Mental Health Stigma Flashcards
What is Mental Health Stigma?
Mental Health Stigma can be divided into two distinct types.
Social/Public stigma is characterised by prejudical attitudes and discriminating behaviour directed towards individuals with mental health problems as a result of the psychiatric label they have been given.
Studies suggested that stigmatising attitudes towards people with mental health problems are widespread and commonly held. In a survey of over 1700 adults in the UK, Crisp et al. (2000) found that:
-the most commonly held belief was that people with mental health problems were dangerous - especially those with schizophrenia, alcoholism and drug dependence
-people believed that some mental health problems such as eating disorders and substance abuse were self-inflicted, and
- respondents believed that people with mental health problems were generally hard to talk to.
What does social stigma mean in relation to mental health?
Public/society being prejudiced and partaking in discriminatory behaviour against people with mental health problems
Percieved Self-Stigma is the internalising by the mental health sufferer of their perceptions of discrimination, and perceived stigma can significantly affect feelings of shame and lead to poorer treatment outcomes. Awareness of the stereotype, agreement with it and applying it to self.
- most detrimental and predominant in ethnic minorities, youth, men, health professionals and those in the military (Clement et al, 2015).
- leads to reduced self-esteem and self-efficacy
- the ‘Why Try’ effect, people with mental health illnesses also believing they are a danger to society, therefore do no socialise, work etc. (Corrigan et al, 2009)
separate from the two main, there is another type of stigma, Structural stigma:
barriers imposed upon people with mental health problems, from the position of policy within institutions and governmental laws.
Until the Mental Health (Discrimination) Act 2013, those with a history or current mental health diagnosis could not:
- partake in jury service in the UK,
- become a member of parliament
- be a company director.
Stigma has a detrimental effect on treatment outcome for people with mental health problems.
Who Holds Stigmatizing Beliefs about Mental Health Problems?
held by a broad range of individuals within society, regardless of whether they know someone with a mental health problem, have a family member with a mental health problem, or have a good knowledge and experience of mental health problems.
For example, Moses (2010) found that stigma directed at adolescents with mental health problems came from family members, peers and teachers:
- 46% of these adolescents described experiencing stigmatization by family members in the form of unwarranted assumptions (e.g. the sufferer was being manipulated), distrust, avoidance, pity and gossip.
- 62% experienced stigma from peers, which often led to friendship losses and social rejection
- 35% reported stigma perpetrated by teachers and school staff, who expressed fear, dislike, avoidance, and underestimation of abilities.
Mental health stigma is even widespread in the medical profession, at least in part because it is given a low priority during the training of physicians and GP’s.
Stigma towards people with mental illness does not only exist in the UK and other developed countries but also in developing countries.
For example:
In China, a questionnaire study found to have low knowledge of the causes and treatments for mental illness, and knowledge was negatively associated with stigma (measured by perceived discrimination and devaluation scale).
•‘women would be reluctant to date a man who had been hospitalised for a mental health problem’
•‘the opinion of someone who had spent time in hospital for a mental health problem would not be taken seriously’.
What Factors Cause Stigma?
- misguided views that people with mental health problems may be more violent and unpredictable
- because they are ‘different’ from ‘normality’ functioning individuals
- early beliefs of demonic/spirit possession would cause caution, fear and discrimination
- medical model implies that mental health problems are on a par with physical illness and may result from medical or phsycial dysfunction in some way. as well as this, the diagnosis implies a label that is applied to a ‘patient’. that label may well be associated with undesirable attributes (e.g. ‘mad’ people cannot function properly in society, or can sometimes be violent), and this again will perpetuate the view that people with mental health problems are different and should be treated with caution.
- media; perpetuating stereotypes, creating negative portrayals of mental health problems.
How Can We Eliminate Stigma?
- campaigns (such as Time To Change, Heads Together, Britian Get Talking) to change the stigmatising beliefs will have to be multifaceted
- challenge existing negative stereotypes especially as they are portrayed in the general social media
- raise awareness of mental health stigmas
- to educate, contact and protest
- social contact has short term effects (e.g. campaigns)
- individual, social and cultural levels
- documentaries, movies, personal empowerment, and language
stigma can be addressed by adopting methods described in the social psychology literature for improving intergroup relations, these methods aim to:
- promote events to encourage mass participation social contact between individuals with and without mental health problems and to facilitate positive intergroup contact and disclosure of mental health problems (For example, Time to Change roadshow sets up events in prominent town centre locations with high footfall).
these events suggest that they:
- improve attitudes towards people with mental health problems
- promote behaviours associated with anti-stigma engagement
- encourage future willingness to disclose mental health problems
THE IMPACT OF AGE AND GENDER ON ATTITUDES (BRADBURY, 2020)
Who possesses stigmatised views?
Questionnaire study focusing on Generalised Anxiety Disorder (GAD) and Schizophrenia
16-18 years olds vs 40+ years
Hypothesis:
Females will report less stigmatised attitudes
Younger people will hold less stigmatised attitudes
Results:
Females held less stigmatised views regarding GAD
Younger people held more stigmatised views regarding GAD
No age or gender effects for Schizophrenia; generally more negative
WHY DOES STIGMA EXIST?
Possible evolutionary and social psychology roots – distinguishing normal and abnormal
Medical model:
there is something physiologically wrong
provision of a label and viewed as patient
Terminology, specifically historical terminology
Madness, Disability, Bonkers, Possessed, Lunatics
Culture; tells us what is not socially acceptable
Media: newspapers, cinema
Four stereotypes of people with mental health problems in mainstream cinema:
Comedy (Me, myself and Irene; Dissociative Identity Disorder )
Faking & Indulgent (Hamlet; depression)
Pity (One flew over the cuckoos nest; ‘insanity’)
Violence (Saw; The Joker) WHY DOES STIGMA EXIST?
Scottish Daily Mail (2015): “Suicide pilot had a long history of depression: why on earth was he allowed to fly?” The Sun (2015): “Madman in cockpit”
IMPACT OF MENTAL HEALTH STIGMA
Treated differently (negatively) – perpetuates mental health problems - Friends, family, colleagues, health care professionals
Prevents engagement in some positive behaviours e.g. applying for a job, education
Can negatively impact relationships
Social isolation
‘Stigma by association’ – stigma and discrimination effects family and carers too
Premature mortality
Homelessness
Reduced help seeking (Clement et al., (2015) found that individuals do not seek help due to the fear of being seen as weak, crazy, be blamed for the problem, because they don’t want to tell anyone, to not have a record of their mental illness, social judgement and rejection, discrimination in employment/education, being ridiculed, shame, and stigma for family.)
