Lessons learned from unintended consequences about erasing the stigma of mental illness

Abstract

Advocates and scientists have partnered to develop and evaluate programs meant to erase the egregious effects of the different forms of stigma. Enough evidence has been collected to yield lessons about approaches to stigma change. Some of the most insightful of these lessons emerge from unintended consequences of good intentioned approaches, and are the focus of this paper. They include the limited benefits of education especially when compared to contact, beating stigma is more than changing words, beware pity as a message, understand the competing agendas of stigma change, replace ideas of normalcy with solidarity, and avoid framing self-stigma as the problem of people with mental illness and not of society. The paper ends with consideration of the back seat role that psychiatrists and other mental health providers should have in stigma change.

Disentangling Stigma from Functional Neurological Disorders: Conference Report and Roadmap for the Future

“…For those with FND, there is a stigma ascribed to having mental illness as the cause of their symptoms. Stigma is a cognitive framing or worldview that leads to stereotyping, prejudice, and unjust discriminatory acts (26). With stigma, negative evaluations lead to negative emotions.…”

Stigma of mental illness and multicultural counseling self-efficacy : investigating the implications of the multicultural training environment, mental health literacy, and empathy.

“…Although the research of mental illness stigma has found that elevated anxiety and fear are associated with increased levels of mental illness stigma (e.g., Angermeyer et al, 2010;Corrigan, 2016), research of other types of stigma offers results similar to those of the current study. For example, in his study of empathy and personal distress in the context of HIV/AIDS related stigma, Olapegba (2010) found that higher levels of personal distress led to higher levels of emotional concern, which then led to lower levels of stigma.…”

“…beliefs, about mental illness that lead to the public's fear, rejection, avoidance, and discrimination against people who have a mental illness (Corrigan, 2016;Parcesepe & Cabassa, 2013). Similar to other forms of bias and prejudice, such as racism and sexism, the public stigma of mental illness matters because it "sets the context in which individuals in the community respond to the onset of mental health problems, clinicians respond to individuals who come for treatment, and public policy is crafted" (Pescosolido et al, 2010(Pescosolido et al, , p. 1324.…”

“…Wei et al (2012) specifically considered the effects of fear associated with counseling a client who was racially different on a counselor's multicultural counseling self-efficacy. A number of researchers have documented the association of fear and public stigma of mental illness (e.g., Angermeyer et al, 2010;Corrigan, 2016;Parcesepe & Cabassa, 2013). Although Rogers (1987) suggested that counselors identify with a client's fear as a means of developing empathy, it could be that a counselor's own, perhaps unidentified, fear is the greater barrier to empathic response.…”

“…The literature centered on mental illness stigma has found fairly consistently that increased fear or anxiety is closely related to increases in mental illness stigma (Angermeyer et al, 2010;Corrigan, 2016;Parcesepe & Cabassa, 2013). In the current study, however, increases in personal distress, the factor of empathy associated with anxiety and emotional discomfort, were associated with lower levels of mental illness stigma.…”