MHM Magazine

Issue 3 | 2022 | MENTAL HEALTH MATTERS | 33 MHM included in mainstream society. A 2016 study on stigma concluded "There is no country, society or culture where people with mental illness have the same societal value as people without mental illness." Stigma may not be obvious or be expressed in large gestures. It can come in the words people use to describe a mental health condition or people living with mental illness. This can involve hurtful, offensive, or dismissive language, which can be upsetting for people to hear. This can cause them to feel alone and that no-one understands what they are going through. Some of the harmful effects of stigma include: • Feelings of shame, hopelessness and isolation • Reluctance to ask for help or to get treatment • Lack of understanding by family, friends or others • Fewer opportunities for employment or social interaction • Bullying, physical violence or harassment • Internalisation of negative beliefs • Social isolation • Low self-esteem • Worsening symptoms • Lack of criminal justice Different types of stigma Society generally still blames the victim. A smoker with cancer is treated less compassionately than a non-smoker with cancer, for example. PUBLIC STIGMA • The negative or discriminatory attitudes that others have about mental illness LABELLINGS STEREOTYPING SEPARATION STATUS LOSS & DISCRIMINATION SELF-STIGMA • The negative attitudes, including internalized shame, that people with mental illness have about their own condition INSTITUTIONAL STIGMA • This is more systemic, involving policies of government and private organisations that intentionally or unintentionally limit opportunities for people with mental illness. • Examples include lower funding for mental illness research or fewer mental health services relative to other health care. Mental health remains more labelled and stigmatised than physical health. In large part, because we can’t ‘see’ mental illness. Wheelchair accessible bathrooms are a legal requirement, but do we apply mental health equivalents? Public and structural stigma becomes embedded. “We start to self-stigmatise and label ourselves as separate,” comments Schoeman. Professionals don’t actually talk about when they’re not OK and are perceived and expected to be strong, to have all the answers, to cope. Stigma around mental illness is a big issue in some diverse racial and ethnic communities and can be a major barrier to people from those cultures accessing mental health services. In some Asian cultures, seeking professional help for mental illness may be counter to cultural values of strong family, emotional restraint and avoiding shame. Among some African groups, distrust of the mental healthcare system can also be a barrier to seeking help. With a growing number of people experiencing a decline in their mental health, society is becoming better equipped to respond to our needs. However, the stigma around mental illness and seeking help remains. Research has shown that healthcare professionals are more guilty of stigmatisation than the general public. In South Africa, up to 44% of patients in the healthcare system experienced stigmatising treatment from a healthcare professional when mental healthcare was needed. Stereotypes & Prejudices People with mental illness are dangerous, incompetent, to blame for their disorder, unpredictable I am dangerous, incompetent, to blame Discrimination Therefore, employers may not hire them, landlords may not rent to them, the health care system may offer a lower standard of care These thoughts lead to lowered self- esteem and self-efficacy: "Why try? Someone like me is not worthy of good health." Source: Adapted from Corrigan, et al.