16:11 PM

Strengthening our competence to reduce stigma

by Roger Whittler, LPC, Missouri Lawyers' Assistance Program clinician

People suffering from mental health and substance challenges often struggle in secrecy, afraid to seek help for fear of being alienated and treated negatively. While a significant number of celebrities, professional athletes, and others are disclosing their own personal struggles and encouraging people with these challenges to seek help, understanding the aspects of distrust in seeking help for emotional distress is important. When mental health is viewed as a source of shame or guilt – stigmatization – people's willingness to seek help is suppressed.

According to Stacy L. Overton and Sondra L. Medina, in the Journal of Counseling and Development, 2008, the barriers and negative attitudes toward people with mental illness that result from stigma affects them greatly. They are often compromised in dealing with daily activities. After hearing negative feedback and experiencing an onslaught of negative actions, they begin to see themselves in a negative light. People who have been diagnosed with a mental illness often find that their self-image and confidence are sacrificed by living under the pressure and negative expectations generated by stigma.

Direct interaction is superior at mitigating the mental health stigma because it puts a name and a face with the stereotype and provides the connection that so often is overlooked. It is far too easy to criticize the behaviors and symptoms of a stranger, but when it is us or a close family member who is being criticized it becomes a different matter altogether. The difference is the personal connection. Below are several recommendations in addition to personal interaction for reducing the stigma of mental illness.

  • Approach others with an open mind. How would you treat a family member or friend in the same situation?

  • Avoid belittling language that draws attention to an individual’s mental health. Remember that a condition does not define someone, but accept that it can impact their personality. If you hear others speaking negatively about an individual, speak up.

  • Consider that the individual dealing with a mental health challenge is likely already aware of, and perhaps anxious about, their situation. Be kind. 

  • Always carefully assess the nature of any apparent mental illness observed. Consider if it is situational, (anxiety in the courtroom only – and not in other environments).

  • Be patient and suspend judgement. If you’re unsure what to say, remain silent and assess further in order to be informed on a constructive approach.

  • Be prepared to listen and believe what you are hearing. This might be hard if you have never dealt with something similar. 

  • Avoid whispering, gesturing, or making light of the person’s appearance or non-conformity.

  • If interaction is possible, inform the person that you are open to talking with them in private.

  • Do not offer quick remedies and suggestions or make public comments about the person. Mental health challenges are complex and can’t be stopped by “flipping a switch.”

  • Try to reflect hope, optimism, and encouragement regarding treatment possibilities.

  • Consider ways to reduce barriers to receiving treatment. This requires self-reflection on how each of us would want to be treated if the roles were reversed.

Overton and Medina reported three methods have been used to combat the stigma of mental health. They include protest, education, and contact or direct interaction with a person of a stigmatized group. 

  • Protest is defined as a complaint or an objection (Merriam-Webster Dictionary, 1990, p. 418). Through protest, an attempt is made to suppress stigmatizing attitudes by directly instructing individuals not to think about or consider negative stereotypes. Protest is used to dispute ingrained beliefs by proposing arguments or facts that dispel the belief system.

  • Education is another method that has been used to mitigate stigma. Education is the means of conveying information to specific populations. Often, education counters myths with facts. Couture and Penn (2003) found that education is helpful for changing attitudes but has little effect on subsequent behaviors.

  • Contact or direct interaction is an additional way to mitigate stigma. There is an extensive body of research showing that interpersonal contact with someone with a mental illness is far more effective at mitigating stigma than either protest or education.

To support change in addressing the stigma of mental health and removing the lack of trust among people who are struggling, we must have a broader understanding and level of competence. Strengthening our competence can help move toward the change we need to support those with mental and substance challenges. How we respond matters. If a person feels criticized, embarrassed, or humiliated, stigma is perpetuated.

The Missouri Lawyers’ Assistance Program provides confidential professional help with mental illness or substance use concerns. Call 1-800-688-7859.