MHM Magazine

stigma, Corrigan & Watson identify the impact of stigma as twofold, i.e. public stigma as the reaction that the general population has to people with mental illness, and self-stigma as the prejudice which people with mental illness turn against themselves. Both public and self-stigma may be understood in terms of three components: stereotypes, prejudice, and discrimination explained in Table 1 . McKenzie and Oliffe et al. published a review of men’s experiences of mental illness stigma across the lifespan. Synthesizing the literature, they identified common threads of stigma experienced by men going through diverse mental illness challenges. Aspects of public (social) stigma were highlighted which in turn drove their experiences of self-stigma. Men who anticipated, perceived, and internalised mental illness- related stigma faced a range of consequences. Those consequences included a reluctance to access and engage with mental health services, poor treatment adherence, employment issues, social disconnection, intensifying suicidal behaviour, and heightened risk for severe mental illness. Furthermore, their review findings confirm the links between gender, masculinity, and mental illness stigma. Strategies for changing public stigma are complex and need a long-term societal strategy and approach. Corrigan & Watson propose three approaches: protest, education, and contact. Through protest the media should stop reporting inaccurate representations of mental illness and the public should stop believing negative views about mental illness. Protest is unfortunately a reactive strategy because it attempts to diminish negative attitudes about mental illness but mostly fails to promote more positive attitudes that are supported by facts. The second approach is through education. By providing accurate mental health information the public can make more informed decisions about mental illness. Research has shown that persons with a better understanding of mental illness are less likely to endorse stigma and discrimination. Lastly, stigma can be further diminished when members of the general public meet and interact with persons with mental illness, who are for instance able to hold down jobs or live as good neighbours in the community. Research has clearly shown an inverse relationship between having contact with a person with mental illness and endorsing psychiatric stigma. Self-stigma clearly affects a person’s self-esteem, self- confidence, and self-efficacy. The reaction of people with self-stigma may be either with indifference or anger. Anger as a reaction to social stigma may energise individuals and they will forcefully react to the injustice. This kind of anger often empowers people to change their roles in the mental health care system. They become more active participants in their management and treatment plans and get involved in improving the quality of healthcare services. In summary, ways in which people with mental illness cope with self- stigma needs to be addressed. Men’s mental health is a significant, complex yet often overlooked issue where stigma plays a pivotal role. Improving men’s mental health should include reducing stigma together with addressing all mental health issues in men. Above all men should be encouraged to seek help when needed. Ultimately, men’s mental health is a pressing issue that requires an integrated societal, governmental, and healthcare response. References available on request. Table 1: Comparing and Contrasting the Definitions of Public Stigma and Self-stigma Public stigma Stereotype Negative belief about a group (e.g., dangerousness, incompetence, character weakness) Prejudice Agreement with belief and/or negative emotional reaction (e.g., anger, fear) Discrimination Behaviour response to prejudice (e.g., avoidance, withhold employment and housing opportunities, withhold help) Self-stigma Stereotype Negative belief about the self (e.g., character weakness, incompetence) Prejudice Agreement with belief, negative emotional reaction (e.g., low self-esteem, low self-efficacy) Discrimination Behaviour response to prejudice (e.g., fails to pursue work and housing opportunities) 2 | MENTAL HEALTH MATTERS | 2024 | Issue 1 MHM