“Stigma against mental illness is a scourge with many faces” ~ Elyn R. Saks
Stigma refers to our negative social perceptions of a person or situation. There are numerous types of stigma that affect people’s perceptions of mental health.
Approximately one in four adults suffers from mental health disorders in the United States. Untreated, these disorders can lead to risky behaviors, including substance abuse, violence, risk-taking, self-harming, and suicide. Untreated mental health issues are one of the leading causes of death globally after heart disease and cancer.
The lack of medical treatment and support results largely from the widespread stigma attached to mental health. People who suffer from mental health issues face immense stigma from all areas of life, which disturbs their every action, affects their self-esteem and motivation, and results in the already challenging journey to recovery appearing insurmountable.
The impact of stigma has two main components: Public and Self Stigma. Both types result in stereotypes, prejudice, and discrimination.
- Public stigma – This refers to the reaction of the general population to people with mental illness. Stereotypical detrimental views, when collective, create widespread negative attitudes. The group discriminates against an individual and regulates appropriate and undesirable behaviors. Public stigma attempts to pressure others into changing their behavior to fit in or by shunning someone deemed unacceptable.
- Self-stigma – This occurs when those with mental illness turn prejudice against themselves. The guilt and shame of discrimination has a damaging effect on self-esteem and self-worth, which prevents people from seeking help.
For example, recent research demonstrated that 22.7% of those with a Substance Use Disorder felt that stigma prevented them from seeking treatment; 11.6% were concerned about the impact on their employment, and 11.1% were apprehensive about the negative opinions of their neighbors or community.
Individuals with mental health issues are doubly challenged. They suffer from the symptoms of the disease as well as the discrimination, misconceptions, and prejudice of others. These challenges result in individuals missing out on opportunities, such as decent housing, adequate health care, myriad relationships, and career prospects.
These are four key areas in which we can help break down the barriers of stigma:
Mental health disorders have always been stigmatized. For hundreds of years, people with mental health conditions were treated poorly as second-class citizens. These individuals were ostracized from familes, isolated from communities, put in asylums or sanitoriums, and even lobotomized.
To this day, words like “schizo,” “crazy,” and “mental” circulate in everyday language to describe objectionable behavior unrelated to mental health conditions.
It has been evidenced that words including “substance abuser,” “addict,” “schizophrenic,” “bipolar,” and “alcoholic” are perceived negatively by the wider public. Therefore, if these labels are attached to a person, it is more likely they will be treated with prejudice.
Because mental health conditions are one of the leading causes of early fatality in the United States, it is evident that the language we all choose to use to discuss these conditions is vital.
Accessibility to Treatment
Great progress has been made with the inclusion of previously disregarded mental health conditions in the DSM-5 such as Substance Use Disorder and certain eating disorders. These conditions are classified as diseases in the same light as cancer, heart disease, or stroke. Unfortunately, however, much of the stigmatized language and discriminatory stereotypes are still common parlance within the medical profession.
All too frequently, ER staff, treatment providers, healthcare centers, and even therapists perceive a patient’s mental health disorder as their fault somehow. They, therefore, may encounter hostility and dispassion and have their symptoms undermined.
This negative perception often results in substandard care or rejection of treatment altogether. Each day is a battle for someone struggling with a mental health issue, and seeking help can be the biggest challenge they face. These individuals must receive the support they so desperately need rather than encounter further rejection and obstacles from those who are meant to care for them.
Combating Racial Disparities
The National Institute on Minority Health and Health Disparities (NIMHD) released data in 2019 stating that Black Americans are 20% more likely to have a serious mental health disorder than white Americans. Moreover, only 50% of Black Americans received the necessary treatment.
Financial discrepancies additionally affect Black Americans’ access to treatment as nearly 11% of this group are uninsured in comparison to 6% of white Americans.
The Race and Equality Foundation released a review in 2020 that evidenced that white, black, indigenous, and people of color (BIPOC) are less likely to have access to mental health care services, receive treatment, and seek out services. This demographic additionally was more likely to receive poor quality of care and to end treatment prematurely.
These discrepancies are predominantly due to the stigma associated with BIPOC people. By bringing awareness to the racial stigma surrounding mental health and healthcare, we can balance the playing field and ensure adequate treatment and support for everyone who needs it.
Tell Your Story
Stigma is created through fear, misunderstanding, and shame. The public stigma of us vs. them and the self-stigma of emotional pain and low self-esteem can be mitigated through connection and truth. By telling our own stories or the stories of those we love, we can highlight the individual struggles that form a collective suffering. Truth can destroy stigma.
If we collectively speak out and raise awareness, we can re-frame our ideologies around mental health.
 “Mental Health | Healthy People 2020”. Healthypeople.Gov, 2020, https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Mental-Health.
 sai, Alexander C. et al. “Stigma as a Fundamental Hindrance to the United States Opioid Overdose Crisis Response”. PLOS Medicine, vol 16, no. 11, 2019, p. e1002969. Public Library of Science (Plos), doi:10.1371/journal.pmed.1002969. Accessed 3 Mar 2021.
 Mental Illness-Related Structural Stigma:”. Mentalhealthcommission.Ca, 2013, https://www.mentalhealthcommission.ca/sites/default/files/MHCC_OpeningMinds_MentalIllness-RelatedSructuralStigmaReport_ENG_0_0.pdf.
 Corrigan, Patrick W, and Amy C Watson. “Understanding the impact of stigma on people with mental illness.” World psychiatry : official journal of the World Psychiatric Association (WPA) vol. 1,1 (2002): 16-20.
 Ashford, Robert D et al. “”Abusing Addiction”: Our Language Still isn’t Good Enough.” Alcoholism treatment quarterly vol. 37,2 (2019): 257-272. doi:10.1080/07347324.2018.1513777
 Freeman, W., Watts, J. W., & Hunt, T. (Collaborator). (1942). Psychosurgery: Intelligence, emotion, and social behavior following prefrontal lobotomy for mental disorders. Baillière, Tindall & Cox. https://doi.org/10.1037/11151-000
 Ashford, Robert D et al. “Substance use, recovery, and linguistics: The impact of word choice on explicit and implicit bias.” Drug and alcohol dependence vol. 189 (2018): 131-138. doi:10.1016/j.drugalcdep.2018.05.005
 Hasin, Deborah S et al. “DSM-5 criteria for substance use disorders: recommendations and rationale.” The American journal of psychiatry vol. 170,8 (2013): 834-51. doi:10.1176/appi.ajp.2013.12060782
 “Mental Health Snapshot Of African American Men”. Nimhd.Nih.Gov, 2019, https://www.nimhd.nih.gov/docs/byomm_factsheet02.pdf.
 Bureau, US. “Health Insurance Coverage in the United States: 2017”. The United States Census Bureau, 2017, https://www.census.gov/library/publications/2018/demo/p60-264.html.
 Bignell, Tracey et al. “Racial Disparities in Mental Health Literature and Evidence Review”. Raceequalityfoundation.Org.Uk, 2020, https://raceequalityfoundation.org.uk/wp-content/uploads/2020/03/mental-health-report-v5-2.pdf. Accessed 17 Feb 2021.