What is Mental Health Stigma?

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Wellness in Schools Program

Contra Costa Office of Education WISP Team

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What is Stigma?

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• What is Stigma?
• A broad term which is used to describe the negative and stereotypical thoughts, attitudes, and feelings about people based on the traits of a person, which can include gender, skin color, sexual orientation, religion, and mental illness. 

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• Stigma can be negative stereotypes, labels, judgements, and prejudice that can lead to discrimination. 
• Stereotypes: Generalized belief; “People with mental illness are violent”
• Prejudice: Judgement based on that belief; “They’re violent, I’m scared and don’t want anything to do with them”
• Discrimination: Action based off judgements and beliefs, “I won’t hire or rent to a person with mental illness because I’m scared of them.” 

Difference Between Stigma and Discrimination 

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• Stigma is an opinion or judgement held by individuals or society. If these prepositions are acted upon, these actions may be considered discriminatory. 

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• Discrimination may be obvious and direct, such as someone making a negative remark about the person’s mental illness or their treatment. 

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• It may also be unintentional or subtle, such as someone avoiding the individual living with mental illness because the person assumes the mentally ill person could be unstable, violent, or dangerous due to their mental health condition. 
• The one living with mental illness may even judge themselves. 

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• Discriminating against someone at work, denying access to education, accommodation, entry to premises, membership of a club or association, or the provision of services under the guise of individual having mental illness. (Mental Health Act 846, 2012; Disability Discrimination Act, 1992) 

Let's Talk

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Why is Stigma Dangerous?

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• The Dangers of Stigma
• Stigma has been used to label certain groups of people as less worthy of respect than others. 

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• These attitudes in the community are  supported by ignorance, prejudice and discrimination, and they are perpetuated when mental illness is represented in an inaccurate way by the media. 

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• There are still attitudes within most societies that view symptoms of mental illness as threatening and uncomfortable, 
• These attitudes frequently foster stigma and discrimination towards people with mental health problems. 
• These reactions are common when people are brave enough to admit they have a mental health issue, and they are often lead on to various forms of exclusion or discrimination – either within social circles or within the workplace 

Why is Stigma Dangerous?

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• The Dangers of Stigma
• Stigma is used as a negative label to identify people with mental health issues.

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• Mental Health Stigma has roots in fear and misunderstanding

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• Many people hold negative opinions towards people with mental health problems because they do not understand the issues involved and because they are relying on myths and misconceptions. 

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• As Mental Health Champions, we are committed to ensuring that people with mental health issues can enjoy the same rights on an equal basis with everyone without discrimination. 
• We also must do everything we can to have honest, open conversations about mental illness to reduce the stigma that others may hold.

Overt and Subtle Signs of Stigma 

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• Overt Stigma, example is making negative comments about people with mental illness or discrimination against them.

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• Subtle Signs is believing and perpetuating the many destructive myths about mental illness, such as the idea that people with mental illness are violent or dangerous

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• Stigma can lead to discrimination. 

Mental Health Stigma

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Different Types of Stigma

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Wellness in Schools Program

Contra Costa Office of Education WISP Team

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Types of Stigma

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• Social Stigma:
• Social Stigma is when members of the general public endorse or facilitate a negative attitude or treatment towards those with mental health conditions. 
• Using people with mental illness as a comedic punchline or a dramatized scare tactic on television.
• Social Stigma effects many areas in life including employment, housing, healthcare and education.
• Self-Stigma:
• Self-Stigma can be one of the most challenging stigmas to overcome and one of the most harmful.
• It is when you believe you are less deserving of help or an opportunity due to your condition. 
• This is often developed through exposure to social stigma that ultimately results in your developing these internal beliefs. 
• Self-Stigma can lead to feelings of shame and hopelessness in the face of mental ill health.
• It can also result in diminished care seeking and treatment engagement; people do not want to  be seen as one of “those” people, so they aren’t likely to seek mental health services. 

Other Types of Stigma 

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• Perceived Stigma
• Similarly, to self-stigma, perceived stigma relates to the beliefs that you as an individual has.
• It is when you believe you will be treated differently by others due to their negative attitudes towards mental health.
• Perceived Stigma can be one of the biggest barriers to individuals opening up about their mental health struggles and seeking the help they need.
• Structural Stigma
• Structural Stigma is when a system is structured in a way – either intentionally or unintentionally – that those with mental health conditions suffer or have fewer opportunities to succeed than those without mental health condition.  

