Forbes and Fifth

Please Don’t Look at Me Like That: Defining and Refining Mental Health Stigma

What is the first thing you would think of if someone told you they had schizophrenia? Do you have a positive reaction, a negative one, or do you not know what to think? What has influenced that feeling? The determiner of how one would react to disclosure of mental illness is heavily dependent on mental health stigma. There has been a long-standing negative connotation associated with mental illness. Many see it as being a lost cause, and others do not believe it is real. Although there has been a shift in this narrative, changing society’s perception of mental illness is still a work in progress. It is a difficult topic to talk about due to its sensitivity. Stigma has a substantial impact on people who are afflicted by a mental illness. However, due to the recent public acknowledgment of this stigma, the community has started to intervene and change it.  

The first step in discussing the effects of mental health stigma is to define stigma. Stigma is the negative connotation that is attached to something. It can be associated with not only mental illness, but also race, income, and age. The article, “Community music as a vehicle for tackling mental health-related stigma,” by Debra Rodgers, discusses what stigma is and how stigma influences different social aspects of a person’s life. One example of this idea is when she refers to another scholar and states that Goffman, someone she sources in the text, suggests that stigma can mark the affected person out to be targeted by criticism, discrimination, ridicule, and undue scrutiny (Whitley and Campbell, 2014: 1), and she [Rogers] comments on  the ‘deeply discrediting’ nature of stigma, which reduces the bearer ‘from a whole and usual person to a tainted, discounted one’ (Whitley and Campbell, 2014: 3). (p. 475). Isolation is the biggest downside to stigma. Due to few people understanding mental health, it makes people want to hide. There is a lot of shame behind having a mental illness. It separates people and makes them feel shameful for something that is  hard to impossible to change, especially alone  

Mental health stigma also influences the ability of a person to get the help they need. Pharmacies have a challenging time looking past the negative connotation of mental illness. Pharmacies should be a safe space for people to get the medications they need to help them feel better. This idea is genuinely surprising, as they interact with people afflicted with mental illness every day. Most would assume that healthcare professionals would be exempt from stigmatizing others, but this shows how deep-rooted stigma is. In the article drafted by pharmacists Suzanne C. Harris et al., “Addressing the Conflict Between Promoting Wellness, Perpetuating Mental Illness Stigma and Making Psychiatric Pharmacy Education Less Intense,” pharmacies contributing to mental illness stigma prevents people with mental illness from achieving their best treatment outcomes, and in turn, their wellness. It also violates professional oath. In addition, when the person with mental illness is also a member of the pharmacy profession, the presence of stigma reduces their opportunity for wellness because the related fear and shame become obstacles to seeking help.10,11 This raises the question of why the profession embraces the importance of mental wellbeing among its members but does not have a plan to eliminate the pervasive stigma directed at persons with mental illness. (Harris and Bostwick, et al. 2021). Health care workers are human beings too, so understandably, they may have biased feelings toward people who have a mental illnesses. There is an attempt being made to change that stigma, but it is troubling to see that there is an issue of stigma in the health care community.  

The largest reason for the spread and longevity of stigma is ignorance. That sounds  negative, but ignorance is not an insult. Ignorance is a lack of information. While I was growing up, no one ever spoke to me about mental health. If it was discussed, it was regarding suicide. It was also associated with being “crazy.” In a research article called “Stigmatizing attitudes of Swiss youth towards peers with mental disorders” conducted by Michelle Dey, et al., the results found that a three-factor model–consisting of ‘dangerous/unpredictable,’ ‘weak-no-sick,’ and ‘social distance’ factors–best described stigmatizing attitudes towards mental health conditions. In addition, the female gender was associated with less stigmatizing attitude. Exposure to mental disorders (being personally affected, personally having received professional help, or knowing someone close who has received treatment for a mental disorder) was either not associated or  negatively associated with stigmatizing attitudes (Dey and Castrol, et al. 2020). The study suggests that the less close you are to mental illness, the more prone to stigmatization you are.  

I took some time to interview my peer, Noah Criddle, a student at Olivet Nazarene University, who studies social work. I wanted to get the perspective as a college student to further understand how mental health stigma has affected his age group. When asked about how mental health was discussed while growing up, Criddle replies that it was not at all talked about. He states that while discussions about mental health were more common than they were in the 50s,   they were not as prevalent as they are now. The most he remembered hearing about depression was that it was something that you should just snap out of. He knew that view was not right, but in that moment, he also did not know how to learn more. Eventually, his friends influenced him to learn more. . In middle school, Criddle noticed that they started to open up more about their negative feelings.  This encouraged them to do research so they could attach a name to their feelings. That then opened the door to learning more about what mental health is.  

