Self-Stigma and Mental Illness: A Psychological Perspective

Many scientific studies regarding self-stigma have arose in the past few decades, providing insight of its effects on the people affected by such. The experience of having mental health disorders is impacted strongly by interpersonal interactions and social factors particularly throughout the course of the lives of people suffering from mental illnesses. As a result, the negative interactions experienced by an individual and their environmental society leads into a barrier against seeking treatment for mental health disorders in the form of self-stigma. Such an issue may leave many detrimental effects on these individuals including the self-restrictions of his or her rights and freedom.

Public stigma refers to the disapproval of certain characteristics or behaviours of people deemed strange or undesirable by social standards. One particular model of self-stigma states that it is the internalisation of such social discriminations and stereotypes, whereby negative stereotypes are relevant to the individual and as a result pessimistic thought intensify leading to self-degradation, diminished self-esteem and lack of self-efficacy. The model presented by Corrigan and Rao suggests that the development of self-stigma is scaffolded across three stages: “Awareness, Agreement and Application. ” First of all, a negative social perception of a personal trait comes to light to an individual. Next, he or she begins to agree with the stereotypes that go against the group the individual belongs to. Finally, the individual applies the ideals of the stereotype to his or her perception of oneself and self-deprecating thoughts oft develop and envelop one’s mind.

Many patients of self-stigma end up believing personal traits they possess to signify incompetence, slowly chipping at their self-esteem and self-efficacy. Under the internalisation of the agreement of these negative stereotypical beliefs, patients are induced with thoughts like “I am weak because I have a mental illness”. Such thoughts diminish the self-esteem and self-efficacy and as a result learned helplessness may occur too in which they believe they will be discriminated against and thus they isolate themselves from interpersonal interactions and other opportunities to protect themselves. They have essentially given up on their lives as they feel like any effort they put in will. This reduction and restriction of self is coined as the “why try” effect, whereby the previously listed adverse mental effects act as obstacles to achieving the patients’ goals. That being said, psychology is a field aiming to understand and improve mental health of society. While self-stigma tends to transition into harming of oneself or other potentially negative consequences, based on the individual’s reaction to the stereotypes he or she may conversely become more motivated and empowered or even remaining indifferent. Although this depends on the perception of the patient, the key to overcoming self-stigma’s potentially detrimental effects and instead gain strength is to challenge the discriminatory stigma and self-stigmatisation thus leading to self-empowerment. In doing so, they will gain a more positive outlook on their lives and have an overall improved lifestyle.

Self-stigma is an issue regarding patients of various mental health disorders. Patients diagnosed with schizophrenia have a notably high-risk rate of being affected with self-stigma due to misconceived stereotypes of the features of the illness. Schizophrenic individuals have overwhelmingly negative public opinion, highlighted by a survey of roughly 2000 adults, whereby they were perceived as unacceptable human beings and were notorious for being dangerous and violent; in terms of danger they were only perceived as second to drug addicts. While the stereotype is far from the truth, the result is somewhat anticipated given the abnormal symptoms of schizophrenia being delusions, hallucinations and disordered thinking. Knight, Wykes and Hayward’s study highlights the decrement of self-stigma on the patients’ self-esteem and self-efficacy due to the sense of helplessness inhibiting their mind: ‘If I could just get back to who I was before this illness started I’d be very happy but I can’t’; ‘I don’t know that you have much of a future with this illness because the future is, they say it gets better as you get older but I’m not finding that’; ‘I especially, try to keep it a secret about my mental illness when I’m in the normal outside world’. Based on Helgason’s study spanning over 20 years, the inner struggles with self-stigma are heavily associated with delays in help seeking behaviours and ultimately reduced positive health outcomes. Therefore, whilst self-stigma doesn’t directly impact recovery of mental illnesses, the accompanying negative effects may adversely contribute to the delay of patients’ recovery.

As Corrigan and Rao (2012) stated, stigma is a “societal creation” and to counteract the destructive consequences caused by unjustified discrimination large scale approaches can benefit both the society and the victims of such prejudice. One possible approach would be raising both personal and public understanding and awareness of the issue. By bringing awareness of self-stigma and mental illnesses to patients personally, their internal struggles can be greatly lessened, and they will be more willing to challenge their self-deprecating thoughts. Furthermore, because people are unfamiliar with the nature of the abnormal behaviours exhibited by sufferers of mental illnesses, they fear them and consequentially ostracise such types of people from society. By setting up anti-stigma campaigns and/or programs we can give the society a better understanding of self-stigma and explain the true nature of various mental illnesses. Therefore, the imposed notoriety and discriminatory attitudes of mental illnesses and self-stigma may potentially subside and in turn create a safer environment for the mentally ill as highlighted in the 2013 anti-stigma training. While these approaches contribute to combatting the negative effects of self-stigma, they are not entirely perfect and still have limitations.

One of the safest approaches would be recommending the individuals to seek support from trusted peers and especially people who share similar experiences to him or her. Having a group identity was found to have positive correlation in the improvement of self-esteem as people who can understand the experiences of the ones struggling tend to be more empathetic and thus create a mutually beneficial environment.