Stigma and mental illness

More than 50 million adults in the United States live with a mental health or substance use disorder. That is roughly 25% of the adult population. This includes people suffering from addiction, bipolar disorder, anxiety disorders, and depression. There are many other behavioral health disorders but these are the ones we hear about most often. Yet less than half of those individuals seek treatment. One of the primary reasons people do not seek treatment is due to the personal experience of stigma that is attached to a diagnosis of a behavioral health disorder. Stigma is labelling a particular group of people as less worthy of respect than other persons, an “us vs. them” attitude. Stigma promotes and reinforces social isolation and limits opportunities for those with brain disorders for jobs and social opportunities.

Social stigma refers to the negative attitudes and behaviors that create prejudices and discrimination toward people with a behavioral health disorder. Social stigma is a result of stereotyping and lack of understanding of these disorders. One erroneous myth is that individuals with a mental illness are potentially violent and dangerous. However, those individuals are more likely to be a victim of a violent crime than to commit such a crime.

In the past, increased knowledge about certain diseases, like leprosy, cancer, and AIDS, eventually led to a decrease in the stigma associated with the disease. It is so easy to think all we have to do is educate those who stigmatize, but as a rule their attitudes and biases began in adolescence and they sometimes do not see any reason to change their beliefs, no matter how irrational they may be. It is a very time consuming process to change another person’s beliefs.

Perceived stigma is how persons who have a behavioral health disorder interpret what other people think of them through their own experience with discrimination. Self-stigmatization has huge negative effects on the wellness of these individuals. Perceived stigma leads individuals to conceal their disorders in order to influence the perception others may have of them. Family members also stigmatize their loved ones by hiding the fact a relative has been treated for a behavioral health disorder. Individuals that self-stigmatize are more likely to be in denial about their illness than those who do not, and less likely to seek and receive the appropriate treatment, which can lead to a worsening of the illness.

One of the easiest ways to overcome social stigma is for those who have a behavioral health disorder to confront their own perceived stigma. But how?

Begin by getting treatment. Do not let the fear of being labeled prevent you from getting help. Just like anyone else, you deserve to be and feel well! Do not isolate yourself. Reach out to people you trust and can confide in. Think about it – there is a 1 in 4 chance that person has a behavioral health disorder also, and if not, they most likely have a family member who does! Do not let your diagnosis define you. You are a person with an illness, but you are not the illness. Do not be ashamed or embarrassed when reaching out for help and connecting with others with behavioral health disorders. That is a sign of strength, not of weakness. Doing so will increase your self-esteem and reduce negative thinking. Probably most important is to not accept stigma and discrimination. Demand respect. You are just as important as any other person. Do not be ashamed or let others define you.

Brain disorders can be effectively treated by medical and social services. There have been significant advances in diagnosis and treatment, yet the stigma surrounding mental health and substance use disorders has not lessened. Untreated and under-treated disorders often lead to more serious mental health or addiction issues, or a “downward drift.” Many people become worse off due to the fear of being stigmatized. Treatment does work, and people do recover.

If all the adults who suffer from a mental health and/or substance use disorder, and their families, would speak out against the prejudice, discrimination, and disrespect suffered due to stigma, it could become a thing of the past. Let’s all start now.

David Browne is the executive director of the Washington County Behavioral Health Board.