When he was younger, it was difficult for Criddle to talk to his parents because did not grow up learning about what mental health is. The younger generation is more conditioned to understand mental health and avoid stigma.  He has been open about therapy to his parents, but they’ve had a challenging time wrapping their heads around mental illness. There is a level of respect, but it is not talked about in depth. One of Criddle’s family members has specifically stated that he has negative feelings that should probably be resolved through therapy, but he does not want to go to therapy. One of the reasons behind his reluctance to go to therapy is the stigma towards men who have mental health issues being less than a man. He stated that he will do anything to avoid judgment. The importance of educating yourself in mental health is extremely important. Mental health stigma can prevent people   from getting the help they need. Though this was an unfortunate norm for the older generations, there is a chance for change. The ignorance of others has influenced mental health stigma, but once an individual becomes educated, they can move forward and teach others not to be ashamed of needing mental health assistance.  

I was diagnosed with generalized anxiety disorder and persistent depressive disorder when I was in high school. When I was first diagnosed, I was terrified. I did not have any prior knowledge of mental illness, so I assumed the worst. Everything I had seen or heard about mental health was negative. I was afraid that if people knew about my disorders, they would look down on me. I considered hiding how I felt to pretend that nothing was wrong with me. I had such a strong stigma that I did not realize that I was not resultantly a “crazy person.” I just placed myself into a category before realizing that this was me that I was talking about.  I was afflicted with these thoughts before I became educated. Once I learned more about my mental health, my life became so much better. My ignorance made me isolate myself from people until I learned more and accepted my disorders. I do not want others to go through that, but if people are ignorant towards mental health, they will also assume the worst. One of the main factors that influenced me to have a negative reaction to the diagnosis was the media’s betrayal of mental health and illness.  

On the International Honor Society in Psychology’s website, there is an article titled “Dissociative Identity Disorder in M. Night Shyamalan’s Split: Fact vs Fiction (Contains Spoilers)” written by Kevin Malley. In this article, Malley discusses the movie Split, which depicts a man who has dissociative identity disorder (DID). There is one personality known as “The Beast.” The article analyzes that personality and comments that The Beast is portrayed as an angry and violent creature who seeks out “impure” humans and consumes them. On the contrary, DID develops in individuals in real life as a coping mechanism, not a weapon. Individuals with DID can be violent, but in most cases, these individuals use their personalities to better cope with the traumas they experienced in early life. They are more likely to hurt themselves than others. (Malley, 2017).  

Unfortunately, the media can depict mental health as dangerous and something to be wary of. If an individual did not know anything about DID, the movie would persuade them to adopt a negative perception of the disorder. Since DID is a disorder that often develops from childhood trauma, it is difficult to see shows and movies portray it in such a hostile way. However, our culture needs to accept some fault in this. We often base our opinions upon what we see on TV. We are not an explorative culture that does research into what is true or not—we passively accept. What then can we do to prevent and readjust stigma? 

While the movie did have an exaggerated, damaging image of DID, Split had its merits in some areas. The text explained that DID is typically caused by childhood trauma. Individuals with DID were often subjected to a sort of physical or emotional abuse that they could not cope with during their current developmental period.. The individuals become psychologically threatened and start looking for ways to protect themselves. One way they find solace is to create splits in their personality. Instead of the vulnerable host dealing with the trauma, a new identity is created to protect the original. This new identity is typically vastly different from the host identity, stronger and better apt to protect itself. As more traumas ensue, more identities are created to protect the host. The movie gives the audience a glimpse of this during a flashback of Kevin’s mother screaming and threatening Kevin. This is followed by several identities stating that those who are “impure” deserve to be consumed by The Beast. “Impure” is used to describe those who have not suffered in their lives. This is more proof that Kevin underwent extreme suffering as a child. (Malley, 2017).  

Though the movie does cover the often-tragic origins of DID, I wish that it had not been so extreme. The extreme nature of the movie causes it not to work as an educational tool. This is due to having both facts and myths about DID which make it hard for people to come out of watching it with a clear idea of what DID is. One way to help that is by doing research and having discussions with others who engaged with the topic of mental health. The Media can shift the ways people see mental health. But we still need to be careful about separating fact from fiction. The best way to separate fact from fiction is to become educated.  

