Editor: Oluseyi Elizabeth Odudimu
Stigma is the negative attitude related to mental health conditions.
Self-stigma is when someone feels less valued because of his or her psychiatric disorder.
Discrimination is the negative treatment people with mental health issues experience every day of their lives.
Direct discrimination is when someone with mental health challenges is treated worse than others.
Indirect discrimination is when an organization’s arrangements expose an individual with mental illness to an unfair disadvantage.
Social isolation and discrimination can cause poor mental health and risk factors for increased morbidity and mortality and reduced quality of life.
In recent years, we can no longer afford to view mental health as separate or unequal to general health. Although many of us still believe that mental illness is contagious, dangerous, or incurable. For these reasons, people with mental illness often experience negative attitudes and are deprived of their dignity and full participation in society.
Stigma and discrimination
Stigma is when someone is negatively differentiated owing to a particular condition, group membership, or state in life. Discrimination is the behavioural impact that results from public stigma leading to social avoidance, coercive treatment, and segregated institutions.
Examples of stigmatizing attitudes and discrimination
Many people often describe individuals with mental illness as abnormal, flawed, unreasonable or naturally undesirable. These can be identified as stigmatizing attitudes and discrediting characteristics that set apart people with mental illness from the rest of society. Unintentionally, some people tend to avoid them with the assumption that they are dangerous, violent, or destructive. Discrimination is when you withhold help, fail to interact or spend an evening socializing, work next to, or have a family member marry an individual with mental illness because of the corresponding stigma.
The harmful effects of stigma and discrimination
Mental illness stigma and labelling theory created prejudice and discrimination against individuals and family members. The stigma of mental illness can also be as harmful as the symptoms, leading to family disagreement, job discrimination, and social rejection.
People with mental illness must deal with two kinds of pain.
Firstly, mental illness directly impacts cognitive, affective, and behavioural problems that limit their capacity to function effectively. Stigma is the second kind of harm that causes social rejection, interpersonal disruption, and fractured identity.
Stigma prevents many from seeking professional services or sticking to treatment because of fear of what society will think of them and the dread of being segregated from social groups. An individual that feels stigmatized may also have to deal with lower self–esteem, engage in deviant behaviour or experience social rejection.
Stigma is challenging and can affect individuals psychologically and limits their social participation. Discrimination also comes in if college, university, or employers refuse to choose an individual with mental illness for employment. Both stigma and discrimination can lead to feelings of hopelessness, and shame and create a serious barrier to diagnosis and treatment.
Common effects of stigma and discrimination include:
- Bullying, physical violence or harassment
- Hindrance to access health care services
- Reduce prospects, self-esteem, and self-efficacy.
- Ordering of rejection from ignorant family, friends, and colleagues
- make people more likely to hide symptoms or illness
- More irregular opportunities for work, school or social activities or trouble finding housing
- Diminish the belief in own abilities and contributes to social exclusion through discrimination.
- Expose to drug addiction, prostitution, and criminality.
- Force into mandatory treatment
- Ill treatment from both the community and health professionals
- Segregation in the institution
- Structural inequities that impinge on health, social welfare, civic participation, and access to psychology resources.
How medical professionals contribute to stigma
Mental illness is often associated with dangerous or aggressive behaviour, and society increasingly perceives mentally ill persons as violent. Tragically, stigmatization of people with mental illness is common among healthcare workers and forms additional barriers to diagnosis, treatment, optimal recovery, and suicidal behaviour.
Some ways healthcare professionals contribute to stigma
- Doctors’ discriminatory behaviour can lead to physical illnesses such as cardiovascular diseases or hypertension and premature death.
- Healthcare professionals, especially psychiatrists, contribute to stigma through both the careless use of diagnostic labels and treatments.
- Under-resourced and overworked healthcare workers are particularly at risk of stigmatising people with mental illness.
- Overlooks patients’ general health problems or disregards them as being delusional.
- Late diagnosis or treatment of physical illness in people with mental illness
- Dealing with stigma as a healthcare professional
- Healthcare professionals are responsible to improve their attitudes and behaviour towards patients with mental illness in order not to contribute to the stigma.
Some ways healthcare professionals can deal with stigma include:
Increase awareness and knowledge of the nature of mental illness and treatment options.
Improve public attitudes toward those who have or have had mental illness and their families.
Treat mental illness patients and their families with respect and kindness
Generate action to prevent or eliminate stigma and discrimination
Provide adequate training and ongoing education for healthcare professionals.
There is also a need to develop strategies to bring about systemic change so that the rights of people with mental illness are respected.
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Dealing with stigma as an individual
- Mental disorders are medical conditions and treatable. Be willing to seek treatment from a therapist and a psychiatrist.
- Do not allow others to dictate how you should feel about yourself, fight stigma by choosing to live an empowered life.
- Bravery, strength, and persistence are the qualities you need to face mental illness and fight stigma. Be courageous!
- Do not bury your head in shame, be a productive member of society.
- Do not harbour self-stigma! Volunteer at church, engage in social activities and connect with trusted family, friends, religious leaders, and coaches.
- Take your treatment seriously.
- Be purpose-driven and show others they can live a meaningful life even while battling mental illness.
- When people make uncultured comments about mental health or attempt to discriminate against you, correct their views of you and the illness.
- Endeavour not to equate yourself with your illness, you have a mental illness, but you are not the illness.
DEALING WITH MENTAL ILLNESS STIGMA
Dealing with stigma as a community
Reducing mental illness stigma and discrimination is everyone’s business. The entire community must be ready to challenge the stigma to improve the attitudes and behaviour of the public. If we break down stigma, we can transform the position, opportunities, and well-being of mentally ill persons in our society.
Some ways the community can deal with stigma include:
- Learn the facts about mental illness, and talk about the experience Policy that promotes equal opportunity and can help you address unlawful discrimination is still wanting in Nigeria and share them with family, friends, work colleagues, classmates and on social media platforms.
- Educate people, be in contact with individuals with personal experiences of mental illness and encourage them to share their stories and struggles to enlighten others.
- Advocate when you hear a conversation or a rude remark about mental illness and kindly express how this can affect them and the need to stop the stigma against people with mental illness.
- Avoid discrimination or labelling them by their conditions, be cautious of your language and remind others to be mindful of their language when meeting people with mental illness.
- Treat all people with respect and dignity and avoid calling them by their illness.
- Promote equality between physical and mental illness and help others understand that mental illness is equally a disease as diabetes, heart disease or cancer. Show compassion for those with mental illness, spend time with them to talk about their lives and give them adequate support.
- Educate the broadcasting company to stop reporting false representations of mental illness.
- Stop believing negative views about mental illness.
- Join SMIF groups’ protest campaigns to challenge the stigmas and false representation of mental illness.
Role of health policy maker
- Nigeria does not have legislation against discrimination that conforms with international conventions and protects the rights of people with mental illness.
- The process of stigmatization occurs when there is a power differential, as only powerful groups can create social inequities.
- To combat mental health stigma and discrimination, policymakers in Nigeria need to put in place principles for the protection of individuals with mental illness.
- Mental health policy that promotes human rights and deals with compliance and discrimination is also required in Nigeria.
Stigma and discrimination need to be removed from our thinking before we can give people with mental illness opportunities, purpose and meaning to their lives and lead to social inclusion. The journey to make a difference begins with you and me.
Every journey begins with one step. If we continue to protest, educate, and be in contact with people with mental illness, social stigma and discrimination can be eradicated from our cultures, beliefs, and traditions.
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U.S. Department of Health and Human Services (1999)