Your coworker makes a seemingly innocent joke about depression. A well-meaning friend tells you that therapy is a waste of time. You minimize your anxiety, urging yourself to “toughen up.”
While these situations may seem harmless enough, the reality is that they are examples of mental health stigma. And when mental health isn’t taken seriously, it’s damaging to both society and individuals.
The good news? In recent years, discussions about mental health have become more common. With everyone from celebrities to high-profile athletes opening up about their struggles, there’s been an increase in mental health education and advocacy.
Yet there’s still much work to be done — in fact, reducing stigma remains one of the World Health Organization’s top priorities.
Let’s look at what mental health stigma is, what causes it, the consequences of stigmatizing mental health, and four ways to fight it.
What is mental health stigma?
Stigma originates from the Latin word meaning “mark or brand.” A stigma is when people hold negative beliefs about others because of their differences.
Mental health stigma, specifically, is a negative attitude toward someone with a mental illness or mental health issue. These attitudes can come from other people, those dealing with mental health issues, or their communities.
6 types of stigma
Stigma shows up differently depending on the context. Here are the six most common types of stigma:
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Public stigma: Public or social stigma comes about when groups of people believe that mental health is negative in some way. It often appears as a widespread stereotype.
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Self-stigma: Self-stigma is an internalized stigma. An individual takes on the negative mental health attitudes of society, their family, or their culture and turns it on themself.
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Institutional stigma: Policies and procedures that disproportionately affect people with mental health conditions systematically impact society. They can happen on a company, school, or governmental level, such as today’s shortage of accessible mental health care.
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Perceived stigma: This stigma relies on the assumption that others will view a mental health issue negatively. In this way, the fear of others’ opinions is so great that a person avoids addressing their mental health needs.
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Stigma by association: Also known as courtesy or associative stigma, this stigma is about being close to or related to someone who has a mental health diagnosis. This type of stigma can hinder family members from openly speaking about challenges or getting professional help for their loved ones.
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Label avoidance stigma: Many people avoid seeking support as they fear having a label and the associated stereotype. The general public’s lack of understanding of that label can hinder their opportunities for employment, healthy relationships, and other pursuits.
Examples of mental health stigma
Stigma is based on many abstract concepts, like individual beliefs and internal biases. But what does it actually look like in real-world situations?
To clarify further, here are a few examples of mental health stigma:
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Name-calling: calling someone with a mental health condition “crazy,” "too sensitive," or "weak"
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Misrepresentation: portraying individuals with mental disorders as overly violent, aggressive, or incompetent
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Minimizing: blaming someone for being unable to "get over" their condition or playing down symptoms
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Mockery: mocking someone for seeking help or mental health services
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Avoidance: treating those with mental health conditions as if they are contagious, less human, or less of an individual worthy of time and consideration
Examples of mental health stigma at work
Studies show that 26% of American adults suffer from a diagnosable mental health condition. Yet it remains a taboo topic in many workplaces, keeping employees from getting the support they need. Here are a few examples of mental health stigma at work:
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Employers who set the expectation that physical health is the only acceptable reason for taking a sick day
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A manager who won’t let you adjust your schedule so that you can go to therapy
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Avoiding treatment because you’re worried your coworkers will find out or you’ll be penalized by not receiving a promotion, etc.
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Coworkers who make insensitive comments or jokes about behavioral health issues
The cost of mental health stigma
The sheer number of people affected by mental health issues is working against negative attitudes and misconceptions. According to a recent survey, roughly 19% of the US population reports clinical mental health problems such as anxiety and depression. Many more struggle with a range of non-clinical mental health issues that negatively affect their health and well-being.
There is also growing evidence that the Covid-19 pandemic has drastically increased mental health suffering for many.
In most groups, someone is likely dealing with a mental health condition, either for themselves or a loved one. At any point in time, our co-workers, friends, and neighbors may be struggling in parallel with the lives we see.
The costs of not addressing these issues are rising globally.
Researchers estimated $2-5 trillion in annual losses in 2020. Primarily from reduced productivity and poor mental health.
Mental health also has a significant impact on the physical health of individuals, families, and communities. Thus, unaddressed poor mental health becomes a matter of public health.
While the impacts are clear and there is more awareness around mental health issues, the stigma of mental illness and poor mental health also prevails.
The history behind mental health stigma
The historical context for mental health stigma can show us why it remains so pervasive today.
