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Mental health: overcoming the stigma of mental illness.

False beliefs about mental illness can cause significant problems. Learn what you can do about stigma.

Stigma is when someone views you in a negative way because you have a distinguishing characteristic or personal trait that's thought to be, or actually is, a disadvantage (a negative stereotype). Unfortunately, negative attitudes and beliefs toward people who have a mental health condition are common.

Stigma can lead to discrimination. Discrimination may be obvious and direct, such as someone making a negative remark about your mental illness or your treatment. Or it may be unintentional or subtle, such as someone avoiding you because the person assumes you could be unstable, violent or dangerous due to your mental illness. You may even judge yourself.

Some of the harmful effects of stigma can include:

  • Reluctance to seek help or treatment
  • Lack of understanding by family, friends, co-workers 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

Steps to cope with stigma

Here are some ways you can deal with stigma:

  • Get treatment. You may be reluctant to admit you need treatment. Don't let the fear of being labeled with a mental illness prevent you from seeking help. Treatment can provide relief by identifying what's wrong and reducing symptoms that interfere with your work and personal life.
  • Don't let stigma create self-doubt and shame. Stigma doesn't just come from others. You may mistakenly believe that your condition is a sign of personal weakness or that you should be able to control it without help. Seeking counseling, educating yourself about your condition and connecting with others who have mental illness can help you gain self-esteem and overcome destructive self-judgment.
  • Don't isolate yourself. If you have a mental illness, you may be reluctant to tell anyone about it. Your family, friends, clergy or members of your community can offer you support if they know about your mental illness. Reach out to people you trust for the compassion, support and understanding you need.
  • Don't equate yourself with your illness. You are not an illness. So instead of saying "I'm bipolar," say "I have bipolar disorder." Instead of calling yourself "a schizophrenic," say "I have schizophrenia."
  • Join a support group. Some local and national groups, such as the National Alliance on Mental Illness (NAMI), offer local programs and internet resources that help reduce stigma by educating people who have mental illness, their families and the general public. Some state and federal agencies and programs, such as those that focus on vocational rehabilitation and the Department of Veterans Affairs (VA), offer support for people with mental illness.
  • Get help at school. If you or your child has a mental illness that affects learning, find out what plans and programs might help. Discrimination against students because of a mental illness is against the law, and educators at primary, secondary and college levels are required to accommodate students as best they can. Talk to teachers, professors or administrators about the best approach and resources. If a teacher doesn't know about a student's disability, it can lead to discrimination, barriers to learning and poor grades.
  • Speak out against stigma. Consider expressing your opinions at events, in letters to the editor or on the internet. It can help instill courage in others facing similar challenges and educate the public about mental illness.

Others' judgments almost always stem from a lack of understanding rather than information based on facts. Learning to accept your condition and recognize what you need to do to treat it, seeking support, and helping educate others can make a big difference.

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  • StigmaFree me. National Alliance on Mental Illness. https://www.nami.org/Get-Involved/Take-the-stigmafree-Pledge/StigmaFree-Me. Accessed April 25, 2017.
  • What is stigma? Why is it a problem? National Alliance on Mental Illness. https://www.nami.org/stigmafree. Accessed April 25, 2017.
  • Stigma and mental illness. Centers for Disease Control and Prevention. https://www.cdc.gov/mentalhealth/basics/stigma-illness.htm. Accessed April 25, 2017.
  • Sickel AE, et al. Mental health stigma: Impact on mental health treatment attitudes and physical health. Journal of Health Psychology. http://journals.sagepub.com/doi/pdf/10.1177/1359105316681430. Accessed April 25, 2017.
  • Americans with Disabilities Act and mental illness. Womenshealth.gov. https://www.womenshealth.gov/mental-health/your-rights/americans-disability-act.html. Accessed April 25, 2017.
  • Picco L, et al. Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem. Psychiatric Research. 2016;246:500.
  • The civil rights of students with hidden disabilities under Section 504 of the Rehabilitation Act of 1973. U.S. Department of Education. https://www2.ed.gov/about/offices/list/ocr/docs/hq5269.html. Accessed May 2, 2017.
  • Wong EC, et al. Effects of stigma and discrimination reduction trainings conducted under the California Mental Health Services Authority. Rand Health Quarterly. 2016;5:9.

