Re-visiting stigma in mental illness

Mental illness. The term is associated with many conflicting images and beliefs. What do you think of when you hear the term ‘mental illness’? Would this differ if it were used to describe a stranger, a work colleague, a celebrity, a friend, or a family member?

“Stigma against mental illness is common. Its impact is serious”1. By definition, stigma refers to a mark of disgrace associated with a particular circumstance, quality or person. Synonyms of stigma include shame, disgrace and dishonour. Stigma in mental illness manifests from uninformed and negative attitudes towards people with mental illness held by people in the general community.

Due to these perceptions, people with mental illness may find that they are treated differently. People with mental illness may be discriminated against, stereotyped, or feel isolated from others. Stigma is a significant barrier to the quality of life for many people. The fear of discrimination causes those with mental illness to avoid seeking help or resources, leaving their mental illness untreated, and may result in homelessness and unemployment.

Thus, stigma can present as a perpetuating cycle, causing external negative attitudes to be embodied by the people who experience them. 


Thornicroft and colleagues2 describe stigma as a concept consisting of three elements: problems of knowledge (ignorance), problems of attitude (prejudice) and problems of behaviour (discrimination).

Others, such as Link and Phelan3, have conceptualised stigma as four interrelated elements including:

• The identification and labelling of human differences;  
• The formation of an association between the label and negative attributes;
• The labelled person is categorised in a way that separates ‘us’ from ‘them’; and
• The labelled person experiences loss of status and discrimination. 

The stigmatisation of individuals with mental illness is dependent on society. Stigma towards mental illness is a socially derived concept that results in unequal access to social, economic and political power.


Mental illness stigma is the result of negative opinions, judgements or stereotypes about individuals who have a mental illness. A common example of stigma is when someone with a mental illness is described as ‘dangerous’, ‘crazy’ or ‘incompetent’. Such descriptions are inaccurate and misinformed.

Though inaccurate, stigma can result in people with mental illness experiencing discrimination, and denied opportunities for work or housing. People with mental illness may also be bullied in their school or workplace. People may also experience negative attitudes or beliefs towards mental illness from their family and friends.
 
The media, as well as the internet, also plays a significant role in reinforcing mental illness stigma. The portrayal of people with mental illness in a negative way reinforces these negative stereotypes. A typical example of where the media reinforces negative stereotypes, is a news report of a violent event that references a person who has a mental illness. This promotes the myth that all people with a mental illness are dangerous.

In fact, research has demonstrated that people with mental illness are more likely to be a victim than a perpetrator of violence. Such depictions ignore the diversity of mental illness and the ways in which mental illness can impact individual lives.   
 

You may be wondering if there is anything you can do to reduce the impact of mental illness stigma. Yes there is! A key perpetuating factor that reinforces the association between negative attitudes and mental illness is ignorance. A first step towards reducing stigma of mental illness, is developing an understanding of what someone with mental illness may be going through. Consider asking the person directly of their experience, or conduct your own research. There are many stories shared online from people with mental illness.

If you are experiencing mental illness yourself, consider drawing on your own experience (if comfortable to do so) to challenge and break down another’s beliefs. When you are exposed to negative stereotypes in conversation or in the media, you can actively quell these myths and educate those around you against harmful and inaccurate stereotyping.

The language we use is also a key factor in the maintenance of negative stereotypes and attitudes. Be wary of the words you use when describing yourself and other people. Try to avoid insensitive and hurtful words, for example, ‘nutter’, ‘crazy’ and ‘psycho’. Also avoid using mental illness in vain to describe your emotions or labelling your behaviours. For example, it is common to describe behaviours which are highly organised as ‘OCD’ behaviours. This detracts from the seriousness of those actually suffering from a debilitating illness like OCD. Another strategy is to use person-first language and to avoid labelling a person by their mental illness. For example, rather than ‘they are bipolar’, you could say ‘this is a person with bipolar’. Person-first language does not define a person based on the disorder they may have, instead it emphasises that they are a person first.


Action is needed by all of us to eradicate stigma associated with mental illness, so that people affected by mental illness are treated as equal members within our society.

For more information in relation to mental illness stigma, please take a look at the report, “A life without stigma”, published by SANE Australia.


If you are experiencing mental illness or stigma associated with mental illness yourself, or you know someone who is, please consider reaching out to:

Mental health professionals, such as psychologists, counsellors or psychiatrists.
Local community health centres.  
Local community mental health centres.
If you want to report stigma, visit the SANE Australia website and fill out an online report form or call 1800 10 SANE (7263).

Written by Danielle, ADAVIC Volunteer