Take action to reduce ‘self-stigma’
When it comes to behavioral health care, the term “stigma” is often used to describe the shame or embarrassment some people feel about mental illness. Therefore, addressing stigma is important because the very concept of shame makes it difficult for many individuals with mental illness to seek help.
As Beacon Health Options continues to recognize July as Minority Mental Health Awareness Month, our ongoing series of blogs has highlighted how people of color experience healthcare differently from White people because of issues around access, cultural differences, and more. Interestingly, another difference among some people of color is how they perceive their own mental illness.
The many faces of stigma
There are three generally understood forms of stigma: “public stigma” — stigma that exists in the general public; “structural stigma” — those company and social policies, practices and procedures that hamper recovery; and finally, “self-stigma” — when people with mental illness internalize public attitudes. It’s this last form of stigma among people of color that we want to focus on today. Consider the following findings from a survey conducted in California.
- Asian-Americans report higher levels of self-stigma, i.e., feeling inferior to those with no mental health problem and less hopeful than Whites that people with mental illness could be contributing members of society.
- Latinos interviewed in English expressed higher levels of self-stigma and were more likely to conceal a mental health condition than Whites.
- Latinos interviewed in Spanish reported lower levels of stigma than Whites, but they were the least likely group to have accessed mental health services.
While some studies suggest that Black Americans are concerned about stigma associated with mental illness, this California survey suggests that Black American adults with a mental illness were less likely than Whites to be embarrassed about seeking mental health services.
Standing up to self-stigma
Personal empowerment is the “broad manner by which we can reduce stigma”, according to a study on the self-stigma of mental illness. As the study notes, empowerment is the flip side of stigma as it implies control, activism, power and more. But how do we get individuals to become empowered to reduce their self-stigma? Below are some suggested steps by researchers who conducted the California survey.
- Disclosure. The first step is to reveal one’s mental illness. Research has shown that letting others know about one’s psychiatric history helps to decrease the negative side effects of self-stigma on their quality of life. This transparency promotes control and power over one’s life.
- ‘Ending self-stigma’ intervention. This promising group approach to reducing self-stigma includes educational materials; cognitive behavioral strategies; methods to strengthen family and community ties; and techniques for responding to public discrimination. A pilot study of the approach showed it reduced self-stigma and increased social support.
- Peer support. Peer support specialists — those people with lived mental illness experience — can help empower individuals by providing support for individuals newly disclosing their illness; fostering a sense of community by sharing recreation and personal experiences; and advocating for any efforts that promote identity and pride. A qualitative evaluation of peer support programs showed that participants felt more self-reliant and empowered and gained improved coping skills.
Stigma is everyone’s challenge
While individuals with mental illness and the professionals who treat them can take steps to address self-stigma, it is important to note that stigma is, fundamentally, a societal problem. After all, it is society’s biases and prejudices that people with mental illness internalize. Therefore, it is society’s responsibility to erase the public stigma that lays the foundation for self-stigma.
That means educating ourselves on what it means to have a mental illness; to understand what the conditions are; and how they translate in the day-to-day lives of those people affected by them. There are many resources to learn about mental illness, several of them below.
National Alliance on Mental Illness: www.nami.org
Mental Health America: www.mhnational.org
Mental Health First Aid: www.mentalhealthfirstaid.org
Centers for Disease Control and Prevention: www.cdc.gov/mentalhealth