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Overcoming Stigma

By Gretchen Grappone, LICSW

how to overcome mental health stigma

Two scenes flashed through my mind highlighting two very different points in my life: getting offered a job as a therapist at the mental health center where I completed my internship for my Master’s in social work, and sitting in a psych ward on the eve of my 18 th  birthday, wondering if I would graduate from high school.

Persevering Through Depression

It took many years of perseverance for me to become that professional sitting on a panel at a national conference. Though I managed to graduate from high school, I dropped out of college at 19 as my depression worsened. I was unemployed, and my only income was Social Security disability. Years of failed depression treatments included medication and talk therapy.

I spent most of my time alone doing what I refer to as “stewing in my own depressive juices.” This lasted for 10 years. During that time, I was challenged by the symptoms of mental illness— insomnia, loss of appetite, lack of concentration, suicidal thoughts. After a decade of being unemployed and living on Social Security, I decided that for my own survival, I had to return to school and complete my social work degree. Of course, my depression was against this:

“You can’t go back to school; you will fail.”

“You won’t be able to concentrate enough to complete your assignments.”

“You’re too stupid to get a college degree.”

Somehow, I decided to talk back to these negative thoughts. My response was simple: “I’m just going to do the best I can.”

And I did. I got myself back to school and finished my degree in social work. Around that time, I also tried a different treatment for my depression, and it worked. Things got easier.

Today, I feel incredibly lucky to say that I am doing exactly what I want to be doing. But really, luck had little to do with it. Besides my symptoms of depression, I faced an additional barrier to school, employment and inclusion in general: unhelpful attitudes from well intentioned health professionals—in other words, stigma.

The Seven Types of Stigma

Public stigma .

This happens when the public endorses negative stereotypesand prejudices,  resulting in discrimination  against people with mental health conditions.

Self-Stigma

Self-stigma happens when a person with mental illness or substance use disorder  internalizes public stigma .

Perceived Stigma 

Perceived stigma  is the beliefthat others have negative cognitionsabout people with mental illness.

Label Avoidance  

This is when a person chooses  not to seek  mental health treatment to avoid being assigned a stigmatizing label. Label avoidance is one of the most  harmful forms  of stigma.

Stigma by Association

Stigma by association  occurs when the effects of stigma are extended to someone linked to a person with mental health difficulties.This type of stigma is also known as  courtesy stigma  and  associative stigma .

Structural Stigma 

Institutional policies orothersocietal structures that result in decreased opportunities for people with mental illness are  structural stigma .

Health Practitioner Stigma

This takes place any time a health professional allows stereotypes and prejudices about mental illness to negatively affect a patient’s care.

Learning to Reject Stigma

One mental health professional once told me, “Maybe you’re not getting better because you’re not trying hard enough.” Another warned me, “You might not be ready to go back to school full time. Shouldn’t you just take one class and see how that goes?” A psychiatrist decided, without asking for my opinion, that I should be sent to live in a group home for people with mental illness. (That did not happen, and that treatment relationship ended that day.)

These scenarios were fueled by the stigma associated with mental illness—stigma that ultimately serves to limit and exclude rather than encourage and include. Had I listened to those professionals, I might never have returned to school or entered the workforce.

So how did I overcome the stigma that I faced? I rejected it. Rejecting—or overcoming—stigma, whether it be self-stigma, public stigma or structural stigma, is one of the keys for those of us living with mental illness. This is not an easy task, to be sure, but it is becoming more possible and a bit easier as more and more of us of speak out about our mental health conditions.

After working as a therapist and witnessing the negative effects of stigma on clients and their family members, I decided to develop a stigma-reduction training curriculum called “Overcoming Stigma.” I spent several months reading every scientific article I could find about stigma research. Most of it simply documented that stigma exists (in hospitals, in psychiatry, in substanceusetreatment centers, in pharmacies, universities, employment, housing, etc.) and that levels of stigma have not changed over the last decade.

