Mental Health Stigma: What it Is & What Is the Impact

What Is Mental Health Stigma?

Mental health stigma describes judgmental, discriminatory, or negative attitudes about mental health concerns or toward mental health diagnoses, treatment, or resources. Only 11-30 % of people with mental health concerns seek help, largely due to stigma. It is critical that mental health stigma be addressed and reduced to improve mental health outcomes.¹

Stigma affects certain groups more than others. For example, males have been found to be more impacted by mental health stigma than females and black people more than white. Additionally, specific cultures and religions have more stigmatized views of mental health, including African, Asian, and Middle-Eastern Cultures. Stigma can also be targeted toward specific mental health diagnoses like schizophrenia.^2,3

Minority Groups & Mental Health Stigma

Stigma is pronounced among minority groups globally. Cultural, racial, religious and socio-economic factors all impact mental health stigma and create a barrier to accessing treatment options and resources. In the Philippines, for example, people are encouraged to rely on traditional healers for help. In Asian cultures, shame can be a barrier to seeking help, and in some African cultures, talking about a problem is believed to make it worse.³

In the US, mental health stigma is higher among Asian, Black, and Latinx Americans. This is due to a lack of access and inadequate quality of services, as well as concerns about the effect on the family, lack of knowledge about mental illness, and internalized shame.¹ Among the LGBTQ population, internalized stigma about mental health concerns, sexual orientation, and gender identity are all barriers to treatment.⁵

Men & Mental Health Stigma

Stigma contributes to the growing mental health problem among men, with cultural norms and expectations about masculinity playing a part. Because fewer men than women seek treatment for mental health concerns,  it has been referred to as a “silent killer”. There is a critical need for stigma to be reduced so that men are more likely to access the care they need.⁶

Mental illness is often under-treated in males, even though depression in men is listed as leading causes of death. In the US, 6 million men are affected by depression each year, and they are 4 times more likely than females to die by suicide. They are also 2-3 times more likely to develop substance use disorders.

Types of Mental Health Stigma

Mental health stigma occurs at three levels, public, self, and institutional. These all create barriers to care and can lead to shame and a reluctance to seek help. Different people may be more affected by one type of stigma than another. For example, some are impacted by living in a culture where mental illness is viewed as weakness, while others are impacted by workplace discrimination.

Types of mental health stigma include:

• Public: Public mental health stigma refers to beliefs, norms, or behaviors prevalent in a population or community. This can include negative or judgmental attitudes toward people with mental illness, beliefs about seeking outside help, or a culture of shame.
• Self: Self-stigma is when a person internalizes the stigma from the public and turns it toward themselves. This can cause someone to feel shame about their challenges, negatively impact self-worth and prevent them from seeking help.⁷
• Institutional: Institutional stigma refers to policies that officially or unofficially discriminate against people with mental health concerns. These could include fewer resources for mental vs. physical health, funding, or discriminatory policies around attendance or medical leave.⁸

Examples of Stigma in Mental Health

Stigma can arise within an entire community, among peer groups or families, or in the workplace. The roots of stigma can include religious or cultural beliefs, community norms, public messages, passed-down beliefs, or workplace policies. Stigma can be blatant or subtle and is often so ingrained that people often aren’t aware of its impact on their experience.

Some examples of mental health stigma include:

• When people tell an individual who is struggling with depression to “just be happy” or “you are choosing to be unhappy”
• A person who doesn’t tell anyone about their symptoms because of shame or embarrassment
• A workplace policy that allows time off for primary care appointments but not mental health appointments
• Having negative beliefs or judgments about a person based solely on their mental health diagnosis
• A culture that believes seeking help is shameful or reflects badly on the family or community
• A group of friends gossiping about someone who sought out mental health treatment
• A culture that views asking for help to be a sign of weakness

Why Does Mental Health Stigma Exist?

There are several reasons for mental health stigma. One is that some mental health diagnoses are considered more socially acceptable than others. For example, anxiety that results in high performance or perfectionism is more accepted than a diagnosis that impacts functioning, like schizophrenia. Lack of understanding about mental health can also  play a part, as can distrust of the system.⁹

Social and cultural beliefs about what mental illness says about a person, for instance, that seeking help is weak or shameful for the family, also drive stigma. Cultural, racial, or religious groups can have negative beliefs about mental health or accessing help and expectations that concerns should be handled within the family or community. Fear of rejection, retaliation, or consequences in the workplace also contributes.

Harmful Effects of Mental Health Stigma

Mental health stigma can be incredibly harmful, as it can lead to self-doubt or self-loathing, a reluctance to ask for help, and fears about rejection or judgment from family and community. Stigma causes people to suffer unnecessarily rather than seek help out of fear of judgment or other consequences.

