Health Opinion

Stigmatised: why mental health stigma is deadly

You lie still in bed- awake. The cold moonlight stings your face as it cuts through the gaps in the blinds, lighting up the room almost as much as your scattered and nervous thoughts fill up your mind. You won’t get any sleep tonight, but then again- what’s new?

Your mind won’t stop; you won’t stop: it won’t stop. It is relentless, the constant onslaught of your mind; your deepest worries about yourself, your biggest fears and the varied spectrum of your imagination flash images in front of your mind that make you shrink. The shaking that comes with your stress and fear won’t stop, it never has and perhaps it never will. Stress, anxiety…depression; the saddest part is that you’re used to it by now.

Diagnoses

Our society has a mental health problem, particularly among young people, and a scenario such as the one painted above is for too many people part of their daily lives. Mental illnesses are at a record high in modern British society; a recent report showed that a fifth of male students suffer mental health issues rising to a third of all female students while 45% of those who identify as LGBTQ suffer from poor mental health. Between 2001 and 2011 ‘inpatient admissions for self-harm increased by 68%’ while suicide is the biggest killer of men under the age of 50 while for only Breast cancer is more deadly for similarly aged women.

To turn your head away from the problem mental health poses in our society is ludicrous; The answers as to why so many suffer mental health problems do not lie with people themselves- today, people are not ‘wimps who don’t know what real life is’ nor kids that think it’s ‘cool to have some kind of problem’ or ‘hormonal teenage girls feeling bad about themselves’ all of which are genuine opinions I’ve heard before.

There are many complicated causes as to our mental health pandemic and the truth is that valuable debates still need to be had. However, one cause is increasingly obvious; the Stigma attached to mental health.

The stigma for mental health is a dominant, strong and destructive entity. You are right in believing it is better than it was a hundred years ago where people were put in Asylum’s for being depressed, but it still persists and is as dangerous to those suffering mental health- and to our entire society-  as it ever was. Almost 9/10 people suffering mental health problems say the stigma – be it the fear of or actual discrimination- make their circumstances worse. This comes from the ‘Stigma Shout’ report commissioned by ‘Time to Change’ in 2008, a charity committed to attacking the mental health stigma. It investigated how the Stigma works and how potent it still remains in communities across Britain- from School to workplace and in our very homes.

There is yet more proof the stigma exists; two-thirds of those suffering mental health illnesses stopped or could not enjoy activities they did before because of actual discrimination against them due to the stigma. Two-thirds also stopped enjoying what were previously enjoyable activities out of fear for being stigmatised. All of these figures increase when looking at female, LGBTQ or BAME individuals who use mental health services.

Symptoms

The stigma has a very real and very significant impact on people’s lives. “Service users and carers report similar areas of their lives that are damaged, including; employment, building new and retaining existing friendships, being able to join groups and activities within the community, feeling confidence to go out, ability to openly disclose mental health issues for fear of being judged and the ability to challenge professionals, to be heard by professionals or make requests for changes to treatment”.

“I’ve stayed away from… social situations” one person explained “because of a lack of confidence/fear of stigma. It has also stopped me applying for some jobs and joining sports clubs. I have often hesitated to disclose my history”.

One of the key aspects of the Stigma is the fact that the everyday discrimination against those with mental health problems is not even perceived as being discriminatory. This is because mental health problems confuse everyone, society itself (and I do not exclude myself from this) are uneducated on mental health. The limit of our knowledge is only what we have heard in passing conversation, and these are often myths. Allow me to de-bunk a few common fables I have come across;

–    You do not need to ‘look sad’ or ‘be sad’ all the time to have depression or be mentally ill.

–    Mental health problems are not a rare commodity; 1 in 4 people will experience a mental health problem in any given year.

–    People with mental health problems are in no way different to someone with none; you almost certainly go to school with people, work with people or have someone in your family who struggles/struggled or will struggle with poor mental health. They are not violent or unpredictable nor are they in some way dangerous. They are humans- kind, loving people, often being some of the kindest you can meet for the struggles they have been through.

–    Your friends, family members or fellow students can’t just ‘talk about it’. 3 in 4 young people fear the reactions of their friends- some of the people who care the most about them- when they, and if they, talk about their mental health problems.

You have a mental health problem, which makes you feel indescribably appalling (Time to Change mentioned a student who described how “the word ‘sad’ falls so pathetically short of the reality. There is no word for the blackness of depression”) however that depth of sadness is multiplied by the stigma tenfold via the myths listed above. If we look at some scenarios the role the stigma plays become clear;

–    If people do not see you feeling sad or stressed, they do not believe you are, making you question yourself; do I actually have a problem? Am I just making something out of nothing? Am I as pathetic as my darkest thoughts tell me I am? The stigma clearly has a devastating effect; “I’m signed off work currently” someone told the ‘Stigma Shout’ report “But I’m embarrassed to be seen out as shops or wherever by people who know me because I don’t LOOK ill”.