According to many studies, effectively reducing stigma pointed to one intervention: contact with someone successfully managing a mental illness. One shining example of this is  NAMI’s In Our Own Voice  (IOOV) program. People with mental health conditions share their powerful personal stories in this free 60- or 90-minute presentation. I decided to integrate elements of IOOV into the beginning of my trainings by briefly disclosing my own depression and giving a few examples of my experiences with stigma. The rest of the training includes a description of the seven most common types of stigma experienced by people with mental illness and substance-use disorders, research about the effects of these stigmas, ways to reduce stigma, and the clinical and agency assessment tools I developed.

I have presented Overcoming Stigma trainings in many different health care settings, and the curriculum continues to evolve, always guided by the latest stigma research. Recent research shows that stigma training needs to be ongoing instead of a one-time thing and, it likely needs to address many stigmas all at once.

My trainings get everyone involved in the discussion; I like to ask for anecdotes from attendees. Here are some real-life examples of stigma shared by health care professionals who have attended my trainings over the past several years:

 • A cardiac surgeon said he would not do surgery on a person with schizophrenia because he didn’t think the person would be able to do the required follow-up care.

• A therapist shared that as a Ph.D. student, he was told he would lose his scholarship if he left for “depression” treatment but could keep it if he left for “medical” treatment.

• A mother puts off making an appointment for her daughter to see a therapist despite her daughter experiencing severe symptoms of anxiety because she doesn’t want her daughter to be labeled as “crazy.”

• A physician attendee said it was well known in her neighborhood that her son had been hospitalized with bipolar disorder and no one acknowledged this fact (much less offered any type of support).

• A mental health clinician working in an emergency room said doctors and nurses often referred to patients in the ER with mental illness as “her patients,” rather than “our patients.”

If I do my job well, attendees leave with the understanding that we all have a role to play in reducing these harmful kinds of stigma. Personally, I still experience stigma, but I am no longer limited by it. I sometimes even chuckle when I hear someone say something particularly stigmatizing because I immediately think, “Well, that’s going to be part of my next training.” That’s not to say it isn’t still discouraging to see or hear things that continue to perpetuate stigma, but for me, there is a feeling of freedom and power in being able to turn a potential lost opportunity into one that is gained.

Gretchen Grappone, LICSW is a trainer and consultant with Atlas Research in Washington, D.C. Her work includes projects with VA medical centers, community mental health centers and other health care settings around the country. She lives in New York City.

Note: This was originally published in the Spring 2017 issue of NAMI Advocate.

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How we’re overcoming the stigma of mental health issues, shame and shunning make mental illness worse. but new studies suggest that attitudes are changing for the better—and that’s largely due to young people..

Today, people in the United States know far more about mental illness than did previous generations. They might know what it looks like: changes in emotions, thinking, or behavior that make function in daily life difficult, if not impossible. They’re much more likely to understand that most of us will experience some form of mental illness in our lifetimes, like depression or anxiety. And they know that smaller numbers of people will experience more severe conditions like bipolar disorder, schizophrenia, or PTSD.

Despite this progress, for decades attitudes toward people with mental disorders have hardly budged. How do we know this? One of the crucial ways we measure prejudice is to ask about “social distance.” In this case, that involves asking: How close would you be willing live to someone with a mental illness? Would you live in the same state? Be in the same classroom or workplace? Participate together on a project? Ride next to them on public transportation? Go out with them? Let your offspring marry them? 

When friends, family, and society shame people for their illness, and shun them, that’s stigma. This shaming can take many forms , from stereotypes (“they’re dangerous”) to moral judgments (“you’re just a coward”) to dismissive labeling (“you’re crazy”). There can be real consequences of stigma, such as lost job opportunities and social marginalization, as well as giving up on seeking treatment. Overt discrimination is a big part of stigma, too: People with mental disorders, in many states, cannot run for office, serve on a jury, keep a driver’s license, or retain child custody. Most perniciously, the stigma of mental illness can lead people to hide their troubles and refuse to get help—which is likely to worsen their condition and create a vicious cycle.

how to overcome mental health stigma

Until very recently, studies consistently showed that the desire for social distance from people with mental illness had not improved over the past 50 to 60 years. In fact, in some ways it had actually worsened, as more people than before automatically linked mental illness with aggression and violence.