Fortunately, becoming educated in mental health has become much easier than in the past. There are more resources through academic journals, documentaries, or even personal stories about mental illness. Many countries are trying to branch out and conduct more research about mental health. In the study titled “Review of Australian initiatives to reduce stigma towards people with complex mental illness: what exists and what works?” conducted by Amy J. Morgan, Judith Wright, and Nicola J. Reavley, they noticed discrimination in the workplace and found that it was because complex mental illnesses, such as schizophrenia, bipolar disorder, and personality disorders, tend to be poorly understood and attitudes are much less positive. The low prevalence of diagnosis of these mental illnesses means that most people do not personally know someone with these illnesses, so they are more likely to rely on stereotypical attitudes. Common stereotypes about people with complex or severe mental illness include are that they are dangerous, unpredictable, are not competent to look after themselves, and have little chance of recovery [4]. Negative attitudes lead to discriminatory behavior, primarily avoidance and exclusion, as people seek to avoid the risks of associating with people with mental illness. This can affect a person with mental illness’ opportunities for finding and keeping a job and their relationships with friends, family, and romantic partners [5]. (Morgan and Wright, et al.2021). I found it intriguing those other countries outside of the United States equally struggle with mental health sigma. I always thought that the United States were behind most countries in terms of mental health acceptation and awareness.  

It was also expressed in the article on community outreach that ‘Education’ is a strategy that relies on building an understanding of mental health issues by challenging commonplace stereotypes with factual information. This is achieved by displacing misconceptions with reliable evidence, often using leaflets, books, media advertising, or campaigns in schools or educational facilities. Some anti-stigma education programs have focused on explaining the biological symptoms and effects of different mental illnesses in a bid to raise public awareness. (Whitley and Campbell, 2014: 1) (p.478). This way of traveling from school to school makes it easier to educate people on a large scale.  It is hard to touch people one at a time, so it is helpful to educate to large groups of people.  

Another way of promoting education is by involving the community. It has been stated that: The opportunity for ‘contact’ between members of the general population and those with mental health issues has been shown to be an influential factor in reducing levels of personal prejudice (Corrigan, 2005). Contact that encourages engagement through shared interests or common goals provides the potential for friendships to develop and the chance for everyday interactions to help minimize commonly established stereotypes surrounding erraticism and violence (Reinke et al., 2004). This successful contact and discovery of mutual shared interests and goals may help to reduce the power difference noted by Link and Phelan (2001) as being essential to the deployment of stigma. (Whitley and Campbell, 2014: 1) (p.478). Interaction with others is precious. Community has always been a useful tool to connect to people. People are social beings, and they learn better as a group. It is easier to learn something when it is coming from a friend, rather than a lecture setting. 

To conclude, the way that we as a culture talk and interact with the topic of mental health will change the prevalent stigma. It is changing, but there is more we can do to help those who live day by day feeling shame surrounding their mental health. I struggled with my feelings towards mental health because I did not have the knowledge I do now. We are afraid of those who need the most support and comradery. Through the numerous ways we can communicate with each other, there is a way to connect with people with mental illness. With that connection and relationship building, we can learn more about different illnesses and realize that they are not scary, but rather people worth being close to.  

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Works Cited 

Criddle, N, Personal communications, November 28, 2021. 

Dey, M., Paz Castro, R., Jorm, A. F., Marti, L., Schaub, M. P., & Mackinnon, A. (2020). Stigmatizing attitudes of Swiss youth towards peers with mental disorders. PLoS ONE, 15(7), 1–18.  

Harris, S. C., Bostwick, J. R., Werremeyer, A. B., Goldstone, L. W., Cates, M. E., & Caley, C. F. (2021). Addressing the Conflict Between Promoting Wellness, Perpetuating Mental Illness Stigma and Making Psychiatric Pharmacy Education Less Intense. American Journal of Pharmaceutical Education, 85(7), 484–492.   

Malley, K. (n.d.). Dissociative identity disorder in M. night shyamalan’s ...The International Honor Society in Psychology. Retrieved November 1, 2021, from Night- Shyamalan-s-Split-Fact-vs-Fiction-Contains-Spoilers tag=All+Things+Psych.   

Morgan, A. J., Wright, J., & Reavley, N. J. (2021). Review of Australian initiatives to reduce stigma towards people with complex mental illness: what exists and what works International Journal of Mental Health Systems, 15(1), 1–51.   

Rodgers, D. (2017). Community music as a vehicle for tackling mental health-related stigma. London Review of Education, 15(3), 474–487.   






Volume 20, Spring 2022