Understanding Mental Health Stigma and How We Can Create Positive Change by Caz Bzdek


by Caz Bzdek

April 2, 2023

Facing the challenge of a mental health disorder is difficult enough. But another layer of pain comes with mental health conditions: dealing with other’s reactions to them.

Mental health stigma describes the negative attitudes held by individuals and society toward those with trauma, depression, anxiety, substance use disorder, and other mental health challenges. Hence, mental health stigma is an obstacle to increasing awareness and ensuring people get the help they need.

Moreover, access to treatment is needed now more than ever, as the mental health crisis continues. Interestingly, however, the stress and challenges of the past two-plus years have had the unexpected effect of reducing mental health stigma.

What Is Mental Health Stigma?

Stigma is defined as “a cluster of negative attitudes and beliefs that motivate the general public to fear, avoid, and discriminate against people with mental illnesses,†according to a report by the President’s New Freedom Commission on Mental Health. There is stigma associated with drug addiction and stigma associated with mental illness.

Erving Goffman, a noted sociologist, studied stigma in the 1970s. He describes stigma as “the phenomenon whereby an individual with an attribute which is deeply discredited by his/her society is rejected as a result of the attribute.â€

Stigma around mental health or other conditions can lead to:

  • Social exclusion and isolation
  • Decreased self-esteem
  • Discrimination
  • Lack of a supportive community
  • Difficulty finding education or employment opportunities
  • Limited access to quality health care.

The Two Types of Stigma

Mental health stigma can be divided into two distinct types.

  1. Social stigma: negative attitudes and discriminating behavior directed towards those with mental health problems
  2. Perceived stigma or self-stigma: feelings of shame and self-blame internalized by those with mental health challenges. Self-stigma can undermine self-esteem.

Clearly, social stigma around mental health often catalyzes self-stigma. Moreover, stigma within a family or community can cause self-stigmatization, even as the larger society becomes more accepting of mental health issues.

History of Mental Health Stigma

The word “stigma†originally referred to a tattoo or mark used for decorative or religious purposes, sometimes used to brand criminals or slaves so that they could be identified. Hence, beginning in the late 16th and early 17th centuries, the word became a negative term.

However, stigma around mental health disorders is traceable back to ancient Greece. In addition, it also traces back to the medieval and Renaissance periods in Europe. During these times, people often believed that mental illness was caused by demonic possession.

Negative attitudes towards mental illness persisted into the 18th century in the United States—leading to the stigmatization of mental illness and resulting in mentally ill people being treated inhumanely. It took decades for greater awareness around mental health issues to filter into both the treatment industry and into society at large. And even today, stigma around mental health is common. In fact, one study measuring attitudes toward mental illness found that only 25 percent surveyed were sympathetic to mental health challenges.

The Consequences of Stigma on Teenage Mental Illness

The most significant consequence of stigma is that people don’t get the treatment they need. Hence, fewer than half of those with a mental health condition get treatment, according to Mental Health America. People are afraid to disclose that they have mental health problems. They fear they will be treated differently or that having a mental health condition will jeopardize their job or their experience at school.

When people with mental health conditions don’t get help, they often self-medicate. They may use drugs, alcohol, or cigarettes. Or they may use self-destructive behaviors as unhealthy coping mechanisms, such as self-harm or eating disorders. Therefore, stigma can lead to teenage substance abuse and eating disorders. Additionally, it can increase risky behavior, social media addiction, and teen cell phone addiction. Adolescents often look for distraction as they try to escape both the pain of a mental health issue and the pain of the resulting stigma.

Mental health stigma also impacts overall health. Over time, the behaviors associated with stigma can increase the risk of chronic diseases and poor health. Therefore, studies find an increased risk of death at younger ages for people with mental illness.

Generation Z Is Reducing Mental Health Stigma

Surveys show that teens are driving the movement to reduce stigma. The National 4‑H Council commissioned a survey with the Harris Poll, exploring teens’ perceptions and experiences related to mental health. More than 1,500 US teenagers between the ages of 13 and 19 participated. They came from diverse backgrounds and geographic areas across the country.

