For a long time, mental health advocates plastered the phrase “break the stigma” across T-shirts, hoodies and bracelets—forever in hopes that the message might get through. This once-unheard cry has, in recent years, begun to gain increasing momentum. However, before the stigmatisation of mental illnesses was properly addressed, it spread through society and culture, playing upon people’s fears, stereotypes and insecurities, culminating in a gargantuan structural issue.
So, where did this stigma originate from, and how did it become the leading goal of a global health movement? A movement that is often simplified and generalised by relying on the buzzword of the decade: mental health.
The stigmatisation of mental illnesses can be understood by the process of how the stigma first develops. People distinguish and label a human difference (mental illness) as socially salient, resulting in differentiated groups and ostracisation.
Those societal differences are then linked to undesirable characteristics and negative stereotypes. What follows is the creation and dispersion of an ‘us versus them’ mentality wherein we begin separating from the groups deemed as ‘different’. Finally, the stigmatised cohorts are socially devalued and systematically disadvantaged—and the cycle continues.
These observations are a key pillar within the mental illness and anti-stigma research of Dr Heather Stuart, member of the Order of Canada and fellow of the Royal Society of Canada. “We’ve all been taught to stigmatise because our social system, from the time we were very young, teaches us this, so we’re all socially hardwired to do it,” the expert told SCREENSHOT.
Dr Stuart makes a clear argument that there is a stigma of mental illness, not mental health. This is a significant distinction that’s not widely recognised or considered, commonly because the phrases are often lobbed together with ease into a pinball machine of instantaneous social cycles.
Considering how things would change if the stigma was actually ever broken, the expert went on to add: “The biggest change would be that inequities would evaporate, any inequity that’s related to having a mental illness would be gone, so that would mean things like equal access to care, the quality of care and legislation that supports human rights.”
The inequities faced by people with behavioural health issues, also called mental illnesses or mental health issues, stem from structural and social conditioning, not individualistic attitudes. The widely adopted structure behind the stigmatisation of society’s mentally impaired has been a long burning fire with a multitude of contributors that won’t be put out simply by just one swift action, yet the fight is certainly present.
Another expert on the matter is Dr Mark Hyman Rapaport, CEO of the Huntsman Mental Health Institute. Dr Rapaport told SCREENSHOT, “[Mental health] disorders are physical disorders, they’re just physical disorders of the most complex organ system in the body.” He also pointed out how people enduring heart conditions and cancers aren’t blamed for their physical illness the way those with a mental illness are.
Although it remains a work in progress, the feat to come that is breaking the stigma of mental illnesses can be done, Dr Stuart, the former chair of the World Psychiatric Association’s Stigma and Mental Health Science Section, assured me.
One of the leading avenues out of the stigmatisation conundrum is to have people with mixed lived experiences engage in direct and indirect social contact—thereby inevitably debunking stereotypes that label people with mental illnesses as dangerous, unpredictable, lazy and incapable of maintaining professional or personal relationships.
In regard to one of the biggest differentiated lived experiences being a parent-child relationship, Nick Jedrzejewski, public affairs manager for the Scottish company See Me, explained that “adults in their interactions with young people—a lot of times that’s where stigma and discrimination come from.”
With one in four Scottish citizens impacted by mental health issues, an inclusive and stigma-free Scotland is a top priority for See Me. The organisation was founded by the country’s government to focus attention on eliminating mental illness stigma and discrimination.
“What you need in any work to tackle stigma discrimination is to ensure that at all points it’s being driven or led by those who have experience of mental health problems,” Jedrzejewski shared.
With leading voices in the space of anti-stigma work calling for the normalisation of mental health conversations, simply talking about it does not mean the stigma will evaporate for those affected by it. A concerted, targeted and multi-faceted solution is needed to solve a multi-layered problem. You don’t stop the onion from burning by simply removing one layer.
Although the data and examples have long documented how real and significant the stigma of mental illness is, documenting the problem can only go so far until it needs a financial injection and serious policy support. There has been a scarcity of implemented change due to the lack of finance binding the problem to policymakers, resulting in a stall of progress.
“It’s fine to blame policy but we’re not really giving them what they need to make the right policies,” Dr Stuart said on the role of policymakers. “Just bringing something to their attention isn’t enough.”
While acceptance and normalisation of mental health conversations is a crucial step in the stigma-stripping process, that isn’t the end. We all have seemingly accepted and facilitated conversations about inflation, but just because we talk about it more doesn’t necessarily mean gas prices will go down. That takes structural change.
However, on the timeline of breaking the stigma, we’re at the point of strategic disclosure. According to Dr Stuart, this is due to the difficult reality that opening up can still result in negative repercussions.
“Stigma is foundational to addressing any action to improve mental health,” Jedrzejewski added on the significance of the present timeline of addressing mental health issues.