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Other Types of Stigma 

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• Professional Stigma: 
• Professional Stigma occurs in any healthcare setting where a patient is judged based on their mental health condition for unrelated causes.
• Example) When those prone to anxiety and stress complain about headaches, many General Practitioners will simply put this down to their stress levels rather than investigate further for a physical cause

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Let's Talk

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1. Why is stigma so dangerous for our young children in the John Swett Unified District?

2. What can stigma look like?

3. What words come to mind when we think or talk about mental illness? What are some words that we hear our children use when talking about mental illness?

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Common Examples of Stigma 

• Here are some common examples of Stigma: 
• “People with mental illnesses are crazy.”
• “People with mental illnesses are always dangerous and violent.”
• “Psycho and Psychotic mean violent and dangerous.”
• “Get over your problems.”, “Get your head straight.”, “Smarten Up.”
• Stigmas are often fixed ideas or judgements.
• Stigma often includes prejudice and/or discrimination. 
• The tone of voice or bodily language people might use when describing mental illness.

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Common Examples of Stigma 

• Name Calling: Calling someone with a mental health condition "crazy", "too sensitive", or "weak".

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• Misrepresentation: portraying individuals with mental illness as overly violent, aggressive, or incompetent or blaming them for being unable to "get over" their condition. 

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• Mockery: Mocking someone for seeking help or mental health services.

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• Avoidance: treating those with mental health conditions as if they are contagious, less human, or less of an individual worthy of time and consideration. 

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The Causes of Mental Health Stigma

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THE WISP GRANT: SUPPORTING STUDENTS THROUGH TRANSFORMATIVE WELLNESS PROGRAMS

Wellness in Schools Program

Contra Costa Office of Education WISP Team

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Causes of Mental Health Stigma 

• Ignorance/Misconceptions: Lack of awareness about the cause or onset of mental health diseases.

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• Cultural Factors/Belief System: Belief that mental illness is a curse, punishment for one’s sins, spirit possession, etc.

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• Fear: People fear the unknown outcome of the condition; people may fear the condition itself and/or they may be fearful towards the burden of care. 

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More Causes of Mental Health Stigma 

• Previous Experience: People might have experience with some form of the illness that may be like that disease that is stigmatized. 
• They may have seen people die from the condition in a bizarre circumstance due to family/societal neglect
• People will sometimes compare and test and question the information they have heard from their own experiences, beliefs, and common sense. 
• Medical Diagnosis: The medical model implies diagnosis, and diagnoses implies a label that is applied to a “patient”. 
• This label may well be associated with undesirable attributes (Ex) ‘Crazy’ people can’t function properly in society or can sometimes be violent).
• This will perpetuate the view that people with mental health problems are different and should be treated with caution.

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More Causes of Mental Health Stigma 

• Lack of Information Systems: Lack of education about mental health struggles for the public

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• Lack of Treatment Facilities: Lack of treatment facilities in areas who desperately need it

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• Media: The media plays an important role in shaping and reinforcing community attitudes; the media helps spread false 
•       information about mental illness.
• Ex.) Cinematic depictions of schizophrenia are often stereotypical and characterized by misinformation about symptoms, causes, and treatment. Schizophrenic characters portray violence behavior, carry out dangerous acts, and commit suicidal and homicidal behaviors.

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Common Examples of Stigma in Media 

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• Myth: They’re prone to violence
• Mental illness alone doesn’t predict violent behavior. Other variables such as age, sex, and level of stress also contribute to outbreaks of aggression
• Can you think of any examples of this?

Common Examples of Stigma in Media 

• Myth: They don’t seek help
• In media, Psychiatrists, therapists, and other mental health professionals are often depicted as cold and unsuccessful in treating some patients who are dealing with a mental illness. This is enforcing the myth that those with mental illness have nowhere to turn.
• With dedicated time and support from a trusted professional, individuals may find the care they need to better manage their mental health. By not showing characters who successfully manage mental health symptoms, we further push the narrative of victimhood that perpetuates “giving up” and fatalistic thinking. 