–    If the stigma is that mental health problems are rare and only for ‘crazies’ then someone who has a mental health problem believes mental health problems are rare and they believe they are as crazy as their biggest fears would have them believe. Even if you were not having bad thoughts about who you were, you may- as do many- develop some as a result of the stigma.

–    If your fellow students believe that you are dangerous, again the domineering stigma of mental health is at play here. If the stigma would have you believe you are dangerous, believe you are unpredictable then you will question everything about yourself.

And this is the true power of the stigma; it doesn’t just attack you from the outside (the prejudice in society) but corrupts you from within. Poisonous sentiments latch upon your already weak mind and torture it even more; malicious toxin seeps into your thoughts to create a concoction so potent that few fail to be affected by it. People suffering mental health problems question their very selves because of the stigma, rocking their confidence, anxiety and stress levels. As a result, their problems are only ever inflamed. If there is an antidote to the stigma, to discover it we must examine the poison we are trying to expel further.

We will never live in a world in which no one suffers poor mental health for that is like suggesting we could live in a world in which no one ever breaks an arm. People will always break arms- never purposefully of course- but we can live in a world in which everyone who breaks an arm can have it seen to by a doctor who can help speed up its natural recovery through various exercises and supports. Indeed, with the existence of the NHS, we do live in such a world. In the same way, it is therefore not utopian to say that we could live in a world where all who suffer mental health can be aided in having it healed and supported. This has still not been realised in the twenty-first century and is, in part, due to the brutal stigma.

Pathogenesis

Let’s take the average person, particularly those suffering mental health problems, as being part of at least 4 key communities/ relationships (I know this terribly simplifies and undermines people’s lives but this is purely for descriptive purposes); Family, Friends, School community / work environment (includes neighbours etc.) and their relationship with health professionals. How does the stigma effect someone’s relationship with these groups when they have a mental illness?

The answer is detrimentally.

The report found that people using mental health services felt their family ‘lowered their expectations of them’. Families assumed that, because of their mental health problem, they would “achieve less, cope less well in specific situations etc.”. Friendships as well are often strained when one reveals their mental illness to a close friend. Participants in the ‘Stigma Shout’ report said that some friends “don’t want to know me” when they discover their friend has a mental health problem. As a result of actual stigma, over 30% of friendships end (according to the report) which, often upon a backdrop of an unsympathetic wider community such as school or the workplace. These can react in often the worse ways to mental health problems, ostracising those suffering mental health problems; ‘People snigger as I walk by and say bad things about me’ one respondent said. While people ‘just want to be treated like another work colleague’ and to include them as they would anybody else, for many their experiences in communities are the opposite, becoming labelled, mocked and pushed out of the social life.

When asked about how their relationship with the health profession was regarding their mental health, the report found that “they just see me as an illness, not a person” was a common reply. Though it is important to note that “Positive experiences of community psychiatric nurses and psychologists were also raised”, those suffering mental health problems generally felt that the health service was almost hostile to them. One respondent said that “Stigma and discrimination have stopped me talking to my GP about physical problems, they say it’s in my head”- this is an experience that too many have to go through.

Antidote

It is clear then that the stigma contaminates all aspects of life; family life can become uncomfortable, friendships cease to be, once hallowed communities become toxic while for many the health profession simply pushes them away.

The stigma poisons not just sufferers, but people all around them; the stigma infixes the idea that mental health is a contagious disease into people. Society reacts as they did to lepers thousands of years ago, forcing those who suffer out of their communities and families to live a reclusive lifestyle which only makes their condition worse.

The Stigma; a senselessly stalwart succubus that drains the life from its victims and the compassion out of society simultaneously. It exists among all communities like a parasitic poison, lingering despite hundreds of years of social evolution and showing no signs of disappearing. It is a colossal barrier to those who suffer mental health, a literal roadblock on the road to recovery and one few can find gaps through.

But if this is an immovable object, there is an unstoppable force.

Can you talk? Do you love humanity or, at the very least, people? Can you listen?

If so, you have the ability to break free from the bindings of the stigma. You begin to change society by changing yourself and in changing your attitude to mental health you can help liberate others from the stigma too.

Say no to the stigma, for the parasite cannot survive if its hosts won’t let it feed on them. The most powerful thing we can do is to do something that we Brits love to do far too much.

It’s to talk (for maximum efficiency combine with tea) and it starts with a single question;

How are you…really?

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