At the same time, studies also showed that people had greater knowledge of ADHD, depression, bipolar disorder, PTSD, and more—but just “knowing” more facts about mental illness can actually make things worse . For example, if you learn that people with schizophrenia may hear voices and become paranoid, you might consider that to be quite frightening, even threatening. Similarly, understanding that people with severe depression may come to feel that their lives are not worth living—and may therefore consider suicide—can trigger the belief that such individuals are utterly self-centered. What might not be understood is that severe depression can foster the belief, in people affected, that everyone else would be better off without them.

In other words, factual knowledge about mental disorders, alone, can actually fuel stereotypes. In addressing stigma, the missing piece isn’t knowledge—it’s contact, empathy, and humanization.

A recent study published in December by the JAMA Network Open suggests that things may finally be starting to change. But the picture is complicated: Some kinds of illness are becoming less stigmatized, true, but people still want to keep distance from other forms. The good news is that young people are much less likely to stigmatize mental illness than older generations—and that there are specific steps we can take, as individuals and society, to keep making progress.

Generational shifts driving acceptance

In surveying a representative group of U.S. adults during a period of over two decades, sociologist Bernice A. Pescosolido and her colleagues found a significant and important decrease in desire for social distance related to depression over the past few years.

That is unprecedented, and of real importance. However, in the same paper , the researchers found that attitudes related to conditions like schizophrenia and substance-use disorders did not show signs of improvement—and had actually worsened.

Even though the participants in this study were many—over 4,000 adults—it would take even larger groups to understand how socioeconomic, ethnic, or racial characteristics affected changing attitudes toward mental illness. Still, from this study and a number of others, it does appear that improvements are driven mainly by younger people.

In fact, research hints at a massive generational shift in how mental illness is perceived and socially experienced. Multiple other surveys and studies besides the one by Pescosolido and her colleagues suggest that both millennials (those born from the early ’80s to the mid-’90s) and Generation Z (who were mostly born in the 21st century) are much more accepting and knowledgeable about mental illness than previous generations.

Why? Rates of diagnosed mental illness have been rising among young people. For example, one 2019 study found almost half experience depression, peaking at 60% for teens aged 14–17—considerably more than previous generations. More recent work conducted during the COVID-19 pandemic hints at a profound mental health crisis .

When the CDC surveyed almost 8,000 high school students in the first six months of 2021, researchers found that depression, anxiety, and other disorders permeated the lives of adolescents during the pandemic. All groups reported more persistent sadness since spring 2020, though the rate rose faster among white teens than others. Nearly half of lesbian, gay, bisexual, and transgender teens reported seriously thinking about suicide, compared with 14% of heterosexual peers. One in four girls did so, twice the rate of boys.

Did that translate into higher suicide rates? Yes , and decidedly so, especially for girls. Some emergency departments have reported a significant increase in teens coming in for suicide attempts. (Note that these numbers are only provisional and could go up with time.)

What’s responsible for these negative trends? That’s a topic hotly debated by scholars, with most suggesting some combination of factors like the pandemic, climate change , political and economic instability, increased educational competition, and technological changes like phones and social media. Even more, for teenage girls in particular, a toxic “ triple bind ” of impossible expectations (be supportive and nurturing, be super competitive, and do both of the above effortlessly while looking “hot”) plays a key role.

However, as depression and anxiety spread among young people, it does seem as though these conditions are becoming normalized—and that youth are becoming more open and compassionate with one another. And high school clubs, as well as college programs, that focus on reducing stigma with respect to mental disorders have been shown to create real benefits .

