Stigma around mental health

Millions of people are affected by mental issues every year, yet more than half do not receive treatment. This is due to a stigma surrounding mental health that makes speaking out about personal mental struggles immensely difficult. People with mental health issues are labeled, discriminated against, and marginalized in many ways. It is important to understand and eliminate the stigma around it.

To gain a deeper understanding about mental health, I interviewed Wendy Evans, a certified counselor (American certification) with more than 20 years of counseling experience. She has been providing consultation in Taiwan for about 12 years.

Stigma of mental health

In recent years, people have opened up more about mental health, but it still doesn’t get enough attention. The stigma around mental illness remains.

One misconception about mental illness is that people with mental illness are prone to violence. While there is a link between severe mental illnesses and violence, most people who have major mental issues are not violent. The causes of problematic behaviors and criminal activities are much more complicated. More often, tendency towards violence is intertwined with other risk factors such as misuse of alcohol, substance abuse, and adverse childhood experiences.

Another common misconception about mental illnesses is that they aren’t real. Just because mental conditions aren’t as visible as physical conditions doesn’t mean they aren’t legitimate medical problems. Mental struggles aren’t just “all in your head”. There are genetic and environmental causes of mental issues, and they can be treated medically or through therapy.

Factors of stigma around mental health

Evans explains: “Factors that contribute to this negative stigma include a lack of understanding, fear, and misleading representation in the media.”

Take postpartum depression as an example. While many women experience “baby blues” after childbirth, some develop postpartum depression, a much more severe and long-lasting mental illness. Yet when mothers are mentally suffering after childbirth, people expect them to be happy with a newborn child. They don’t realize the magnitude of physical changes like a dramatic drop in hormones can produce, or that emotional issues like being sleep-deprived, overwhelmed, and anxious can cause depression. On top of that, mothers struggling with postpartum depression are interrogated about why they’re sad, and sometimes even criticized for being depressed.

The expectation is that mothers should be happy and enthusiastic after having a new baby. When women don’t feel this way, they are criticized and misunderstood. This dynamic is a clear example of ignorance and stigmatization of mental health issues. Many people do not understand that there is a difference between sadness and depression, nor do they acknowledge the significance of mental health problems.

And this is just one example.

The general public lacks knowledge about mental health. When someone is going through a mental struggle they are too frequently reluctant to talk about it. Or when one person encounters another who is having a mental health problem, observers can feel uncomfortable or unsettled and also not want to have open conversations. When people don’t bring up the topic of mental health, it will not gain enough attention and people will remain ignorant. Then the cycle continues.

Misleading representation in the media is another factor that contributes to this negative stigma. If you are not a person who cares about mental health, majors in psychology, or attends medical school, chances are that you probably learned about mental health through the media, simply by skimming through a few sentences or seeing random images.

However, most portrayals of mental health are misleading and stereotypical. Oftentimes, mentally-ill individuals are perniciously depicted as dangerous, incompetent, ungrateful, and unrecoverable. Due to the lack of understanding, people accept the inaccurate depictions of mental illness in the media. They are unable to distinguish between fiction and fact, stereotypes and reality.

Consequences of the stigma

Public stigma can be internalized and become a type of self-stigma. People may experience feelings such as embarrassment, self-loathing, self-hate, and hopelessness if they suspect they are facing mental health issues.

Evans agrees, “To place shame upon a person who is struggling with mental health is like kicking someone when they’re already down.” The societal stigma around mental health is so entrenched that those struggling are often reluctant to talk about it or seek help. This leads to a higher risk of self-harm and suicide.

Furthermore, stigma around mental illness develops into discrimination. “Because their behavior may not always fit the norm, individuals troubled by mental illness may experience negative and dismissive words and attitudes from others,” says Evans.

Not only are people with mental illnesses discriminated against on a social level, they also face systemic discrimination. In many countries, governments do not allocate adequate spending to mental health research. A World Health Organization’s (WHO) report regarding the global underinvestment in mental health shows “just 51 percent of WHO’s 194 Member States reported that their mental health policy or plan was in line with international and regional human rights instruments”, and only “52 percent of countries met the target relating to mental health promotion and prevention programmes”. Both are way below the 80 percent target.

How to respond to people with mental health issues

The stigmatization of mental health is prevalent and detrimental, but not impossible to overcome. One way to reduce the stigma is to reach out to people who are struggling.

“If someone talks about hurting or killing himself/herself, we should always take it seriously. Not doing so, could theoretically make us an accomplice to their suicide”, Evans notes. Even if you think they’re joking, you should still show compassion and check up on them.

When someone tells you about their struggles, it can be difficult to know what to say or what to do without hurting them or causing misunderstandings. But that’s not a reason to ignore and walk away from a person who’s speaking out about their mental struggles. Showing kindness matters.

Here are some tips for what to say, and not to say, to someone experiencing mental health issues:

What to say:
1. “Do you want to talk about it?”
2. “What can I do to help?”
3. “That sounds difficult. How are you coping?”
4. “I’m here for you if you need me.”
5. “Are you seeking my perspective or would you rather I listen?”

What not to say:
1. “Why don’t you go see a therapist?”
2. “There are lots of people who have it much worse than you.”
3. “You wouldn’t feel this way if…”
4. “It’s just in your head.”

Instead of being judgmental and critical, be a good listener. Mental health issues can affect anyone. Someday, you might experience mental health issues, and you will want someone to listen to you and understand you. So treat others the way you want to be treated.

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We will deal with people going through emotionally tough times at some point in our lives. This could be someone we know, or it could be ourselves. It is our responsibility to become educated about mental health so that we can provide a friendly environment for people to speak out and seek help.

No one wants to be called weak or violent when they’re fighting a silent battle on a daily basis. No one wants to have opportunities taken away because others think their mental condition is interfering with their professional lives.

Be aware of your attitudes and behavior. Choose your words carefully. Educate yourself. Most importantly, be kind.

Wendy Evans is a USA certified counselor living in Taipei with more than 20 years of experience working with people struggling with various issues including depression, anxiety, relationship issues, parenting, addiction, weight management, eating disorders and disordered eating. For more information or to schedule an appointment, you can email her at wendyevansconsulting@gmail.com.