How Social Stigma Impacts Access to Mental Health Services

Currently, more than 50% of people who are struggling with mental illness in the United States do not receive the medical care they need.1

One of the biggest barriers to receiving mental health treatment is perceived stigma. Defined as the process of labeling, devaluating, and discriminating, stigma can present both as negative or discriminatory attitudes that others have about mental illness, as well as negative perceptions or shame that people struggling with mental health have about their own conditions. Both public stigma and self-stigma create barriers to accessing mental health services. Let’s look at some of the ways we can identify and address the stigma that surrounds mental health care.

What causes stigma against mental illness?

  • Negative attitudes and behaviors – People who struggle with mental health issues often report feeling devalued, dismissed, and dehumanized by healthcare workers.2 Sadly, a 2016 report concluded that public stigma is a universal issue, with no country, society, or culture not impacted by a tendency to discriminate against individuals with mental illness.3
  • Lack of awareness – Another common avenue of stigma is simply a lack of awareness. For many people, it is only through anti-stigma training that they become conscious of how unintended beliefs and behaviors may be contributing to a stigmatizing environment for others.4  
  • Self-stigma – A 2017 study of over 200 individuals experiencing mental health issues saw a direct correlation between greater self-stigma and decreased recovery.5 Often, self-stigma can develop in a person after years of internalizing public perceptions concerning mental illness.
  • Lack of training in the healthcare field – Poor training when it comes to providing mental health support can contribute to stigmatization by creating hesitancy and a desire for avoidance around discussions of mental health issues.2  
  • Stigma in workplace culture – A national poll performed by the American Psychiatric Association discovered that half of all workers suffer from a fear of stigma against mental health struggles, and more than one in three were concerned about retaliation or being fired if they sought mental health care.1 However, on a more positive note, the same poll found that the vast majority of workers report their employers offer some type of mental health resource, and more than 60% feel that they are being provided sufficient mental health coverage. Learn more about employer-provided mental health support and how to foster a happier, healthier workplace environment.

How Stigma Hurts Those Suffering from Mental Illness

Some of the consequences of stigma for access and quality care include:

  • Delays in seeking care6
  • Discontinuation of treatment7
  • Suboptimal therapeutic relationships8
  • Patient safety concerns9
  • Poorer quality mental and physical care10

4 Steps to Combating Stigma Against Mental Health Support

  • Normalize talking about mental health – One of the best ways to reduce mental health stigma is to become more open with your own mental health journey. If you are open with people close to you who you can trust, they can feel freed up to be honest about their own mental health struggles. Witnessing this openness in action encourages others to respond to misconceptions and negative comments with honesty. Fight the myth that mental health issues are something to hide by modeling openness to those close to you.
  • Choose positive language – Choose words that positively influence the attitudes of others towards mental health struggles. People are not defined by their struggles, so practice using people-first language rather describing an individual by their diagnosis. For example, a person should not be described as “bipolar,” but rather as an individual who “has bipolar.” While it may seem subtle, the difference in perception between labeling a person by their struggles and recognizing them first and foremost as an individual has a huge impact on respecting personal dignity.
  • Join a support group – Fight the isolation of stigmatization by joining or forming a support group. The National Alliance on Mental Illness (NAMI) is a great place to look for online groups and resources.
  • Seek treatment – Lastly, seeking early treatment is critical if you or someone you know is struggling with mental health issues. For those you know who are in treatment, offer support, encouragement, and non-judgment. Demonstrate compassion and understanding when people share the struggles they’re going through. By directing compassion toward others in their mental health journeys, you’ll most likely experience increased compassion toward yourself and your own struggles, as well.

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Works Cited

  1. American Psychiatric Association. (2019). About Half of Workers Are Concerned about Discussing Mental Health Issues in the Workplace; A Third Worry about Consequences if They Seek Help. Retrieved from American Psychiatric Association: https://www.psychiatry.org/newsroom/news-releases/about-half-of-workers-are-concerned-about-discussing-mental-health-issues-in-the-workplace-a-third-worry-about-consequences-if-they-seek-help
  2. Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare. Healthc Manage Forum, 30(2), 111-116.
  3. Rössler, W. (2016). The stigma of mental disorders. EMBO Rep., 17(9), 1250-1253.
  4. Sukhera, J., & Chahine, S. (2016). Reducing mental illness stigma through unconscious bias-informed education. MedEdPublish, 5(2), 16.
  5. Oexle, N., Müller, M., Kawohl, W., Xu, Z., Viering, S., Wyss, C., . . . Rüsch, N. (2018). Self-stigma as a barrier to recovery: a longitudinal study. Eur Arch Psychiatry Clin Neurosci, 268(2), 209-212.
  6. Corrigan, P., Druss, B., & Perlick, D. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest, 15(2), 37-70.
  7. Edlund, M., Wang, P., Berglund, P., Katz, S., Lin, E., & Kessler, R. (2002). Dropping out of mental health treatment: patterns and predictors among epidemiological survey respondents in the United States and Ontario. Am J Psychiatry, 159(5), 845-51.
  8. Thornicroft, G., Rose, D., & Kassam, A. (2007). Discrimination in health care against people with mental illness. Int Rev Psychiatry, 19(2), 113-22.
  9. Brickell, T., & McLean, C. (2011). Emerging issues and challenges for improving patient safety in mental health: a qualitative analysis of expert perspectives. J Patient Saf., 7(1), 39-44.
  10. Jones, S., Howard, L., & Thornicraft. (2008). ‘Diagnostic overshadowing’: worse physical health care for people with mental illness. Acta Psychiatr Scand., 118(3), 169-71.