By: Christie Hunter

The study of the stigma of mental illness has been in the literature for decades. There remain various different theories regarding how this type of stigma affects individuals and numerous approaches for decreasing it. These theories and approaches have changed over the years. Positive progress has been made since discrimination and stigma toward mental illness was first identified. This article will address some of the recent thoughts and research on the subject, especially as it relates to mental illness stigma in the female population.

Lange, et al. (2003), studied the correlation between stigma and mental health treatment seeking in Black and Latina women as compared to White women born in the U.S. and some interesting findings were the result. There are cultural differences in stigma that make it less likely that minority females will seek treatment even when they know that they could benefit from services. Some of this is due to distrust of those in helping roles where practitioners who have nothing in common with them are unable to relate to their experiences. The authors also identified that insurance coverage and transportation issues were factors.  However, overwhelmingly the minority women in the study cited that they did not seek treatment because of how they would be seen in their communities.  Cultural differences were also reported in immigrant women. Stigma affects all women with mental illness, but it needs to be noted that it is especially prevalent in the minority population.

The authors of another study add to these findings in their examination of the way that professionals, politicians, and activists frame the stigma relating to mental illness (Corrigan, et al., 2005).  There has, in the past two decades, been a focus on reducing stigma from a public health perspective. Corrigan, Watson, Byrne, and Davis (2003), note that a Surgeon General’s report in 1999 identified stigma as being a significant barrier to individuals seeking mental health treatment.  As a result, focus has been placed on emphasizing the biological reasons behind mental illness as a genetic or brain illness. Education programs have been implemented to raise awareness of mental health issues in the general population. While this has helped to decrease some of the stigma, there is concern that this approach can lead to pity or otherness that can be just as damaging (Corrigan, et al., 2005).

From a social justice lens on the other hand, consumers of mental health services may be seen in a better light, as being humans who are worthy of dignity and respect (Corrigan, et al., 2005). They argue that one of the best ways to accomplish this is to encourage and empower those same consumers to advocate for, to treat, and to work toward helping others with mental illness. The authors also stress the need to recognize the intersections among race, socioeconomic status, and gender that is exacerbated by mental illness. This is especially important to remember as it relates to women in all marginalized groups who also seek mental health treatment.  These researchers are quick to note that both approaches are valid, and that neither approach is effective without the other.

The Americans with Disabilities Act (1992) prohibits discrimination based on qualified disabilities in state and local governments. Mental Illness is classified as one of these protected disabilities. However, it is also important to keep in mind the findings of Feldman and Crandall (2007), that outright discrimination is not the main problem with stigma. Women especially may be more prone to internalized or self-stigma in which the way that others see them becomes the way that they see themselves. This can lead to lower self-esteem and avoidance of a label or treatment.

What then does it all mean, and how can a reduction in stigma occur? One important takeaway from the research is the importance of a diversity of approaches taking into account the unique circumstances of women, from different demographic groups. Additionally, approaching the problem of stigma from both a public health/education perspective and from a social justice perspective seems to be most effective.    For further reading and an easy-to-remember method of reducing stigma using the acronym U.N.I.T.E, visit here:  http://www.theravive.com/end-stigma/

Reducing mental health stigma for all women is important, because treatment is important, and stigma has been shown repeatedly to stifle the willingness to seek treatment. The thing that ends up happening is that women internalize the perceptions of society, and the avoidance that is often a result.  This can deepen the effects of the symptomatology of mental illness that already exists.

Women comprise approximately half of the population, the nature of their mental health issues sometimes mean more stigma than what is present for males. Women are seen as being more emotional, dramatic, even attention seeking, and so often legitimate symptoms of mental illness go ignored and untreated. A multi-faceted approach to the problem is the best option. Additionally, using mental health consumers to help other people is well-advised. This provides information directly from the people experiencing the illness, and there is something to be said for knowing an illness from the inside in order to identify what others may need.

By Christie Hunter

References:

Americans With Disabilities Act (1990).  The Americans with Disabilities Act of 1990
and Revised ADA Regulations Implementing Title II and Title III. Retrieved from http://www.ada.gov/2010_regs.htm

Corrigan, P., Markowitz, F. E., Watson, A., Rowan, D., & Kubiak, M. A. (2003). An attribution model of public discrimination towards persons with mental illness*. Journal of Health and Social Behavior, 44(2), 162-79.

Corrigan, P. W., Watson, A. C., Byrne, P., & Davis, K. E. (2005). Mental illness stigma: Problem of public health or social justice? Social Work, 50(4), 363-8

Feldman, D. B., & Crandall, C. S. (2007). Dimensions of mental illness stigma: What About Mental Illness Causes Social Rejection? Journal of Social and Clinical Psychology, 26(2), 137-154

Nadeem, E., PhD., Lange, J. M., M.S., Edge, D., PhD., Fongwa, M., PhD., Belin, T., PhD., & Miranda, J., PhD. (2007). Does stigma keep poor young immigrant and U.S.-born black and Latina women from seeking mental health care? Psychiatric Services, 58(12), 1547-54.