Stigma: A Thorn in the Side of Mental Health Care

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Trish Lockard is the author of Make a Difference with Mental Health Activism and a freelance editor and writer. Her business offers manuscript assessment and all levels of editing, from developmental down to proofreading. She volunteers for the National Alliance on Mental Illness (NAMI.)

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Words Matter

Our social vernacular is peppered with terminology that we have forgotten is hurtful to people with a mental health diagnosis. After you have read this, pay attention to how often you hear people use words such as crazy, nuts, insane, wacky, looney, or nutjob. People talk flippantly about needing to be put in a padded cell or joke about killing themselves if some mundane thing happens. If this strikes you as overly sensitive or unnecessarily politically correct, I ask that you adopt a position of empathy toward those you have been institutionalized. Or who have attempted to die by suicide. Or for the loved ones of those who succeeded.

The Root of Stigma—False Beliefs

The National Institutes of Health break down an explanation for stigma into a three-part process:

Stereotypes, which create a negative belief
Prejudice, which is an agreement with that belief
Discrimination, a behavior response to that belief

Stigma often leads to discrimination. Discrimination can be obvious and direct, such as someone making a negative remark about a person’s mental illness or treatment. Or unintentional or subtle, such as someone avoiding a person because it is assumed he or she could be unstable, violent, or dangerous due to mental illness.

Some of the harmful effects of stigma on those with a diagnosis include:

Reluctance to seek help or treatment
Lack of understanding by family, friends, co-workers, or others
Fewer opportunities for work, school or social activities or trouble finding housing
Bullying, physical violence or harassment
Health insurance that doesn’t adequately cover your mental illness treatment
The belief that you’ll never succeed at certain challenges or that you can’t improve your situation

Stigma is an Opponent We Can Defeat

In her 2017 article “9 Ways to Fight Mental Health Stigma,” NAMI’s Communications Manager Laura Greenstein offers simple suggestions for igniting change:

Mural of actress Carrie Fisher, former NAMI spokesperson.

Talk Openly About Mental Health. One of the most influential movements of the last few years is the courage of celebrities to “come out” about their diagnoses and struggle with mental illness, such as depression, panic attacks, anxiety disorder, OCD, and bi-polar disorder I and II. These brave celebs include Ryan Reynolds, Dwayne Johnson, Kristen Bell, Carrie Fisher (who was a spokesperson for NAMI), Demi Lovato, Mariah Carey, Lena Dunham, Prince Harry, John Hamm, Catherine Zeta-Jones, and Brian Wilson.
Educate yourself and others
Be conscious of language
Encourage equality between physical and mental illness
Show compassion for those with mental illness
Choose empowerment over shame
Be honest about treatment
Let the media know when they’re being stigmatizing
Don’t harbor self-stigma

Advocacy: What Works and What Doesn’t

The National Institutes of Health conducted extensive research into what strategies work to decrease stigma and which have little or no effect. In summary, the findings show us:

Anecdotal evidence suggests that protest campaigns have been effective in getting stigmatizing images of mental illness withdrawn.
Protest is a reactive strategy; it attempts to diminish negative attitudes about mental illness but fails to promote more positive attitudes that are supported by facts.
Education provides information so that the public can make more informed decisions about mental illness. Research shows that persons who demonstrate a better understanding of mental illness are less likely to endorse stigma and discrimination.
Stigma is further diminished when members of the general public meet persons with mental illness who are able to hold down jobs or live as good neighbors in the community. Opportunities for the public to meet persons with severe mental illness may discount stigma.

The Time for Action is Now

In addition to Laura Greenfield’s suggestions, there is plenty you can do to end stigma and bring a healthy awareness to mental illness. Here are a few more ideas.

StigmaFree is NAMI’s campaign to end stigma and create hope for those affected by mental illness. Through powerful words and actions, we can shift the social and systemic barriers for those living with mental health conditions.

A button that looks like a Lexapro tablet. Battling stigma. — A button that looks like a Lexapro tablet.

Wear your meds. This campaign is daring. Wear your meds are buttons, each button showing an image of a commonly prescribed medication to treat mental illness. Anyone who wears one of these buttons is signaling that they’re open to sharing their personal story of how the medication helped. It’s a powerful action and requires courage. Can you do it?

Shirts, lapel pins, buttons and more. Wear your support for mental health awareness. A wide variety of clothing and accessories promote awareness. Be prepared to address the issue and answer questions. These items can be purchased from many online stores, including Amazon.

MakeItOK. The MakeItOK campaign, specifically designed to reduce stigma, is based in St. Paul, Minnesota. The website offers extensive resources, such as posters, flyers, a PowerPoint presentation, brochures, tip cards, and more.

[Are you ready? Read Make a Difference with Mental Health Activism.]