According to ancient writings, many of the world’s oldest cultures connected supernatural causes and mental health problems. For example, the Greeks blamed different types of madness on specific gods.
It wasn’t until 400 B.C. that Greek physician Hippocrates treated mental disorders as physical problems. As a result, instead of seeking religious solutions, future Greek medical writers prescribed quiet, occupation, and certain drugs to the mentally ill.
Unfortunately, the Middle Ages in Europe brought a return to the supernatural. At this time, the mentally ill were labeled as witches or thought to be demonically possessed.
As time progressed, fear of the mentally ill increased. Throughout the 1600s, mental institutions were built in Europe and those labeled insane were treated as if they weren’t human.
Finally, in the 1800s, reformers began to fight for better treatment for the mentally ill. Meanwhile, research on serious mental illnesses such as schizophrenia continued around the world. By the 1950s, new anti-psychotic drugs were helping people with severe mental illness live normal lives.
Unfortunately, mental health stigma persisted. From 1950 to 1990, the level of danger that people associated with the mentally ill increased. Even though support for mental health treatment increased, research shows that it didn’t directly decrease stigma.
The causes of mental health stigma
We’ve seen that throughout history, people with mental health conditions have been mistreated. But what exactly is the cause behind mental health stigma?
Stigmas in general often develop from misinformation, pre-existing prejudices, and a lack of education on the topic. Let’s dive into each of these and see how they contribute to the prevalence of mental health stigma today.
1. Misinformation in the media
News media regularly features the most intense and dangerous forms of mental health conditions. Films and TV shows also tend to focus on inaccurate or stereotypical examples of severe mental illness.
They may use characters who are schizophrenic or suffer from extreme bipolar disorder as villains. The problem with this is that individuals probably won’t do their own research on mental illness. As a result, misinformation will lead to negative beliefs about mental health.
2. Pre-existing prejudices
Pre-existing beliefs about mental health can perpetuate the misinformation mentioned above. For example, if from a young age, your parents said that “men don’t cry,” you may believe that men who have mental health problems are weak. And when the media reinforces that idea, you will be less likely to question it.
This is harmful because the reality of mental health is more nuanced than your pre-existing beliefs may allow you to see. To reduce mental health stigma, individuals must be self-aware of their own biases and prejudices.
3. Lack of education
Research shows that the attitude you have towards mental health is based on “personal knowledge about mental illness, knowing and interacting with someone living with mental illness, and cultural stereotypes.”
Most of us weren’t taught about mental health in school. That means that we’re not given a clear understanding of the wide spectrum of mental health experiences. This lack of education leaves the door open to harmful misconceptions about mental health.
How mental health stigma impacts the workplace
The impact of stigma goes beyond individual experience — it also profoundly affects the workplace and the economy.
According to a recent survey, roughly 19% of the US population reports clinical mental health problems. Many more struggle with a range of non-clinical mental health issues that negatively affect their health and well-being.
There is also growing evidence that the COVID-19 pandemic drastically increased mental health problems. All these numbers are concerning, but the effects compound even further when there is mental health stigma in the workplace.
In December of 2021, BetterUp Labs collected data from 1,421 full-time working adults in the UK. We wanted to understand more about how attitudes about mental health are affecting workers in different parts of the globe.
Our survey revealed that employees are afraid to take time off due to mental health and hide their reasons from their employers. As just one example, a whopping 71% of respondents reported pushing through a difficult mental health struggle to avoid taking time off work in the past three months.
So what is the real cost of this kind of mental health stigma?
Well, some researchers estimated $2-5 trillion in annual losses in 2020, primarily from reduced productivity and poor mental health.
When employees are mentally stressed and don’t feel safe to ask for the support they need, it leads to burnout, high turnover, and worse results from the work they do accomplish.
While there is increasing awareness around mental health issues (and the negative side effects of ignoring them), the stigma of mental illness continues to impact our world.
How mental health stigmas impact individuals
Mental health stigma can lead people to avoid getting support for their mental health concerns. This may come from a fear of discrimination or prejudice.
This has many negative consequences for the individual, including:
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Reluctance to seek treatment: Fear of stigma can result in delayed treatment of issues, which in turn can exacerbate the condition.
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Social isolation: Often, people with mental health problems avoid interacting with others due to fear of rejection. Loneliness and isolation can make symptoms worse over time.
