Effects of Labelling in Mental Health

The term ‘label’ refers to individuals whose actions or behavior deviates from social norms and what is acceptable in society. These individuals are labeled and develop a stigma attached; this can have an overall impact on the individuals’ behavior once the label has taken form. Being labeled as ‘mentally ill’ can have significant effects on different aspects of the individuals’ life. A mental disorder is an illness that goes against normal everyday functioning and development, however it is hard to classify as people express themselves in different ways. Being stigmatized with a mental disorder can result in the individuals believing them to be different from others and failing to function adequately in the eyes of others. It has been found that the way in which the public respond to people with mental disorders has been influenced by the generic label applied to mental disorders. In turn, this can have both positive and negative effects on the labeled individual, as will be discussed in this essay.

Thomas Scheff (1966) was the first to apply the labelling theory to mental illness. He dismissed the general perceptions of mental illness and proposed that illnesses were instigated by society. When the expectations and behaviour internalises, it forms the central identity of the individual and completes the process of being ‘mentally ill’.

Link et al (1997) developed the ‘modified labelling theory’ which extends Scheff’s original labelling theory (1966). They challenge the importance of factors such as stereotyping and stigma and claim that even if labelling an individual does not produce the mental disorder, it can have negative effects on them. To test each of the 5 steps of the modified labelling theory, Link et al compared data on 5 different groups; psychiatric patients experiencing their first treatment, psychiatric patients with repeated treatment, community residents not currently in treatment, untreated community residents and ‘well’ community residents. The modified labelling theory concludes that effects of cultural ideas such as incompetency can lead to negative effects when the label is applied, which in turn leads to the ‘mental patient’ feeling devalued and discriminated against. This leads to feelings of demoralisation and rejection.

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The coping strategies to labelling they found that people adopt are; social withdrawal, secrecy and education (Link et al 1997). Withdrawing from society indicates the need to protect their self-esteem and feelings of isolation and rejection. Secondly, keeping their disorder a secret can affect the patients’ mental state in terms of acting ‘normal’ just to fit in, whilst the problem still occurs. Thirdly, the need to educate others about the disorder may increase awareness of the label and have adverse effects. This could assist others attitudes negatively, as they may think of them differently and treat them in this way. In turn, these strategies can have implications for other aspects of their life. For example, withdrawal and educating could pose a negative view to others about the ‘mental patient’ which could limit their chances for employment and amount of earnings (Kroska and Harkness 2006). This would affect their standard of living and quality of life (Link et al 1997), which could result in a downwards spiral and worsen their condition.

In a previous study, Link (1987) demonstrated that current patients with a mental illness, former patients and community residents had the same belief that patients will be devalued and discriminated against and that the official label will be internalised. Depending on how strong the label is would affect the individual more negatively. For example, stronger labels would lead the individual to more feelings of rejection, demoralisation, unemployment, and earning less income. This was incorporated into the modified labelling theory.

Wright, Gronfein & Owens (2000) contributed to the developing of the modified labelling theory and studied the social psychological influence of stigma on 88 mentally ill patients self image, who had recently been deinstitutionalized due to hospital closure. Their experience of social rejection and the impact of stigmatization on the self concepts were examined during the first two years of being discharged. They found that stigma has a long-term effect on mental patients and is a powerful, negative driving force in their lives. The feeling of rejection they received continued to distort their self-perception and formed the label. This provides further support for the modified labelling theory. The methodology of conducting longitudinal studies in the research above provides empirical evidence for the negative effects of labelling as it shows that the feelings of rejection are persistent and long term. This improves the validity of the results and makes them more conclusive.

Further support for the negative effects of being labeled with a mental disorder suggests that people are looked at and judged upon in various ways, not taking into account the seriousness of the illness. (Serres, 2004). This was supported by Angermeyer and Matschinger (2003) who examined public attitudes towards people with schizophrenia and people with depression. They found that labeling someone with a mental disorder has an impact on people’s attitudes towards them. They concluded that people adhered to the stereotypical view of schizophrenics being ‘dangerous’. This initiated a stronger negative effect on the way people react emotionally to those diagnosed and would dissociate themselves from them. Contrary to this, the effect of labeling had almost no effect on those diagnosed with depression. This suggests that labels are socially constructed and are dependent on the severity of the illness. Mentally ill people are unfairly treated in accordance to their ‘label’.

Although much of the evidence presented demonstrates how labels can have a negative effect on those diagnosed with a mental disorder, contradictory evidence shows how labeling can have positive effects on the individual. Critics argue that even if negative attitudes are directed toward mental patients, it does not always result in rejection. For example, Gove and Fain (1973) reported that present sufferers and former patients are inconsistent in reporting instances of rejection. This dismisses the notion that stigma has long-term effects. Further research concludes that any rejection felt by patients is due to their deviant, behavior as opposed to the stigmatized label of a ‘mental patient’. This shows that not all labels have the ability to cause rejection and withdrawal; instead it could be the mental patients actions that form people’s attitudes.

A positive outcome from being labeled with a mental disorder is that it may help the individual come to terms with their illness, face their problem and get professional help. Weinstein (1979, 1983) came to the conclusion that numerous patients do not feel stigmatized and negatively effected by the label ‘mental patient’, instead they favor the treatment received by professionals. This may help the patient feel secure as they are getting help from professionals and aid a faster recovery. The treatment received would potentially reduce the symptoms involved e.g. anxiety, therefore, helping them in various elements of their life. Such as getting more actively involved with society, improving their self-esteem and fight against the negative feelings (Rosenfield, 1997). This would also be beneficial to the patients’ family and their social network, as it would make them more aware and weary of the patient and the disorder which would elicit feelings of emotion and support (Wright, Gronfein & Owens, 2000).

However, Link et al challenged the above studies as although they demonstrate the positive effects of labels, they have been criticized for focusing on only some attitudes whilst disregarding the relevant ones. In addition to this, they suggested that their findings were irrelevant to labeling tests and concentrated more on other aspects. Therefore the validity of these studies is questionable.

In conclusion, although there is research demonstrating that a labeled mental disorder can have positive effects on the patient such as treatment and coping strategies of how to deal with associated symptoms (e.g. stress), research is still limited. A vast majority of the research presented shows how labeling someone with a mental disorder can lead to a negative outcome, such as feelings of rejection and discrimination which could potentially worsen the extent of the disorder. As supported by Kroska & Harkness (2006), who proved that psychiatric labeling may ‘exacerbate patients’ mental illness’. The modified labeling theory has been very influential and has been the concrete for much research in this field which shows labels to have a negative effect and that stigma plays an important role in the process.