The results showed that young people have a keen understanding of the mental health challenges their generation faces. Here are some of the findings of the survey related to this age group’s perceptions around mental health struggles and treatment.

  • 81 percent of teens believe that mental health is a significant issue for youth in this country.
  • 82 percent of those surveyed urged Americans to talk more openly and honestly about mental health issues
  • 83 percent agreed with the statement “It is important for people to take action with their mental health.â€
  • 79 percent wished that their schools would provide a safe, inclusive space where students could come together to talk about mental health.

Moreover, the vast majority of teens surveyed agreed that “as a culture, we should embrace both the ups and downs of mental health; it’s okay to feel bad sometimes.â€

“Internalizing prejudice and discrimination is not a necessary consequence of stigma. Many people recognize stigma as unjust and, rather than being swept by it, take it on as a personal goal to change.â€

—Patrick W. Corrigan and Deepa Rao, On the Self-Stigma of Mental Illness: Stages, Disclosure, and Strategies for Change

Myths and Truths About Mental Health

Stigma and negative attitudes about mental health create stereotypes and myths.

Here are a few myths and truths about mental health.

The myth: Mental illness is rare, and most people are not affected by it.

The truth: Most families in America are affected by mental illness. Prior to 2020, about 43 million American adults (18 percent of adults in the US) suffered from mental illness and 1 in 5 teens (20 percent) suffered from a mental health disorder, according to the National Institute of Mental Health. Those numbers have significantly increased as a result of the pandemic.

The myth: People with mental illness don’t get better. A report by the US Department of Health and Human Services (DHHS) found that only one-quarter of young adults (ages 18–24) believed that a person with mental illness can recover.

The truth: Most people with mental health conditions can and do recover. Studies show that most get better, and many recover completely.

The myth: People with mental health disorders or substance abuse disorder should take the blame for their illness.

The truth: Individuals who suffer from mental health and substance abuse disorders are not to blame for their conditions. Moreover, the roots of these conditions are complex. In addition, they often include genetic and neurobiological factors. Also included are environmental causes such as trauma, societal pressures, and family dysfunction.

The myth: People with mental illness are not good at their jobs. The DHHS report found that just 42 percent of Americans believe that a person with mental illness can be as successful as others in the workplace.

The truth: People with mental illnesses are good employees. Studies by the National Institute of Mental Health (NIMH) and the National Alliance to the Mentally Ill (NAMI) confirm this. There are no differences in productivity.

The myth: Treatment doesn’t help. The DHHS report found that only about half (54 percent) of young adults who knew someone with a mental illness believed treatment would help them.

The truth: Treatment can and does help. Consequently, there are now more treatment approaches than ever. These include integrated treatment in residential and outpatient programs. In addition, treatment includes group and individual therapy, experiential modalities, mindfulness practices, and other approaches.

Read about Caz’ journey dealing with trauma, abuse and redemption within mental health treatment.

How to Fight Mental Health Stigma

To reduce mental health stigma, action must be taken at all levels of society.

Hence, individuals and organizations can make a difference.

  • The media can avoid sensational stories about mental illness and portray more stories of recovery by people with mental health challenges.
  • Political leaders can support policies that help people access mental health treatment more easily. Also, they should work toward increasing funding for mental health awareness campaigns.
  • Researchers can continue to study and monitor attitudes toward mental illness.
  • Mental health organizations can provide education and resources in their communities.
  • Everyone can change the way they refer to those with mental health conditions by avoiding labels. Instead of saying, “she’s anorexic,†for example, say “she has anorexia.â€
  • Individuals can learn how to offer reassurance and acceptance to friends, family members, neighbors, or others with mental health challenges.

In conclusion, when we all work together we can create change by acknowledging the prevalence of mental health issues in our society and letting go of old ideas about mental health. As we collectively shift our attitudes toward those with mental health challenges, we are reducing mental health stigma. As a result, more people will get the help they need to recover and live full, healthy lives. -Caz Bzdek