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Self-stigma happens when we accept other people’s negative, inaccurate views about ourselves. We internalise their prejudice – leading to low self-esteem and self-efficacy (Barbara Hocking, 2013). When an individual is affected by mental illness, their knowledge, understanding and attitude towards it differ as they do amongst other people in society. Although significant developments have been made over the past few centuries in the field of psychology and mental health, attitudes toward self-stigma haven’t progressed as fast. The effects of self-stigma, such as how people feel about themselves, also has a profound impact on their nature, which further affects treatment, support and rehabilitation. To be effective in combating self-stigma, it is important to clarify that it cannot be tackled in isolation but be integrated with other various programs tackling mental health and illness as a whole, and to reduce stigma in society. Therefore, through the encouragement of disclosure, empowerment, recognition and acceptance of difference of mental health in the community, can society eliminate the stigma portraying mental health.
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Stigma is a multidimensional phenomenon. Corrigan and Watson underlined the theoretical difference between perceived public stigma and anticipated self-stigma (Pattyn &Sercu & Bracke, 2014). Public sigma refers to the awareness of stereotypes held by society towards the individuals who seek such services, and to people with different mental conditions. However, public stigma can be very broad and can refer to acts such as gambling and drinking, where society can create stereotypes, induce prejudice which can ultimately lead to discrimination. The common stereotypes include; dangerous, where the mentally ill possess a threat to the community, when in fact they are more at risk of being attacked or harming themselves, rather than harming other people. Unqualified/unfit, where they seem incompetent for the work in which they wish a career in, whilst also including the stereotype that the individual is at fault and responsible for their own mental health illnesses. Following the stereotyping towards a particular group, prejudice becomes in effect, generating fear, antipathy and disdain towards them. Finally, after the biases such as stereotyping and prejudice merge together, discrimination is revealed and can expose negative actions and responses, ranging from evasion to expulsion. The stereotyping, prejudice and discrimination can be seen via Corrigan’s study (Stigmatizing attributions about mental illness, 2000) which shows that the public seems to disapprove persons with psychiatric disabilities significantly more than persons with related conditions such as physical illness. Given this research, models of self-stigma need to account for the deleterious effects of prejudice on an individual’s conception of him or herself. They begin to believe that they are less valued because of their mental illness, which in turn will affect their confidence in the future. However, research also suggests that, instead of being diminished by the stigma, many persons become righteously angry because of the prejudice that they have experienced (Chamberlin J. 1998). Therefore, as shown above, stigma is an accumulation of all stages such as stereotypes, prejudice and discrimination, which attributes to the loss of self-esteem in individuals and confidence within themselves, proving stigma prevents people with mental illness to seek treatment and support.
Accepting others’ prejudiced beliefs about mental illness leads those affected by self-stigma to believe that they are less worthy of respect and inclusion in society (Henry. J et al 2010). Who we are, and our sense of self distorts due to this acceptance, and when this occurs on top of mental illness and other hardships in life, it is no surprise that is can have a detrimental impact on one’s recovery. A loss in one’s sense of self results in an individual’s inhibition to pursue life goals as they adopt the negative mindset reflective of public stigma, and do not believe they are entitled or have the skillsets to enjoy normative pleasures such as employment opportunities, adequate shelter, treatment services, trusted health professionals and a positive portrayal in the media in perpetuating the image of those with mental illnesses (Overton & Medina 2008). It seems pointless to seek improvement of life through rehabilitation, seeking employment and even attempts at socialising, as individuals suffering with mental illness would rather choose to isolate themselves in solitary, thus experiencing a diminished quality of life, hence showing why it is a problem in today’s society when accepting others’ beliefs about mental illness. In a study conducted by Corrigan (Schizophrenia Bulletin, 2001), research participants completed three measures that represented familiarity (Level of contact), prejudicial attitudes (OMI Questionnaire), and social distance (Social Distance Scale). The results concluded that persons with mental illness are viewed as childlike, and need to be watched by a compassionate caretaker, which leads to social distance. These findings also show how negative views about mental illness lead to negative behaviours toward person with psychiatric disabilities (Corrigan 1998), as well as how individuals who are relatively more familiar with mental illness, either through school learning or experience with peers and family members, are less likely to endorse prejudicial attitudes about mental illness. However, as stated before, many people become angry because of the prejudice that they have experienced, where their reaction empowers people to change their stance of the mental health system. This change allows the individual to become more inclusive within the treatment plan, often pushing for improvements in the quality of services (Corrigan 2002). Therefore, self-stigma has a detrimental effect of one’s self-esteem and sense of self, as individuals accept societies prejudicial beliefs about their mental illness.
Reducing self-stigma is an essential part of any initiative to combat stigma against mental illness in the community, and so promote recovery as well as social inclusion (Barbara Hocking, 2013). A study from the Mental Health Federation of New Zealand, Fighting Shadows (2008) analysed the issue of self-stigma and concluded with eight recommendations to eliminate it. They include, recognition the contribution of individuals with mental illness, celebration and accept difference, affirm human rights, encourage disclosure, encourage empowerment, support recovery practices, provide peer support services and challenge society’s attitudes and behaviour towards mental illness (Peterson & Barnes & Duncan, 2008). These recommendations above are based to help disrupt the cycle of stigma and discrimination on personal and societal levels, however there is a lot more left to do. In this day and age, the media are major contributors to self-stigma, as stereotypes associated with mental illness are often the results of negative media coverage of mental health issues, hence reflecting the acceptance of others prejudiced belief of mental health through media, especially social media. Other contributions which can have a negative impact towards self-stigma include medication for two reasons. The first is the side effects of it, where it makes it difficult for the individual to stay motivated and where it dulls the senses. The second reason relates to being reminded about mental illness every time they take medication, and it’s even worse when others know you’re taking it. For many people, being told their diagnosis for the first time was also the first time they felt self-stigma. They internalised the beliefs and myths surrounding mental illness that they had grown up experiencing, realising that all of these now applied to them (Peterson & Barnes & Duncan, 2008). Education and awareness is vital for overcoming stereotypes, prejudice and discrimination as shown in the study (Schizophrenia Bulletin, 2001), where the results showed how individuals who are familiar with mental illness, either through school learning or experience with peers and family members, are less likely to endorse prejudicial attitudes about mental illness. Therefore, to combat stigma against mental illness within the community, it is important that it cannot be tackled in isolation, however through various programs and initiatives, tackling mental health and illness as a whole.
Therefore, through the learning of stigma as a multidimensional phenomenon, as well as how self-stigma is caused, can society eliminate the stigma portraying mental health and illness. To be effective in combating self-stigma, it is important to clarify that tackling self-stigma must integrated with other various programs tackling mental health and illness as a whole, and to reduce stigma in society.
- Barbara Hocking (2013). Sane Australia in Action. Life without Stigma 3-5
- Corrigan PW. River LP. Lundin RK, et al. Stigmatizing attributions about mental illness. J Commun Psychol. 2000;28:91–103.
- Henry. J et al 2010. Stereotype threat contributes to social difficulties in people with schizophrenia. British journal of clinical psychology, 49, 31-41
- Overton, S. L., & Medina, S. L. (2008). The stigma of mental illness. Journal of Counseling & Development, 86(2), 143-151.
- Corrigan PW. Empowerment and serious mental illness: treatment partnerships and community opportunities. Psychiatr Q. 2002 Fall; 73(3):217-28.
- Peterson, Barnes and Duncan (2008). Fighting shadows. Mental Health Foundation Of New Zealand (72-75)
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