Learn about Stigma, Prejudice and Discrimination Against People with Mental Illness

More than half of people with mental illness don’t receive help for their disorders. Often, people avoid or delay seeking treatment due to concerns about being treated differently or fears of losing their jobs and livelihood. That’s because stigma, prejudice and discrimination against people with mental illness is still very much a problem.

Stigma, prejudice and discrimination against people with mental illness can be subtle or it can be obvious—but no matter the magnitude, it can lead to harm. People with mental illness are marginalized and discriminated against in various ways, but understanding what that looks like and how to address and eradicate it can help.

The Facts on Stigma, Prejudice and Discrimination
Stigma often comes from lack of understanding or fear. Inaccurate or misleading media representations of mental illness contribute to both those factors. A review of studies on stigma shows that while the public may accept the medical or genetic nature of a mental health disorder and the need for treatment, many people still have a negative view of those with mental illness.

Researchers identify different types of stigma: (See chart below.)

  • Public stigma involves the negative or discriminatory attitudes that others have about mental illness.
  • Self-stigma refers to the negative attitudes, including internalized shame, that people with mental illness have about their own condition.
  • Institutional stigma is more systemic, involving policies of government and private organizations that intentionally or unintentionally limit opportunities for people with mental illness. Examples include lower funding for mental illness research or fewer mental health services relative to other health care.

Stigma not only directly affects individuals with mental illness but also the loved ones who support them, often including their family members.

Stigma around mental illness especially an issue in some diverse racial and ethnic communities and it can be a major barrier to people from those cultures accessing mental health services. For example, in some Asian cultures, seeking professional help for mental illness may be counter to cultural values of strong family, emotional restraint and avoiding shame. Among some groups, including the African American community’s, distrust of the mental healthcare system can also be a barrier to seeking help. (See more on mental health in Diverse Populations.)

Types of Stigma

  Public Self Institutional
Stereotypes & Prejudices People with mental illness are dangerous, incompetent, to blame for their disorder, unpredictable I am dangerous, incompetent, to blame Stereotypes are embodied in laws and other institutions
Discrimination Therefore, employers may not hire them, landlords may not rent to them, the health care system may offer a lower standard of care These thoughts lead to lowered self-esteem and self-efficacy: “Why try? Someone like me is not worthy of good health.” Intended and unintended loss of opportunity

Source: Adapted from Corrigan, et al.

Media representations of people with mental illness can influence perceptions and stigma, and they have often been negative, inaccurate or violent representations. A study published in April 2020 looked at a recent example, the popular film Joker (2019), which portrays the lead character as a person with mental illness who becomes extremely violent. The study found that viewing the film “was associated with higher levels of prejudice toward those with mental illness.” Additionally, the authors suggest, “Joker may exacerbate self-stigma for those with a mental illness, leading to delays in help seeking.”

The stigma of mental illness is universal. A 2016 study on stigma concluded “there is no country, society or culture where people with mental illness have the same societal value as people without mental illness.”

Harmful Effects of Stigma and Discrimination
Stigma and discrimination can contribute to worsening symptoms and reduced likelihood of getting treatment. A recent extensive review of research found that self-stigma leads to negative effects on recovery among people diagnosed with severe mental illnesses. Effects can include:

  • reduced hope
  • lower self-esteem
  • increased psychiatric symptoms
  • difficulties with social relationships
  • reduced likelihood of staying with treatment
  • more difficulties at work

A 2017 study involving more than 200 individuals with mental illness over a period of two years found that greater self-stigma was associated with poorer recovery from mental illness after one and two years.

An editorial in the Lancet notes that the impacts of stigma are pervasive, affecting political enthusiasm, charitable fundraising and availability, support for local services and underfunding of research for mental health relative to other health conditions.

Some of the other harmful effects of stigma can include:

  • Reluctance to seek help or treatment and less likely to stay with treatment
  • Social isolation
  • Lack of understanding by family, friends, coworkers, or others
  • Fewer opportunities for work, school or social activities or trouble finding housing
  • Bullying, physical violence or harassment
  • Health insurance that doesn’t adequately cover your mental illness treatment
  • The belief that you’ll never succeed at certain challenges or that you can’t improve your situation

Source: Adapted from Mayo Clinic