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Common Examples of Stigma in Media 

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• Myth: They’re overly dramatic 
• TV Shows and movies tend to focus on the “dramatic unhappiness of the character”, but fail to portray exactly what the character’s condition is and therefore miss the opportunity to show effective treatment
• Most people with mental illness live relatively drama-free 

Mental Health Stigma in Media

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Mental Health Stigma in Media 

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Mental Health Stigma in Media

• The Worst Examples of Mental Health Stigma in Media 

The Effects of Stigma 

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THE WISP GRANT: SUPPORTING STUDENTS THROUGH TRANSFORMATIVE WELLNESS PROGRAMS

Wellness in Schools Program

Contra Costa Office of Education WISP Team

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The Effects of Stigma 

• Stigma leads to negative effects on recovery among people diagnosed with mental illnesses. These effects can include:
• Reduced Hope
• Lower Self-Esteem
• Increased psychiatric symptoms
• Difficulties with social relationships
• Reduced likelihood of staying with treatment
• More difficulties at work
• Reluctance to seek help or treatment and less likely to stay with treatment
• Social Isolation
• Lack of understanding by family, friends, coworkers, or others
• Bullying, physical violence, or harassment
• Health insurance that doesn’t adequately cover your mental health treatment
• The belief that you'll never succeed at certain challenges or that you can’t improve your situation

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How Mental Health Stigmas Impact Individuals 

• Reluctance to Seek Treatment
• Fear of stigma can result in delayed treatment of issues, which in turn can exacerbate the condition
• Social Isolation
• Often mental health sufferers avoid interacting with others due to fear of rejection. 
• Loneliness and isolation can make symptoms worse over time.
• This creates more challenges, digging a metaphorical hole that can be hard to climb out of
• Violence and Hate
• While media may focus on violence, the opposite is more likely to be true. 
• Those who are actively managing their mental health, particularly more sever forms of psychological distress, are more likely to be victims of violence. People of color, women, and LGBTQI+ individuals are particularly vulnerable to being the victims of violence or hate crimes when mental health diagnosis is also present. 

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How Mental Health Stigmas Impact Individuals 

• Feelings of Shame
• This is a common consequence of mental suffering. Due to stigmas, many feel shame about having a diagnosis at all. Shame then perpetuates more social isolation and can lead to feelings of low self-esteem and self-worth. 
• Unemployment and Discrimination at Work
• Having a mental health issue can result in lack of employment. 
• Some companies may not want to take on a person who seems to be struggling in any way. 
• It also leads to discrimination at work if colleagues joke or offer unhelpful or hurtful commentary. 
• Company policies and procedures that are not accommodating can perpetuate the problem. 

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Why is It Important for Us to Talk Mental Health Stigma?

THE WISP GRANT: SUPPORTING STUDENTS THROUGH TRANSFORMATIVE WELLNESS PROGRAMS

1. What false myths and misunderstandings does stigma perpetuate? 

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• What does mental health stigma look like in our children? Why is it important for us to have conversations with them about the impact of mental health stigma?

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Preparing For The Future: How to Support Our Children 

• Though depicting mental health in films is a tricky process, some films and TV shows do a much better job than others in discussing illness and suicide without excessive violence or glorifying destructive actions without consequences.
• To navigate the unclear waters of whether a program or film is appropriate or harmful for children, we recommend showing a healthy concern over the viewing material and if possible, co-watching questionable programs with your child and discussing the subject matter openly thereafter

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Preparing For The Future: �Navigating Through Media 

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• Knowing your child or teen’s emotional development level is also especially important for determining appropriate subject matter. 
• Teens with more delayed social processing, or inversely, teens who are overly attuned to pain may struggle with the strong emotions that come with more mature themes, or graphic scenes. 
• Be sure to maintain open levels of honest communication with your child, free of judgement or criticisms. 
• Suggestions:
• Listen closely to your child’s response to sensitive mental health subjects.
• Avoiding offering immediate advice.
• Ask clarifying questions and leaving time for reflection.
• Consult a professional when needed. 

How Do We Address Stigma?

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THE WISP GRANT: SUPPORTING STUDENTS THROUGH TRANSFORMATIVE WELLNESS PROGRAMS

Wellness in Schools Program

Contra Costa Office of Education WISP Team

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What Can We Do to Address Stigma? 

• Speak Out
• One of the best ways to end stigma is to speak out about it. 
• When you notice it happening, use your voice to help shine a light on it.
• Once made aware of the ways they might be negatively impacting others, most people will want to stop doing so as a result.
• Be a Safe Space for Others
• Be mindful of others who might be suffering from mental health challenges and allow them space to discuss their experiences and feelings.
• You don’t have to be a trained professional to give someone the gift of feeling heard and seen.
• Remember to try to talk less and listen more; this will allow you to hear as much as the person wants to share 

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What Can We Do to Address Stigma? 

