Adia Harris, Contributing Writer
You’re walking down the street and a man on the corner you are approaching is acting strangely. Maybe he’s oddly dressed, appears disheveled or perhaps homeless. He is muttering to himself, looking up at the sky as if waiting for answers.
What do you do?
Possibly, you avert your gaze to avoid eye contact and mistakenly engage this individual. You might instinctively surmise this person is mentally ill, and could potentially be problematic when engaged.
And perhaps, on a surface level, this is true. NAMI statistics show over a quarter of both the prison and homeless populations in the U.S. are comprised of individuals with a recent history of mental illness. However, any apparent connection between me,ntal dysfunction and socioeconomic hardship should be investigated further. Research contrastingly shows that many common misconceptions borne of negative stereotypes about mental illness, including lack of cognitive capacity and assumptions about people with mental illness being violent, are not as true to reality as the public often thinks.
So how do our socially accepted views affect individuals suffering from mental health conditions, and why does it matter?
Most of us are familiar with the term stigma, or as defined by a quick Google search, “a mark of disgrace associated with a particular circumstance, quality, or person.” Significant amounts of mental health research are dedicated to how public stigma operates, however most of us are not familiar with its potential effects on individuals who are actually struggling with mental illness, particularly as a main contributing factor to a symptom known as self- stigma.
Self-stigma is a form of stigma that occurs when an individual with a certain trait/behavior (i.e. bipolar disorder or schizophrenia) believes and internalizes negative public attitudes (i.e. individuals with depression are emotionally weak, therefore I must be emotionally weak.) This internalization is often detrimental to an individual’s self-efficacy and can impede recovery during episodes of illness.
Erica James, an Atlanta-based marriage and family therapist, who also works with children and adolescents in foster care, has found internalized stigma can surface as significantly low self-esteem.
“A lot of work I have to do in addition to helping work through issues is empowering my clients to learn and uncover traits about themselves they already possess that are positive, so if they are suffering from disorders like depression or anxiety, it’s not the only trait that they have and it is something they can work through.”
Unlike with physical conditions such as diabetes or cancer, individuals with mental illness may view their disorders as a character flaw rather than a common treatable condition. Instead of compartmentalizing their illness as one aspect of themselves, they may believe it to be their complete identity. This can lead to what is academically considered the why try effect, when individuals behave in ways that devalue their sense of worth and abilities, disrupting recovery, and even hindering the long-term pursuit of personal goals.
From a racial standpoint, research indicates African Americans are more prone to experience higher levels of both public and internal stigma than their white counterparts, and can even face what is known as double stigma. Double stigma occurs when someone feels doubly discriminated against because of their membership in two separately stigmatized groups, possibly leading to treatment-resisting behavior for fear of negative identification in more than one social circle.
“I think [prevalent mental health misconceptions in the black community] are shifting a little bit, but it really comes from us depending on our communities and families for help of any kind, [but] sometimes they are just not equipped or knowledgeable enough to help us though certain challenges,” James stated.
It may not be possible to completely eradicate symptoms of internalized stigma, however there are positive resources available to individuals, including peer support groups with others dealing with similar mental health concerns.
There is a clear need for increased public awareness about mental health on a societal level. Because public stigma can be a powerful inciting cause behind the internalizing of negative attitudes, we must collectively aim to delegitimize misconceptions through education to improve mental health outcomes.
As a therapist, James agrees that education is key. “A lot of people kind of fear the phrase mental health…they have an idea of what it is and may think of it in just one way. But mental health is an umbrella term and a lot of things go underneath it.”
Combating Stigma Resources & Initiatives:
NAMI - Stigma Free
Mental Health America - African American Mental Health