Harmful effects of mental health stigma include:

• Reluctance to seek help or treatment
• Withdrawal from family and other supports
• Workplace and institutional discrimination
• An increase in negative mental health outcomes, including suicide risk
• Feelings of self-doubt and shame
• Unemployment and other workplace problems¹⁰
• Bullying
• Isolation
• Ridicule from others

How to Deal With Mental Health Stigma

There are things a person can do to deal with mental health stigma. Public stigma can be addressed through education, advocacy, support, and improving access to resources. Self or internal stigma can improve with therapy, talking with others, sharing stories, and seeking support from people with similar struggles. Institutional stigma can be addressed at the organizational or government level.

Here are some ways to deal with mental health stigma:

• Get treatment: Although mental health stigma makes it much harder to reach out for help, it’s important to overcome this and seek help anyway. A mental health provider can help you deal with the feelings of shame or reluctance caused by stigma.
• Don’t isolate yourself: It is important to seek out support from family and community, as isolation can worsen symptoms of depression and other mental health disorders.
• Join a support group: Joining a group of people who share similar struggles can make it easier to open up, helping people feel less alone with their problems and concerns.
• Learn about mental health: Getting education and information about mental health helps decrease stigma. Learning about the causes of mental illness and that it is not the person’s fault or caused by weakness can increase understanding and compassion.
• Talk to others who have mental health concerns: Talking with others who share similar concerns is a great way to validate and normalize experiences. It can help a person feel less isolated and alone and reduce stigma through understanding and compassion.
• Become familiar with available resources: One factor that fuels stigma is distrust or lack of access to available resources. Becoming educated about the types of resources available and how to access them can help. 
• Volunteer: Helping others can be a great way to take the focus off of one’s problems, increase compassion and understanding, and reduce stigma.
• Advocate for funding: Lack of available or sufficient resources contributes to mental health stigma. One way a person can work toward a solution is by advocating for resources and funding in the community.¹¹
• Address inequality and discrimination: Inequality and discrimination also feed stigma, as it becomes the norm to discriminate against those with mental illness, which is then internalized. Once a person has received the care they need and feels better, addressing these issues in communities, institutions, or government can be a powerful way to fight stigma.

How to Support Someone Who Is Dealing With Mental Health Stigma

When someone is dealing with mental health stigma, it is important to support them. Stigma can cause people to feel isolated, which makes mental health symptoms like depression and anxiety worse. Stigma gets in the way of someone asking for the help they need. Additionally, dealing with stigma for a long time can result in the person developing emotional burnout and feeling overwhelmed or shut down.

Here are some ways to support someone who is dealing with mental health stigma:

• Educate yourself: Seeking out reputable information and learning about the significant impact of mental health stigma and the challenges one may face can help your loved one throughout their mental health journey.
• Encourage storytelling: One way to reduce the impact of stigma is to encourage a person to tell their story and to listen and offer non-judgmental support.
• Help your loved one find resources: Sometimes, stigma can get in the way of researching available treatment options and creating a distrust of providers. You can help by searching for and identifying potential providers and resources and providing contact information to reduce that barrier.
• Go along for the ride. Offer to go along to appointments if this would be helpful.
• Educate others: If you are part of a shared community with the person affected by mental health stigma, sharing information with others in the group can be helpful. This can include educating them about mental health stigma, symptoms, harmful language, and messages and providing more effective strategies for supporting loved ones.
• Advocate for mental health rights: This is not only helpful for addressing stigma at a higher level but can also show your loved one that you are passionate about mental health and reducing stigma.
• Encourage open dialogue: Encouraging others to talk openly and honestly about mental health can reduce the secrecy around it and normalize these types of discussions.
• Use respectful language: Be aware of using language that can unintentionally contribute to stigma. This can include using words like “crazy”, or using diagnoses like “I’m so OCD”, etc. in casual conversation. You can model speaking about mental health issues openly and respectfully.

When to Seek Professional Support for Mental Health Stigma

In some situations, seeking professional help to address any negative symptoms that have developed due to mental health stigma is a good idea. When stigma is a barrier to addressing symptoms that are significant enough to impact one’s ability to function at work, home, or school, or if they impact relationships, sleep, or appetite, it’s important to seek help.

It might seem counterintuitive, but talking about the discomfort one feels about getting help with a therapist can help them move past it. Your therapist is not going to take this personally, and they have likely helped others with it before. An online therapist directory or online therapy platform is a great choice for finding a therapist, especially when one is concerned about privacy or judgment from others if going to appointments in person.

In My Experience

Stigma is alive and well. While many people have sought out treatment for mental health since the Covid-19 pandemic, others still resist asking for help. My practice is located in the midwestern U.S., and stigma seems to be much more prevalent in rural areas. Far fewer resources are available, and people tend to have more negative attitudes towards mental health.

In big cities and suburbs, however, mental health is much more accepted than it used to be, and many urban providers report having more demand than ever. I encourage anyone struggling with a mental health issue to seek out help in spite of stigma. Readily available online resources can make it easier for people who may not want to share that they are seeking treatment.