The Hostility of Mental Health Stigma

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Mental Health Stigma (MHS) is the hostile expression of the abject undesirability of a human being who has a mental illness. It is the instrument that brands the mentally dysfunctional (victim) defective due to stereotypes. MHS is purposed to protect the general population from unpredictable and dangerous behaviors by any means necessary. MHS is fomented by prejudice, ignorance, and discrimination. The stigmatized are devalued in the eyes of others and subsequently in their self-image as well.

Between 50 and 65 million U.S. adults and adolescents have a mental illness; 90% of those will be impacted by mental health stigma, a presence that elicits unsupportable levels of shame and jeopardizes the emotional and societal wellbeing of the victim.

Origins and Evolution

The Signaling Event. MHS is triggered by a set of signals or a signaling event, i.e., an occasion, experience, news story, encounter where the visibility of behaviors and mannerisms associated with mental illness elicit a reaction.

The Label. Labeling defines the signaling event and distinguishes it from other labels. ‘Woman’ is a label; it is specific, restrictive to gender, and says certain things that distinguish it from other labels. A successful label elicits a strong public reaction. The defining characteristics of the label become the stereotype. Labeling is subject to the labeler’s belief system and, like stereotype and stigma, is reliably inaccurate because of implied expectations of behavior. 

The Stereotype. Labeling gives the signal a moniker for identification; the stereotype defines it and gives it meaning. Stereotyping is a cognitive differentiation of something that piques one’s interest; everyone stereotypes. Mental health stereotyping is distinguishable by pathographic overtone that identifies the victim as unpredictable, potentially violent, and undesirable. 

Ironically, 14th-century asylums in Spain and Egypt were built to protect the mentally afflicted from the dangerous and violent members of society.

Mental health labeling and stereotypes support and collaborate with preconceived notions of mental illness, generated by the natural aversion to weakness and difference. This is supported by an ignorant and prejudicial belief system and, on occasion, personal experience. Labels and stereotypes are unbound by truth or evidence; believability is the ultimate criterion.  

Stigma. A stigma is a brand or mark that negatively impacts a person or group by distinguishing and separating that person or group from others. The branding concept originated with the ancient Greek custom of identifying criminals, slaves, or traitors by carving or burning a mark into their skin. Stigma is identified by three types: (1) abominations of the body, (2) moral character stigmas, and (3) tribal stigmas. The first refers to physical deformity or disease; tribal stigmas describe membership in devalued races, ethnicities, or religions; and moral character stigma refers to persons perceived as weak, immoral, duplicitous, dishonest, e.g., criminals, substance addicts, cigarette smokers, and the mentally ill. 

Mental Health Stigma. The objective of MHS is the perceptual protection of the general population from the unpredictable and dangerous behaviors associated with mental illness by any means necessary, including deception, misinformation, and fear-baiting. Its ultimate goal is to negatively impact the social reintegration of the victim. 

  • Anticipatory stigma is the expectation of a stigma due to behavior or diagnosis, and subsequent adverse social reaction. This causes a resistance by the potential victim to disclose any physiological aberration.  
  • Stigma-avoidance identifies those who avoid or postpone treatment fearing the associated stigma will discredit them and negatively impact their quality of life. Studies indicate almost one third of the potential victims resist disclosure, impacting the potential for recovery.
  • Family-stigmatization occurs when family members reject a child or sibling because of their mental illness. Throughout history, it was commonly accepted that mental illness was hereditary or the consequence of poor parenting. A 2008 study found 25% to 50% of family members believe disclosure will bring shame to the family. (Courtesy-stigma denotes a supportive family member.)

An active stigma is a parasitic one. If it finds enough suitable hosts, the parasitosis can spread rapidly by traditional means. Studies show the aversion to mental illness is prosocially hard-wired which provides an abundance of hosts.  

Contributing Factors to MHS. The stigma triad of ignorance, prejudice, and discrimination is generated and supported by preconceived notions, general obliviousness, a lack of education, and society’s deep-rooted fear of its susceptibility. The primary attributions to MHS are public opinion, media misrepresentation, visibility, diagnosis, and the disease or pathographic model of mental healthcare. 

How MHS Affects the Victim 

MHS impacts the victim through a series of stigma experiences:

  • Felt stigma. The anticipated or implied threat of a stigma.  
  • Enacted stigma. The activated stigma. 
  • External stigma. Victim holds the perpetrator responsible for the stigma. 
  • Internalized stigma. Victim assumes behavioral responsibility for the stigma.
  • Experienced stigma. Victim’s reaction to the stigma.

The victim anticipates their mannerisms, behaviors or diagnosis will generate a stigma (felt stigma). When the stigma is realized it becomes an enacted stigma. The victim blames the person who originated the stigma (external stigma) or assumes responsibility due to behavior (internalized stigma). When the stigma impacts the victim’s wellbeing, it becomes an experienced stigma

MHS Impact. Mental health stigma can negatively affect the victim’s emotional wellbeing and quality of life by jeopardizing their:

  • Safety, health, and physiological wellbeing 
  • Livelihood
  • Housing
  • Social Status
  • Relationships

Solution

Mental health stigma will not be mitigated or eliminated until the mental healthcare community embraces the wellness model over the disease of mental health. The disease model of mental health focuses on the problem; creating a harmful symbiosis of the individual and the diagnosis. The wellness model emphasizes the solution. A battle is not won by focusing on incompetence and weakness but by knowing and utilizing our strengths, and attributes. That is how we positively function―with pride and self-reliance and determination―with the awareness of what we are capable. 

Establishing new parameters of wellness calls for a reformation of thought and concept. In 2004, the World Health Organization began promoting the advantages of the wellness over disease perspective, defining health as a state of physical, mental, and social well-being and not merely the absence of disease or infirmity. The World Psychiatric Association has aligned with the wellness model and it has become a central focus of international policy. Evolving psychological approaches have become bellwethers for the research and study of the positive character strengths that facilitate the motivation, persistence, and perseverance helpful to recovery. Wellness must become the central focus of mental health for the simple reason that the disease model has provided grossly insufficient results.

A WORKING PLATFORM showing encouraging results for most physiological dysfunctions and discomforts is an integration of positive psychology’s optimum human functioning with CBT’s behavior modification, neuroscience’s network restructuring, and other positivity targeted approaches. including affirmations, autobiography, and methods to regenerate self-esteem and motivation.

This new wellness paradigm, however, should not be a dissolution of medical model approaches but an intense review of their efficacy, and repudiation of the one-size-fits-all stance within the mental health community. 

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Why is your support essential? ReChanneling is dedicated to the research and development of methods to alleviate symptoms of physiological dysfunction and discomfort. Our vision is to reshape the current pathographic emphasis on diagnoses over the individual, which fosters a deficit, disease model of human behavior. Treatment programs must disavow ineffective, one-size-fits-all approaches and target the individual personality through communication, empathy, collaboration, and integration of historically and clinically practical methods. All donations support scholarships for groups, workshops, and practicums.

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