The Dictionary Definition -- “a mark of disgrace”

Stigma is defined in Webster’s Dictionary as “a mark of disgrace associated with a particular circumstance, quality, or person.” Not surprisingly, when the dictionary describes how the word is used, it provides this as an example: "the stigma of mental disorder.”

According to Webster, synonyms for stigma include shame, disgrace, dishonor, ignominy, opprobrium, humiliation, (bad) reputation. There is not a positive word or image in the list.

Fear of Stigma Drives People Away from Seeking Help

Stigma is an important factor in why treatment rates are so low. While disparities in service delivery and inadequate funding also impact treatment rates, the fact is that stigma also drives people away from the service system. As articulated by the A Report on the Public Comments Submitted to the President's New Freedom Commission on Mental Health:

Stigma leads others to avoid living, socializing, or working with, renting to, or employing people with mental disorders - especially severe disorders, such as schizophrenia. It leads to low self-esteem, isolation, and hopelessness. It deters the public from seeking and wanting to pay for care. Responding to stigma, people with mental health problems internalize public attitudes and become so embarrassed or ashamed that they often conceal symptoms and fail to seek treatment (2003).

Data from the National Survey on Drug Use and Health (NSDUH) suggest that approximately 18 percent of adults in the United States have a diagnosable mental, behavioral or emotional condition. However, roughly one in five adults with a mental health condition report not receiving mental health services -- inpatient treatment/counseling, outpatient treatment/counseling or prescription medication for problems with emotions, nerves or mental health – in the past year (SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH 2015 and 2016). Clearly, there is a significant gap between the need for and receipt of mental health care.

Moreover, the solutions being promoted to address low treatment rates can make the problem worse. Disproportionately, these solutions involve judicial sanctions, ordering compulsory and involuntary treatment. The fear of being treated without consent drives many people even further from the systems and treatments that can help.

News Coverage Shapes Discourse and Attitudes

Press and other media coverage of mental health-related issues is often negative and, therefore, helps to solidify the myths and misconceptions about people with mental health conditions. An article in the journal Health Affairs in which the authors studied trends in media coverage of mental illness, Trends in News Media Coverage of Mental Illness in the United States, exposes the grossly disproportionate level of stories conflating violence and mental illness as compared to favorable articles presenting positive images of people with mental health conditions. The study team from Johns Hopkins University examined 400 articles published in major print and television news outlets between 1995 and 2014 that mentioned mental health conditions. Fifty-five percent of these articles also noted violence, while only 14 percent cited recovery and 7 percent mentioned people in recovery (McGinty, Kennedy-Hendricks, Chosky and Barry, 2016). Other images and descriptions of people with mental health conditions in the media are equally negative, often inaccurate and stigmatizing. Unfortunately, depictions set views even when depictions are not accurate.

Inaccurate Conflation of Mental Illness and Violence

One of the most damaging and inaccurate images of people with mental health conditions is that they are dangerous and violent. The standard television and movie image of the deranged killer is deeply ingrained in our collective mind. But the common beliefs are belied by the evidence. Here are the facts, as reported by the University of Washington School of Social Work:

  • The vast majority of people with mental illness are not violent.
  • People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime. People with severe mental illnesses, schizophrenia, bipolar disorder or psychosis are 2.5 times more likely to be attacked, raped or mugged than others in the general population.
  • Media portrayals of people with mental health conditions exacerbate the misconceptions.