Mental health, society and stigma.

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Written as part of the Meer-e-Karwan series.

The purpose of this article is to discuss mental health, the issues of stigma and to signpost to some important resources and organisations.

Mental health problems are a significant contributor to the overall disease burden worldwide, with major depression being the second leading cause.

  1. 1 in 5 adults experience mental illness in a given year
  2. Mental health and behaviour illnesses are estimated to cause over 40 million years of disability in 20-29 year olds.
  3. In Britain alone; between 2003 and 2013, 18,220 people with mental health problems committed suicide
  4. I in 15 has made a suicide attempt in their life.
  5. 75% of young people with a mental health treatment are NOT receiving treatment
  6. The average wait for effective treatment is 10 years1-3.

The World Health organisation definition of health is “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.” Mental health in this regard refers to our emotional, psychological and emotional well being.

There are a number of mental health problems and they are multifaceted in their aetiology. For example, they can be caused by a combination of biological factors (e.g. genes, brain chemistry), life experiences (e.g. trauma, abuse) and/or family history of mental health problems4.

Physical and mental health are also not two separate entities as poor physical health increases your risk of developing mental health problems and individuals with mental health problems have a worse trends in morbidity and mortality.

Mental health problems can include depression, schizophrenia, post traumatic stress, learning and eating disorders as well as substance misuse and addiction. The discussion of these is beyond the remit of this article, and as such, we shall focus on the stigmatisation of people with mental health problems.

Society and Stigma

Despite the vast numbers of people affected by mental health problems, there is a huge social stigma and discrimination that is experienced. This stigma crosses barriers of countries, cultures and various creeds. Nearly nine out of ten people with mental health problems face discrimination and statistically we know that these groups face issues with finding work, being in a steady relationship, having adequate housing and being socially included in mainstream society2.

Mental health stigma can be divided into two types;

  1. social stigma – prejudiced attitudes and discrimination directed to those with mental health problem
  2. Self stigma – the internalisation by the mental health sufferer of their perceptions of discrimination, leading to feelings of shame and guilt5.

Stigma has three important aspects to it; stereotypes, prejudice and discrimination6.

  1. Stereotypes represent collectively agreed upon notions of groups of people and often include negative beliefs about mental health issues e.g. perceptions of danger, incompetence and character weakness.
  2. Prejudice is the endorsement of stereotypes and they involve a negative evaluative component, which can yield to emotional responses (e.g. anger, fear) to stigmatised groups. The power in prejudices can be seen when it turns inwards e.g. being at the centre of prejudice can lead to many persons not pursuing life opportunities for themselves.
  3. Discrimination is the unfair treatment of someone based on their mental health problems.

Strategies for changing public stigma

Broadly speaking, three approaches have been proposed to deal with social stigma; protest, education and contact7.

  1. Protest include challenging the inaccurate and hostile depictions of mental health, which can be found in media and public opinion.
  2. Education is the provision of information to individuals and groups in order to maximise their understanding and lessen negative stereotypes. A number of studies have shown that educational strategies have led to improved attitudes and reduction in the likelihood of discriminating8.
  3. Contact includes people with mental health disorders meeting those without, especially in the context of a social environment e.g. work. Research has shown that such contact events have led to decreased endorsement of psychiatric stigma.

What can YOU do?

Educate yourself!

Mental health issues are extremely common and unfortunately, so is the prejudice and discrimination against the people who are affected. The first step is always to educate yourself, and then to educate others. Knowledge is a powerful tool, which can not only help break down stigma, but also to help empower groups of people to come forward and seek the help they need, without the fear of perceptions. Below are some useful resources, which provide with statistics, have educational material and signpost to relevant groups for professionals, patients and the general public.

 

Resources

Time to change.

https://www.time-to-change.org.uk/

Social movement working to raise awareness of and ending stigma associated with mental health.

Mind

https://www.mind.org.uk/

Mental health charity in England, which is working to procvide information and advice to those with mental health problems.

Mental Health Foundation

http://www.mentalhealth.org.uk/

Improving lives of those with mental health problems and/or learning difficulties.

The centre for mental health

http://www.centreformentalhealth.org.uk/

Organisation working to improve quality of life for those with mental health problems. A wealth of information and support links.

Depression Alliance

http://www.depressionalliance.org/

Information and support to those affected by depression.

Relate

http://www.relate.org.uk/

Offering advice, relationship counselling, workshops and meditation.

Anxiety UK

https://www.anxietyuk.org.uk/

Charity supporting those living with anxiety disorders including information provision, support and 1:1 therapy.

 

References

  1. Time to change. About mental health. https://www.time-to-change.org.uk/about-mental-health
  2. Mental Health Foundation. Mental health statistics: https://www.mentalhealth.org.uk/statistics/mental-health-statistics-most-common-mental-health-problems.
  3. Centre for Mental Health, UK. https://www.centreformentalhealth.org.uk/the-decade-of-delay
  4. World Health Organisation. Constitution of the World Health Organisation as adopted by the International Health Conference, New York, 19-22 June 1946.
  5. Corrigan PW. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002 Feb 1(1): 16-20.
  6. Corrigan PW. Mental health stigma as social attribution: implications for research methods and attitude change. Clin Psychol Sci Pract. 2000;7:48–67.
  7. Allport GW. The nature of prejudice. New York: Doubleday Anchor Books
  8. Roman PM., Jr Floyd HH., Jr Social acceptance of psychiatric illness and psychiatric treatment. Soc Psychiatry. 1981;16:16–21.
  9. Corrigan PW. River LP. Lundin RK, et al. Three strategies for changing attributions about severe mental illness. Schizophr Bull. 2001;27:187–195