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

Mentalhealth.gov: www.mentalhealth.gov

Mental Health First Aid: www.mentalhealthfirstaid.org

Centers for Disease Control and Prevention: www.cdc.gov/mentalhealth


7 Comments. Leave new

HeleneZimmermanLCSW /BCD-R/EAP
July 29, 2020 6:40 pm

Denial is the first and foremost defense. However, I noted in my practice millennials are not in denial. My practice has a wide range of ethnicity and cultural diversity. Insurance coverage availability should give more access to a private practitioner.

Reply

Great tips for standing up to self-stigma.

Reply

Mental health issues are health issues that need to be dealt with. The stigma around mental health is old-fashion and outdated and has no place in modern society. Please do not allow these self-imposed beliefs to stand in the way of seeking help. These are confusing times. If you would like someone to talk to, we, the therapists, can help. Thank you

Reply

As a society it is important to have access to mental health counseling. What your blog reminds us is that there are many people who have an issue with asking or seeking help. We have come a long way and we have a long way to go in helping ease people’s worries and fears about seeking counseling.

Reply
Brenda Homefield-Rosenzweig
July 30, 2020 11:58 am

I would strongly remind clinicians to continue impart to their clients, as much educational information about the client’s specific “challenge” as possible. Ensure that there is no “self-loathing” or shame about whatever ones’ “diagnosis”. Refer to a broad range of illnesses or conditions that human beings cope with, i.e. Cancer, MS; Diabetes, Dementia, etc. whereby condemnation / judgement by “society” would be absurd! Help Re-frame whatever your client may have previously viewed in the light of Shame.

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PM Vincenza Dante
July 30, 2020 2:51 pm

Stigma can be a true obstacle to treatment. If you can find a psychiatrist/clinician from the client’s heritage or who speaks their language that can help create more openness.

Reply

The best way that clinicians can reduce “stigma” regarding mental health challenges is to be willing to talk — openly and honestly — about our own mental health challenges. I find I’ll build rapport rapidly with a new client if I have no problem admitting I’ve had similar difficulties.

If we hide the fact that we experience similar problems, or that we have in the past, by that very act of lying by omissions we impart shame to our clients regardless of color, ethnicity, gender, etc. Our own shame imparts shame to our clients; we are equal opportunity shame spreaders if we don’t get a handle on our own issues in that regard.

producer!

we teach our clients, who, by the way, are quite adept at sensing who we are, at knowing us without us even opening our mouths, are very good at sensing things on a subconscious

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