730.2019.1672838.

Zäske, H. (2016). The Influence of Stigma on the Course of Illness. The Stigma of Mental Illness – End of the Story?, [online] pp.141–155. doi:https://doi.org/10.1007/978-3-319-27839-1_8.