How can we fight the stigma against mental illness?

We all have mental health – and yet stigma and discrimination associated with mental ill health are widespread and damaging.

60% of people with a mental health disorder do not seek help from a health professional.
“World Health Organisation 2019”

9 out of 10 people with a mental health problem have experienced stigma and discrimination.
“Time to Change”

The majority of people with a mental health problem wait over a year to tell close friends and family.
“Time to Change”

What are our misconceptions and assumptions and do we recognise them as such? What can we do to better understand mental health for ourselves and others and reduce the stigma against mental illness? And why should we try?

Lots of questions. Let’s explore some possible answers…

person shape sitting cross legged in a jar shaped container - titled the conversation

Recognising that our mental health is an intrinsic part of our overall health and wellbeing, in conjunction with our physical health is something you will now hopefully be more aware of. If you need a refresher check out How Healthy Are You?

How do you think about Mental Health now?

The statistics about stigma and discrimination against mental ill health and the impact this has for people living with this are damning. Often it is all to easy to accept this as is, or ignore it completely. However, we think we can do more – and should do more.

Where to start?

An interesting exploration to check out misconceptions is to complete a simple activity.

On a blank piece of paper write down all the negative, inappropriate, judgemental words and phrases you can think of – whether you use them or not – associated with mental ill health. On this occasion you can be as politically incorrect and as rude as you dare to be!

For example:

  • Get a grip!
  • Time waster
  • Weirdo

On a second piece of paper write down all the positive, acceptable or neutral words or phrases associated with mental ill health.

For example:

  • Living with depression
  • Coping
  • Mentally unwell

Take a few moments to look at your lists and consider:

  • Which list did you find easier to compile?
  • Which has got most words and phrases?
  • How many of the words and phrases do you use or hear others using day to day?
  • What does this tell you about how you think about mental health, in general?

You will not be on your own if you found it easier to compile the list of negative words and phrases or if you found this list to have lots more words.

Typically it is easier to think of the negative words than positive and some of the phrases we use regularly promote the stigma associated with mental health. The key thing to remember here is that …

Language does matter.

Stigma and discrimination are real and both are damaging.

Looking back at your negative words list, you can begin to appreciate what it might feel like to have people refer to you, however ignorantly, as a ‘weirdo’ or someone who is ‘lazy’ or a ‘time waster’.

Stigma associated with mental health issues can have a significant impact on people, from feeling isolated to being less likely to seek help. And it is not unusual for this to continue into recovery. It is also not unusual for people to use similar language about themselves – which perpetuates the problem and their feeling of self-worth.

We believe that we all have responsibility to be aware of our own habitual language associated with mental health and how this may contribute to the stigma.

Exploring some of the myths…

Misconceptions around mental health issues and our attitude to mental health are also fuelled by some of the myths.

Some common myths about mental ill health include:

  1. People suffering with mental ill health (particularly schizophrenia) are
    dangerous or violent.

    In reality people living with psychosis are more likely to be the victims of violence or be harmful towards themselves than others. It is not all like One Flew Over the Cuckoo’s Nest or the stories in the media.
  2. Children or young people do not suffer from poor mental health.
    This is not true.
    Mental health problems affect 1 in 10 children and young people – MHFA England. Early intervention can prevent reoccurring issues and promote positive recovery.
  3. Depression is a sign of weakness and people should ‘snap out of it’.
    Depression is complex and linked with changes in brain chemistry and function –
    there can be genetic factors influencing whether you are more likely to
    suffer from depression, plus environmental and social factors. And just like you can’t “snap out” of a broken leg, you can’t “snap out” of depression.
  4. People with mental illness never get better and cannot function in
    everyday life.

    Many people with diagnosed mental health conditions live fulfilling
    and highly productive lives (most of the time). There is always hope for recovery with the right treatment and support.
  5. People with mental illness lack intelligence.
    There is no link with mental health and intelligence – mental ill health does not discriminate! Some mental health conditions may make it more difficult to remember facts/ information, while others don’t – this is not about intelligence!
  6. There is nothing I can do to help someone who has mental ill health.
    There is a lot we can do. Being there and connecting personally, listening without judging and asking how people are – twice…More about this later. Lots of research shows everyday conversations can have a positive impact and our attitude towards mental health can make a difference.

Thinking differently about mental health

The Mental Health Continuum below is a useful way of framing the link between mental health and mental wellbeing. It also helps explain the fluidity of our mental health and how it changes. It is not as simple as we have good mental health or we have poor mental health. The measure is much more complex. There are no absolutes – what is healthy for one person may not be for another.

Someone may have a diagnosis of a mental health condition, for example depression, and have positive mental health. Another person may not have a diagnosed issue and have poor mental health.

An easy way to look at this is the sleep example. We all need a different amount of sleep each night to feel rested. I am an 8 hour a night girl and if I consistently get less, I get grumpy (just a little…). Other people function perfectly well on 5 hours a night. Neither is right or wrong – it is personal to us.

In the same way, our mental health is personal to us. The continuum helps explain this.

Mental Health continuum showing axis mental health min and max and severe diagnosis to no diagnosis

There are numerous reasons why our mental health might change depending on the situations we are experiencing. Our mental wellbeing and fitness can be impacted by these different situations and cause us to move from one quadrant to another. Some factors may include:

  • Specific events or situations – redundancy, moving house, new job or boss
  • Life stages – parenthood, children leaving home, menopause, caring for elderly relatives
  • Family and relationships – relationship breakdowns, death, money

Lots of people who move from the upper right to the lower right quadrant never go on to receive a diagnosis. This isn’t inevitable. Sometimes our mental wellbeing is just not as positive and our mental fitness declines – just as with our physical health.

Recognising the signs of this is the start to being able to to something about it. We will talk of ways you can look after your mental wellbeing throughout this series. Look out for the other modules for practical tips and tools.

Doing something, no matter how small is better than doing nothing.

And we believe that being part of the Eat, Move, Be Happy Wellbeing Community is definitely a step in the right direction!

Stigma is part of the continuum because, as we have seen with the activity above, it is real. It can be a barrier to recovery due to the perceptions people hold about mental health and mental illness. Talking about mental ill health can help reduce this stigma.

For some people, fear of encountering stigma or self stigma can prevent them seeking help and support. Seeking a diagnosis can mean people receive the treatment they need to move into the top right quadrant. And early treatment and intervention promotes recovery.

People who do have a diagnosis and are coping well can also feel they cannot move to the top left quadrant due to the perceptions people hold if someone has ever received a diagnosis. And often this is down to ignorance and our misconceptions.

So, considering our mental health as fluid and something that can and will change in time is a more realistic way of thinking about it. Recognising that it isn’t always going to be absolutely fabulous – whatever scale you use to measure it, can release some pressure if we don’t feel mentally 100%. It is ok not to be ok.

Reaching out to people, connecting, listening without judging are all essential steps to helping people. A simple yet effective way of reaching out is to ‘ask twice‘. If you notice something different about someone you know, ask them how they are… and then ask again. We are wired to habitually reply, ‘I’m fine thanks…’ when sometimes that second enquiry, especially coming from someone who obviously cares about the answer, may just get people talking…

An important thing to remember is that, whether we have a diagnosis or not, feeling mentally less well will pass …

Remember – recovery is possible and likely.

Need further support…

If you are worried about your mental health please seek professional help and advice from your GP. If you cannot visit your GP and need urgent help visit A&E.

Other sources of help include:

  • The Samaritans who offer a free, confidential 24 hour helpline.
  • Mind a Mental Health Charity offering information and support line.
  • Time to Change working to end mental health discrimination.

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