All evidence to date suggests that many kinds of mental illness carry less stigma for younger generations. As these young people attain full maturity, the tide could eventually turn even for disorders like schizophrenia—the way it has, convincingly, for issues like same-sex marriage over the past 20 years. There are steps we can take to keep pushing this process forward.

What can create more positive change?

First, from a “top-down” perspective, enforcement of anti-discrimination policies, including the Americans with Disabilities Act, can help to drive acceptance. Title I of the ADA blocks employers from discriminating against people with disabilities, including mental illness, and requires them to make reasonable accommodations. Last week, a man in Kentucky won a half-a-million-dollar judgment against the employer who fired him for having a panic attack at work, which will surely discourage other companies from doing the same.

Beyond employment protection, we need enforcement of laws mandating “parity” for coverage of mental and physical disorders, and there’s much work to do with police and the courts to make a distinction between criminal activity and mental health crises.

Such steps can limit the consequences of stigma, but they can’t erase its existence. Though we’ve learned that information all by itself doesn’t reduce stigma, that doesn’t mean we should stop educating people from early ages about diagnosis and treatment—and there is evidence to suggest public health campaigns can reduce stigma if properly funded and executed.

For example, surveys conducted two years after Scotland’s multiyear, multiplatform “See Me” campaign—which aimed to normalize mental illness— showed a 17% drop in fear of people with serious mental illness, among other good outcomes. A much briefer social media campaign in Canada called “In One Voice”  resulted in a “small but significant” decrease in a desire for social distance one year after it ended—though the same study also found that people didn’t feel more motivated to actually help someone in a mental health crisis.

The contrasting results of these two campaigns suggest that size and scope matter when it comes to changing attitudes. Scotland’s much more comprehensive approach made more of an impact than “In One Voice.” And it emphasized personal contact, not just factual knowledge, asking us to “see” real people in all their complexity.

The California Mental Health Services Act is a statewide prevention and early intervention program directly addressing stigma and discrimination, including “a major social marketing campaign; creation of websites, toolkits, and other informational resources; an effort to improve media portrayals of mental illness; and thousands of in-person educational trainings and presentations occurring in all regions of the state.” An independent evaluation found that it succeeded in reducing stigma in California, “with more people reporting a willingness to socialize with, live next door to, and work with people experiencing mental illness.” Participants also reported “providing greater social support to those with mental illness.”

Policies and education do work to reduce stigma, but they alone cannot change human hearts.

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It has probably helped a lot for more and more people to talk about their experiences with mental illness, on social media and through popular media like magazines and television. In 2013, the New York City chapter of the National Alliance on Mental Illness teamed up with marketing company JWT New York to launch the “I Will Listen” campaign. They asked people to publicly pledge on social media to hear and support individuals struggling with mental illness.

That early effort encouraged others to later speak out about their experience with depression and addiction on platforms like TikTok and Facebook, making private struggles public in a way that previous generations only glimpsed with books like William Styron’s groundbreaking 1990 memoir Darkness Visible . Or, more recently, books like Kay Redfield Jamison’s memoir An Unquiet Mind (1996), Andrew Solomon’s The Noonday Demon (2001), and Brian Broome’s Punch Me Up to the Gods (2021). 

It’s important to note that there is little solid evidence to date that talking about mental illness on social media reduces stigma—and, in fact, at least one study found that social media (if it promotes stereotypes) can actually increase stigma. That doesn’t mean people shouldn’t try. It could simply mean that it isn’t enough for people to talk about their own experiences with mental illness; we might also need concerted efforts to limit hate speech and misinformation on social media about people with mental illness. And that personal disclosures of mental disorder need to be grounded in rehearsal, support, and timing, as is the case with stigma expert Pat Corrigan’s program, Honest, Open, and Proud .

