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Stigma and mental illness

The experience of stigma associated with mental illness is devastating and can be detrimental to recovery. Link and Phelan defines stigma in terms of five interrelated components: labelling, stereotyping, separation, status loss, and discrimination.

They further note that each of these five elements must occur within a power differential, where the stigmatized individual possesses a lesser amount of power. Stigma is often the response to individuals who are expressing an undesirable or frightening characteristic and can be viewed as a continuum from intolerance or agitation to prejudice and discrimination.

On the more negative end of the continuum, prejudice and discrimination are rooted in commonly held stereotypes that are associated with mental illnesses. These stereotypes are concentrated within an image that individuals with a mental illness are unable to make competent decisions, are dangerous to themselves and/or the public, and require coercive intervention as they will not seek treatment autonomously.

In fact, the diagnosis of a mental illness is coupled with negative stereotypes regardless of the presence of abnormal behaviour. Although work has been done to reduce stigma and educate the public about mental illnesses, significant barriers still exist to differentiate people with a mental illness from mainstream society.

Social stigmatization of those with mental illnesses has long been studied; however, the majority of analyses have focused on the knowledge and attitudes of the general public. A number of inaccurate ideas about symptoms, etiology and treatments have been identified. Social distance is used to measure peoples’ willingness to interact with someone who has a mental illness. These studies have shown that many people want to distance themselves from someone who has a mental illness as much as they would with someone with a drug dependency or someone who has been convicted of a crime.

Examining stigma experienced by people with mood disorders is essential as The World Health Organization identifies depression as a major contributor to the global burden of disease due to “its relatively high lifetime prevalence and the significant disability that it causes.” A qualitative study of stigma by Dinos et al. suggests that individuals with mood and anxiety disorders may experience stigma differently when compared to individuals with psychotic disorders highlighting the importance of studying the effects of stigma on individuals with a variety of illnesses.

From the smaller body of research examining stigma from the perspective of someone with a mental illness, it has been reported that stigma may greatly affect an individual’s decision to seek treatment resulting in delaying or avoiding treatment all together.

In those who do seek treatment, stigma may be partially responsible for nonadherence to treatment regimens. Perceived stigma has also been shown to be related to reduced social functioning in people with bipolar disorder and impaired functioning in the workplace for people with depression and anxiety. Stigmatization can lead to negative feelings about ones’ self-including: shame, self-derogation, feelings of incompetence, and overall low self-esteem.

Source: Depression Research and Treatment Volume 2012 (2012), Article ID 724848, 9 pages doi:10.1155/2012/724848