Mental Health Struggles: How to Remove the Stigma and Get Help for Yourself and Others

Mental health began as a movement in the US in 1908 when Clifford Beers wrote a book about his own admission into three mental hospitals. The book is still referenced today by mental health professionals. One hundred years later, in 2008, an article published in World Psychiatry, the journal of the World Psychiatric Association, noted that there was still confusion over the definition of mental health: “Mental health is, quite unfortunately, still viewed by many as a discipline, either as a synonym of psychiatry, or as one of its complementary fields.” 

Why is this unfortunate? It conflates mental health with mental illness—it assumes that anyone concerned with their mental health needs psychiatric care or institutionalization. Physical health does not cause the same confusion. People are quite willing to talk about exercising and eating right without the assumption that they need hospitalization and without fear that their audience will immediately cross to the other side of the street.

Modern History of Mental Health as a Stigma

When the movement for de-institutionalizing the mentally ill began in the 1960s and 1970s, the promise was for community-based treatment. That community effort never materialized, and the mentally ill became highly visible, whereas for centuries they had been kept hidden away. Recent surveys have revealed a shift in the public’s feelings toward mental illness. However, many people still avoid the mentally ill because:

• They believe mental illness to be a result of bad parenting or trauma, rather than genetic or biological.
• They have no sympathy for drug or alcohol dependency.
• They fear that the people with mental challenges are dangerous.

In general, merely being labeled with a mental illness causes as much negative feeling in the public mind as an actual diagnosis.

Other stigmas are associated with and exacerbate the sigma against mental challenges:

• Chronic discrimination by race, gender, ability, and so on is itself stressful and compromises mental health.
• People from low income and other marginalized communities have less access to mental health care.
• Marginalized groups who seek mental health care experience twice the discrimination—once for being marginalized and once for needing mental health care. Three factors (for example, racial minority, low income, and need for mental health care) triple the discrimination. 
• Families, society, and men themselves may interpret mental illness in men as failure—an inability to care for their families and succeed at work. Men with mental health problems are more likely to be considered a risk for violence and crime. 
• The American Psychological Association points out men are four times more likely to commit suicide but considerably less likely to be diagnosed with depression. 
• The APA also states that men and boys have been over-represented in psychological studies leading to a biased treatment of males (for example, in diagnosing boys with ADHD) and females (assuming girls do not have ADHD). 

Reducing the Mental Health Stigma

The mental health stigma is still strong in the workplace, despite an increase in access to services through workplace programs. In a 2019 poll by the APA, 62% of the 1005 adults surveyed were willing to use those workplace services, yet only 51% were willing to openly refer to their mental health with their boss or coworkers and 35% fear being fired if they did speak. In seeking mental health support, 57% turn to family and friends and only 22% seek care from any mental health professional—through workplace programs or anywhere else.

The biggest influence in reducing the mental health stigma is contact with someone who is open about their mental health challenges. The organization Bring Change to Mind has sharing stories as one of their guiding principles. They also recommend paying attention to the language you use to describe someone living with mental illness and pursuing mental health:

• Do not say someone is “mental” or “crazy” or use words like “pyscho, schiz, and lunatic.”
• Use the phrase “living with” as in “living with mental illness” or “living with schizophrenia” rather than “mentally ill” or “schizophrenic.”

In their Stamp Out Stigma campaign, the Association for Behavioral Health and Wellness (ABHW) stresses the need for education about mental health. They note that half of us will have a mental health issue in our lifetime but only a third of those with an issue will get help. Yet, most mental health disorders are treatable. In educating others, ABHW recommends that you:

• Be clear and factual.
• Know your terminology and how to use it (for example, do not capitalize disorders such as schizophrenia unless they include a proper name such as Asperger’s syndrome).
• Focus on your own or the other person’s strengths.
• Avoid glamorizing suicide as in “successful suicide attempt;” instead say “tried to take their own life.”

The American Psychiatric Association recommends drawing parallels between physical health and mental health so that people realize the additional stigmas faced by those seeking improvements to their mental health. This helps to “normalize mental health treatment just like any other health care treatment.”

You will be able to offer people more support if you know the signs of mental health challenges. Be aware that diagnosis is difficult even for mental health professionals. If you feel someone may be struggling, frame your question as a query about their well-being, not as a diagnosis. For example, “You seem to be especially sad these days. Is there a way I can help?” The signs include:

• Withdrawal and sadness that lasts more than 2 weeks
• Intense worry or fear, especially if it interferes with daily activities
• Severe weight loss or gain
• Repeated use of drugs or alcohol
• Major mood swings.

TIP: When asking someone about what you have observed, you leave room for them to explain. For example, the loss of a beloved pet could have caused the sadness you observed or the person may already be receiving help for the symptoms.

Reducing Your Own Feelings about Your Mental Health Challenges

If you are feeling stressed, anxious, and overwhelmed, you already know that help is available because you are reading this article. However, you may still be reluctant to seek help because of the mental health stigma that may have taken root in your family, community, and your own mind.

To start removing the shackles of that stigma:

• Change the way you speak about yourself. You are not depressed. You struggle with depression. You are not an addict. You have an addiction. You are more than your mental health challenge—you are a whole person with a challenge. Remember, people “have cancer;” they are not “cancerous.”
• Educate yourself and others. By knowing the terminology, by being aware of the treatment options, and by openly sharing your story, you help to destigmatize mental illness just as physical illness is destigmatized. You will find more support from family, friends, and the community if you are open about symptoms, diagnosis, and treatment.
• Equate mental health with physical health. Both are important; they influence each other; and you have as much right to feel mentally strong as physically strong.
• Find support. If you do not get the support you need, understand that the process of changing someone else’s mind and attitude may be slow; that you may need to seek support elsewhere; and that support is available. Many groups dedicated to mental health are free, both for you and for those who wish to support you.

TIP: The National Alliance on Mental Health (NAMI) has free support groups around the nation: 1-800-950-NAMI (6264).