Beyond social media, news and entertainment media have a long way to go in representations of mental illness. Many studies through the years have shown that stigmatizing portrayals result in more social stigma and can make suffering much worse in people suffering from mental illnesses. Although more accurate and humanized accounts do appear, the predominant themes are ones of incompetence and violence. We simply need better, more accurate, and more humanized media portrayals—and perhaps that needs to start with targeting journalists and other content creators with specialized education in college, graduate school, and professional development courses. As well, better access to evidence-based treatments is a huge priority for the entire mental health profession. We now understand that many forms of psychotherapy and family-based treatment, as well as medications when needed, can combat some of the most serious symptoms and impairments related to mental disorders. But distressingly low proportions of those in need of such care actually receive evidence-based treatments. For many, even just regular therapy is financially out of reach. At an overall per-capita level, funding for mental health research, via the National Institute of Mental Health, remains far lower than for conditions like cancer.

That is quite ironic. Several generations ago, cancer was highly stigmatized as a disease triggered by one’s loss of will to live. Indeed, if your relative died from cancer, you would instead put in the obituary that she passed away from an unknown illness. Today, though—given the huge spike in disclosure and acceptance—cancer has become a true cause, engendering support and large economic outlays in the battle against it. Understanding that treatment can be effective might help reduce stigma of mental illness, if we can grow to see it as just another human problem that medicine can address, given the time and tools.

Finally, as noted above, young people appear, in many surveys, to be the drivers of changed attitudes and behaviors. A devastating kind of stigma is self-stigma—and the evidence indicates that millennials and Gen Z are turning away from seeing themselves as broken for feeling depressed and anxious, toward seeing themselves as having common illnesses that can be managed and even overcome with treatment, group support, and solidarity.

Young people are the key. Not just because they are always the ones who will shape the future, but because today’s youth are facing formidable mental health challenges. If we can support their mental health through these waves of stressful social change, they might have the compassion and the wisdom to alleviate the suffering of those with mental illness, instead of making it worse with stigma.

About the Authors

Stephen Hinshaw

Stephen Hinshaw

Stephen Hinshaw, Ph.D., is Distinguished Professor of Psychology at UC Berkeley and Professor of Psychiatry and Behavioral Sciences at UC San Francisco. His focuses on developmental psychopathology, child and adolescent mental health (particularly ADHD), and the use of clinical trials to understand underlying mechanisms. He also actively investigates mental illness stigmatization and attempts to reduce such stigma. Hinshaw has authored over 400 articles, chapters, and commentaries, plus 12 books, including Another Kind of Madness: A Journey through the Stigma and Hope of Mental Illness and The Mark of Shame: Stigma of Mental Illness and an Agenda for Change .

Jeremy Adam Smith

Jeremy Adam Smith

Uc berkeley.

Jeremy Adam Smith edits the GGSC’s online magazine, Greater Good . He is also the author or coeditor of five books, including The Daddy Shift , Are We Born Racist? , and (most recently) The Gratitude Project: How the Science of Thankfulness Can Rewire Our Brains for Resilience, Optimism, and the Greater Good . Before joining the GGSC, Jeremy was a John S. Knight Journalism Fellow at Stanford University.

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  1. Mental health: Overcoming the stigma of mental illness

    Stigma is when someone views you in a negative way because you have a distinguishing characteristic or personal trait that's thought to be, or actually is, a disadvantage (a negative stereotype). Unfortunately, negative attitudes and beliefs toward people who have a mental health condition are common. Stigma can lead to discrimination ...

  2. 9 Ways to Fight Mental Health Stigma

    And that’s where family and friends can offer support to them, says Dr. McLaughlin. “Talking to them is important, telling them you notice a change in their routine, in their behavior,” he ...

  3. Overcoming Stigma

    Overcoming Stigma. OCT. 15, 2018. By Gretchen Grappone, LICSW. I was sitting alone in the hallway of the Carter Center conference area in Atlanta during the 2012 Rosalynn Carter Symposium on Mental Health Policy. I had just finished being a panelist and talking about how employment and education helped me overcome the stigma associated with my ...

  4. How We’re Overcoming the Stigma of Mental Health Issues

    An independent evaluation found that it succeeded in reducing stigma in California, “with more people reporting a willingness to socialize with, live next door to, and work with people experiencing mental illness.”. Participants also reported “providing greater social support to those with mental illness.”.