• Remember that Words Matter
• Be mindful of how you discuss mental health and mental illness.
• Avoid labeling terms such as “crazy”
• If you notice others, such as the media, using terms that further perpetuate stigmas, let them know.
• Bringing awareness to how we all speak about these issues can change the narrative over time significantly. 
• Share Your Own Journey
• You don’t have to share your deepest, darkest secrets on social media to talk openly about your own mental health journey.
• But talking openly with others, even on a small scale, can help to decrease the amount of social stigma around the mental health issues. 
• This tells others that they are not alone and can bring about feelings of hope that is possible to overcome mental health challenges. 

Ways to Cope With Stigma: �How We Can Advise Parents Dealing With Stigma  

• Be Mindful of Negative Self-Talk 
• Pay attention to how you speak to yourself, even in your mind. The things we say to ourselves have a way of becoming the narrative of what we think about ourselves.

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• If you are constantly judging and criticizing yourself, you are more likely to believe the messages you tell yourself.

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• These kinds of automatic negative thoughts create pathways in your mind that reinforce themselves and become harder to change moving forward.
• Try coaching parents/children to use positive affirmations to reinforce the good and change your thought patterns. 

Ways to Cope With Stigma: �How We Can Advise Parents Dealing With Stigma  

• Treat Yourself Like a Friend
• If a close friend or family member were to come to you and tell you the same thing that you are thinking about yourself, what would you tell them?

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• Chances are you would be kind and supportive rather than attacking or critical.

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• Self-compassion strengthens resilience. 
• So, if you'd say it to a friend, make sure you'd say the same to yourself. 

Ways to Cope With Stigma: �How We Can Advise Parents Dealing With Stigma  

• Avoid isolation 
• Stigma and disease thrive in the dark, quiet recesses of our mind. 
• While it may be tempting to avoid interacting with others, challenge yourself to connect with someone, anyone. 
• Set a goal, start small, and build on it. 
• For example, reach out to a friend once or twice a week.
• Even just a text to say "hi" is a start. 
• This can seem bigger and more intimidating in our minds than it really is, especially if you've been isolated for a while.
• Once that feels less hard, reach out to more friends or family each week.
• Try to meet up for a dinner or coffee. Build up larger interactions with others. 

Ways to Cope With Stigma: �How We Can Advise Parents Dealing With Stigma  

• Work on Building Mental Fitness
• Whether you are struggling with mental illness or a less severe mental health issue, you can develop and strengthen skills that help you maintain and improve your own mental health. 

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• Making practices that build your resilience, compassion, flexibility, and stress tolerance part of your everyday isn't a cure-all, but it can give you a stronger foundation to face your mental health issues. 

Ways to Cope With Stigma: �How We Can Advise Parents Dealing With Stigma  

• Join a Support Group
• There are some support groups out there for both those managing their mental health as well as their family members supporting them. 
• A couple of places to start are the National Alliance on Mental Illness (NAMI located in Contra Costa and Alameda County) and MentalHealth (Alameda County) America. 
• Joining a support group can help with feelings of loneliness and isolation. It can also provide a reminder that you are not alone in your suffering. You never know where those connections might lead. 

Ways to Cope With Stigma: �How We Can Advise Parents Dealing With Stigma  

• Remember You Are Not Your Illness
• It can be tempting to own your illness in the ways you talk and think about it.
• But, separating it out a bit can help give it less power.
• For example, try helping the person reframe from thinking they are broken. You might help them realize that they are having a bout of low mental well-being. 
• Instead of saying "I'm an anxious person", say, "I am having anxiety symptoms". 
• Instead of saying "I am a depressed person", say "I am having depression symptoms"
• This may seem like a simple distinction, but we really are what we tell ourselves we are. 

Ways to Cope With Stigma: �How We Can Advise Parents Dealing With Stigma  

• Get Professional Help 
• The longer you delay reaching out, the more negatively mental health issues can affect your life.

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• With the help of a trained professional, you can take steps toward better understanding what you are struggling with and what you can do to overcome it. 

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• If you in fact have an illness, or serious condition, a trained mental health care professional can help you understand your options for treating it. 
• Talking through the stigma you are experiencing can be powerful..