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Mental health stigma refers to negative beliefs people may hold about those with mental illness, which can lead to stereotypes, prejudice, and discrimination. Public awareness and literacy have increased substantially over the years, yet some entrenched stigmas persist today.

What Does Mental Health Stigma Mean?

Mental health stigma involves marking and discrediting people due to their differences, which can instill feelings of shame or worthlessness. Those with mental health conditions may be labeled, stereotyped, or discriminated against as a result. For example, someone with a mental health condition may be called “crazy” or “dangerous”. Another may be denied a job due to their diagnosis.

Different models of stigma propose different structures for the construct. One views stigma as a combination of three components: cognitive (ignorant beliefs), emotional (negative feelings of dislike or fear), and behavior (ostracization and oppression). Another defines stigma by the process through which it arises. This involves distinguishing and labeling differences, linking labels to negative stereotypes, placing labeled people in distinct categories, decreasing their status, and limiting access to social, economic, and political power, which perpetuates rejection and discrimination.

What are the different types of stigma?

Mental health stigma has been categorized into three types. Public stigma refers to the negative attitudes society has toward people with mental illness. Self-stigma or internalized stigma is when an individual with mental illness internalizes these negative attitudes. Institutional stigma is systemic and includes laws or policies from the government or other organizations that, intentionally or not, discriminate against those with mental illness. An example of institutional stigma is the insurance coverage disparities between psychiatric treatment and medical treatment.

What is internalized stigma?

Personally accepting and agreeing with stereotypes and prejudices held against oneself is called internalized stigma or self-stigma. Some believe that it results in part from the stress of experiencing stigma. Internalized stigma is linked to emotional distress, feelings of low self-worth, and loss of self-efficacy. There can be practical ramifications as well; for example, internalized stigma may stop someone from applying for a job because they don’t believe they are capable.

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How to Combat Mental Health Stigma

People with mental disorders have been blamed, vilified, and ostracized throughout human history. While attitudes about mental illness, and treatment for those conditions, have improved dramatically over the last century, stigma has not disappeared. Yet individuals, organizations, and societies are continuing to address mental health stigma and its consequences.

Is mental health stigma decreasing?

The evolution of stigma over time is complex. Today there is greater awareness, information, and literacy than in years prior. Yet that doesn’t always translate into attitudes and beliefs. For example, a recent study that assessed trends in the stigma of mental illness in the U.S. between 1996 and 2018 found a substantial decrease in stigma for major depression but not for schizophrenia or alcohol dependence. The study also reported a substantial increase in acceptance of biomedical causes of mental illness, but that acceptance didn’t lead to less social rejection. While there has been progress, it’s far from uniform or all-encompassing.

How can society combat mental health stigma?

Research suggests that awareness and literacy, though important, are not always effective at reducing stigma. One experience that does seem to reduce stigma is interacting with people with mental health conditions. Proximity to and relationships with people with mental illness, and being open about those relationships with others, can shift attitudes. In the absence of live interactions, depictions in television and movies can be helpful substitutes. Similarly, celebrity disclosures can be beneficial as well. 

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