When we or someone we love struggle with a mental health problem like anxiety or depression, it is not just the symptoms that interfere with our lives. It is also the stigma we may anticipate, internalize, and experience from others that can be an extra burden and a barrier to recovery1. The word “stigma” derives from ancient Greek, referring to a mark on the body (such as a burn, puncture, or tattoo) that would indicate an undesirable or devalued characteristic. It communicates to people that they are to stay away2. Today, mental health stigma can be thought of more as a process than a physical mark.
Mental Illness Stigma
The process of stigma begins with an awareness of negative stereotypes about individuals who experience mental health problems and treatments, as well as those seeking treatment. People then move from being aware of the stereotypes to believing they are true. From there, many act, either consciously or unconsciously, on those negative stereotypes, which leads to discrimination against people who have mental health problems3.
The experience of stigma for having a mental health problem has been associated with increased difficulty in seeking mental health treatment, and it persists during treatment4. It can also be a barrier to forming meaningful relationships in personal and professional settings5. Stigma may also interfere with the ability to find meaningful employment, adequate income, and housing6.
Strategies to Reduce Stigma
Just as it is important to know about evidence-based treatments for mental health problems and for public health initiatives to reduce the harmful stereotypes about mental health problems and treatments, it is also important to explore strategies to help reduce the impact of mental health stigma.
In a recent study, led by Drs. David Kondrat and Patrick Sullivan at Indiana University, researchers wanted to test if connecting to a social support network could reduce the harmful impact of stigma and discrimination of individuals experiencing mental health problems7.
In a survey study of over two thousand Canadian adults with a wide range of mental health problems, researchers found that the individuals’ perceptions of social support had a strong, positive, and direct effect on mental health. Those who reported having greater social support also reported more positive mental health. The effect of mental health stigma and discrimination was lessened, too.
Strong Social Support
This study provides further evidence for the importance of having a strong social support network to cope with mental health problems over time. The researchers highlight that an individual’s social support network can include family, friends, and treatment providers. Given that many mental health problems run a chronic course, the researchers also suggest that resources should be devoted to boosting the network and equipping it with the tools needed to manage it, especially at the onset of an illness. And they highlight the importance of training and education for frontline health care providers through strength-based case management, which is oriented to attaining meaningful life goals in the context of illness, rather than only reducing symptoms and risks associated with illness.8
This study was a survey and not an experiment, so we cannot conclude that social support truly reduces the impact of stigma. However, many exciting future research questions emerge from it: How can researchers encourage social support networks to sustain their support of people experiencing chronic mental health problems, and not burn out? Are particular aspects such as emotional or instrumental support more helpful for reducing the burden of mental health stigma? Do the sources of support, such as health care providers, friends, or family, have different effects on the relationship of discrimination and mental health? Hopefully, these questions will be considered in follow-up studies.
Make Connections
The most important takeaway from this study is to try to connect to and strengthen your social support networks. You may consider joining peer-to-peer networks such as NAMI (National Alliance on Mental Illness) (https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition). Or ask your mental health care provider about local peer groups and meet-up groups.
Explore connecting by sharing your personal story of illness or recovery on these websites: Anxiety and Depression Association of America (ADAA) (https://www.adaa.org/living-with-anxiety/personal-stories), Depression and Bipolar Support Alliance (DBSA) (http://www.dbsalliance.org), and The Mighty (https://themighty.com/mental-illness/). You may also consider creative ways to connect, such as through photography in PhotoVoice (https://photovoice.org).
If you are a family member or friend of someone with mental health problems and you want to provide better support, check out this resource guide from NAMI (https://www.nami.org/Find-Support/Family-Members-and-Caregivers), or visit ADAA to discover how to help a spouse or partner (https://www.adaa.org/finding-help/helping-others/spouse-or-partner).
Sarah Krill Williston is a PhD Candidate in the Roemer lab at the University of Massachusetts Boston. Sarah’s research primarily focuses on developing strategies to increase mental health literacy and reduce mental health stigma, to empower individuals to more effectively seek evidence-based mental health care for anxiety and trauma-related disorders. In addition, Sarah’s clinical interests include providing evidenced-based treatments (primarily CBT, ABBT) to individuals with mood, anxiety and trauma-related disorders, with a particular interest in working with military families, active duty service members, and veterans.