Having risen from only 22 per cent in 2002, 79 per cent of Scottish people in 2022 now agree they can confidently talk about their own mental health, according to a recent See Me survey. However, there is no complacency found there, as Dr Rapaport has argued that the stigmatisation of mental illness is explicitly a human rights issue.
“I don’t think there’s ever a point where we can just say ‘this is done, job done, and we can move on from this, it won’t happen now,’” Jedrzejewski stated when questioned about how we can move towards a non-stigmatised society. “You need to continuously be trying to make a difference.”
At the forefront of the breakable stigma is the long-standing notion that those who express emotions are weak—stemming from the preceding decades of suppressed emotions. It therefore has become vital that those who share their mental health journey are increasingly viewed as not only strong and in-tune with their emotions, but as cultural leaders who will have an instantaneous positive impact.
Understanding how the language used to discuss mental illnesses impacts people provides a crucial learning curve for those who want to engage in conversations around this subject in a respectful and non-judgemental way.
You likely don’t have to think back to decades or even yesterday to recall the last time you heard something, or someone described as ‘crazy’. Whether it crossed your mind or not, this is a vividly all too common and detrimental example of the stigmatisation of language, as the word derives from meanings including deranged and diseased, thus, calling an individual with a mental illness ‘crazy’ equates to declaring, via blame, that something is inherently wrong with them.
This societal and structural fault line of language can be applied to many examples. “They experienced a drug addiction” instead of “they’re a drug addict.” And “they were diagnosed with a bipolar disorder” over “they’re bipolar.”
The stigma following individuals with a mental illness can often be worse than the actual illness itself, which can be medically and psychologically supported. The external perception however is a structural undertone of society that doesn’t have a vaccination or cure.
“The key to breaking down stigma is going to be creating a dialogue,” Dr Rapaport told me.
The ongoing emergence from the stigmatisation of mental illnesses can be compared to other stigmatised movements of the past and present that have been around before any attention was on mental health including but not limited to, homophobia, sexism, HIV and racism. From these stigmatised movements, all of which have volatile stigmas around them that fluctuate with society’s interest or lack thereof, mental health advocates have an ever-complex roadmap of like-minded societal successes and failures to learn from.
Dr Stuart concluded: “If you’re not a part of the solution you’re a part of the problem.”
So, while all lived experiences are continually changing, there are human emotions and societal implications behind the differences in each experience—presenting an opportunity for all to connect and engage in a sustainable manner for a healthier and happier society. Although stigma isn’t yet measurable, our social climate has the obligation to drastically tame our stigma footprint polluting innocent minds.
Recent data has shown that Europe is facing a dramatic increase in both anxiety and depression and the use of antidepressants. The Organisation for Economic Co-operation and Development (OECD) has collected data and discovered that Europeans are facing a substantial mental health crisis—with the COVID-19 pandemic cited as one of the most significant contributing factors.
The report—formulated by Euronews using data provided by the OECD—found that, since 2000, the consumption of antidepressants has increased by almost two and a half times in 18 European countries. The dataset also found an overwhelming spike in Europeans suffering with anxiety or depression.
Not only did the 18 European countries witness a 147 per cent increase in antidepressant use from 2000 to 2020, there has also been a spike in government spending on the medication. In 2020, Germany spent $812 million on antidepressants, Spain $649, and Italy $456 million.
In regard to which country saw the biggest increase in antidepressant consumption over the 20 years recorded, the answer is the Czech Republic—which saw a whopping 557 per cent increase. France, on the other hand, only witnessed a 38 per cent increase.
However, perhaps the most surprising finding from the data collected by Euronews is the fact that, out of 24 European countries, Iceland has the highest rate of daily dosage consumption of antidepressants. The findings go on to note how this discovery may come across as confusing to some, especially considering the fact that Iceland was voted the second-happiest country in the world in 2020. Therefore, it appears that there is no current correlation between happiness and the use of antidepressants.
The OECD also stated in a May 2021 report that the COVID-19 pandemic has significantly impacted the mental health of young people across Europe. Not only has there been a decrease in access to proper services and support, there has also been a surge in generalised anxiety.
The European Foundation for the Improvement of Living and Working Conditions (Eurofound), published further findings after it conducted a survey of 200,000 people, which took place from spring 2020 to spring 2022.
It indicated that the number of people reporting ‘bad’ or ‘very bad’ health more than doubled between 2020 and 2022. Despite the lifting of most lockdown measures in early 2022 as the pandemic considerably subsided, this number continued to increase, from 7.9 per cent in March 2021 to 12.7 per cent in March 2022.
Furthermore, there is a risk that with the current cost of living crisis in Europe reaching an unprecedented level, those who are struggling will experience greater anxiety or depression.
Finally, it seems unmet mental healthcare is also a serious concern. Due to a backlog in hospitals and important services, many young individuals are unable to access the help they need. The survey specifically found that young women in particular are more at risk, with one in four reporting unmet needs.