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Violence and hate: Those who are actively managing their mental health, particularly more severe forms of psychological distress, are more likely to be the victims of violence than others. People of color, women, and LGBTQI+ individuals are particularly vulnerable to being the victims of violence or hate crimes when a mental health diagnosis is also present.
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Feelings of shame: This is a common consequence of mental health suffering. Stigma-based shame perpetuates social isolation and can lead to feelings of low self-esteem and self-worth.
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Unemployment and discrimination at work: Some companies may not want to take on a person who seems to be struggling. It can also lead to discrimination at work if colleagues joke or offer unhelpful or hurtful commentary.
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Substance use disorders: Mental health stigma is closely related to stigma against people with substance use disorders. The combination of both can be dangerous, and stigmas make it that much harder for these individuals to seek help.
Ways to cope with stigma
You don’t have to face your mental health struggles alone. Let’s take a look at some ways you can cope with stigmas effectively.
1. Get professional support
The longer you delay reaching out, the more mental health issues can affect your quality of life. With the help of a trained mental health professional, you can take steps toward understanding what you are struggling with and what you can do to overcome it.
If you have an illness or serious condition, a trained mental health care professional can help you understand your options for treating it. Talking through the stigma you are experiencing can also be powerful.
2. Be mindful of negative self-talk
Pay attention to how you speak to yourself, even in your mind. The things we say to ourselves have a way of becoming the narrative of what we think about ourselves. If you are constantly judging and criticizing yourself, you are more likely to believe the messages you tell yourself.
These kinds of automatic negative thoughts create pathways in your mind that reinforce themselves and become harder to change moving forward. Try using positive affirmations to reinforce the good and change your thought patterns
3. Avoid isolation
Stigma and disease thrive in the dark, quiet recesses of our minds. While it can be tempting to avoid interacting with others, challenge yourself to connect with someone, anyone. Set a goal, start small, and build on it.
For example, reach out to a friend once or twice a week. Even just a text to say “hi” is a start. This can seem bigger and more intimidating in our minds than it really is, especially if you’ve been isolated for a while. Then, eventually, build up to larger interactions with others.
4. Remember you are not your illness
It can be tempting to own your illness in the ways you talk and think about it. But separating it out a bit can give it less power. Reframe: you aren’t broken, but you might be experiencing a bout of low mental well-being.
Instead of saying “I’m an anxious person,” say, “I am having anxiety symptoms.” It may seem like a simple distinction but we truly are what we tell ourselves we are.
5. Join a support group
There are many support groups out there for both those managing their mental health as well as the family members supporting them.
A couple of places to start are the National Alliance on Mental Illness (NAMI) and MentalHealth America. Joining a support group can help with feelings of loneliness and provide a reminder that you are not alone in your suffering.
6. Work on building mental fitness
Whether you are struggling with mental illness or a less severe mental health issue, you can develop and strengthen skills that help you maintain and improve your own mental health.
Mental fitness practices that build your resilience, compassion, flexibility, and stress tolerance aren’t a cure-all, but they can give you a stronger foundation to face your mental health issues.
How to fight mental health stigma
Whether you are suffering from stigma, know someone who is, or you simply want to help limit its impact on your community, there are many things you can do.
Here are a few ideas you can start with today.
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Speak out: One of the best ways to end stigma is to speak out about it. When you notice it happening, use your voice to help shine a light on it.
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Be a safe space for others: You don’t have to be a trained professional to give someone the gift of feeling heard and seen. Try to talk less and listen more. This will help you hear as much as the other person wants to share.
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Remember that words matter: Be mindful of how you discuss mental health and mental illness. Avoid labeling terms such as “crazy.” Bringing awareness to how we all speak about these issues can change the narrative over time significantly.
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Share your own journey: You don’t have to share your deepest, darkest secrets on social media to talk openly about your own mental health journey. But talking openly with others, even on a small scale, can help to decrease the amount of social stigma around mental health issues.
Taking your first step in addressing mental health stigmas
Stigma can show up in both obvious and subtle ways. It is important to first recognize it so that you can take steps to limit its impact on you and those around you.
If it is impacting you, name it, speak truth to it, and find supportive people to join your journey as you work on your own mental health.
At BetterUp we believe that engaging with your own mental health doesn’t mean that you are fragile. In fact, with the help of our coaches, understanding your mental health is the first step toward building mental fitness and developing the tools and confidence to flourish, no matter where you are now.
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