“The time to eradicate mental health stigma and discrimination is now”

In a publication timed to coincide with World Mental Health Day on 10 October 2022, a Lancet Commission Report “Ending stigma and discrimination in mental health”, comprising 50 global authors, makes a call to governments, employers, schools and health and social care providers to recognise that “mental health is part of being human” and to “act now to prevent stigma and start inclusion”.

The report defines and characterises four ways in which mental health stigma can arise;

1. Self stigma
   

   Where individuals turn in on themselves, reinforcing negative stereotypes leading to demoralisation and the “why try” effect.

2. Stigma by association
   

   Usually involving close family members.

3. Public stigma

   The way a community views and acts towards mental health issues, often leading to misinformation, prejudice and discrimination.

4. Institutional stigma
   

   Where the policies or practices of governments or organisations work to the disadvantage of those with mental health issues.

The authors refer to the double jeopardy felt by many – dealing not only with the impact of the primary condition but the secondary consequences of stigma. The report points to the cost of mental health stigma, often leading to social exclusion in education or the workplace, loss of property and poorer healthcare.

Media reporting of mental health issues was found to offer a mixed benefit – some reporting was found to fuel a “misconception” that mental health was “dangerous and unpredictable”, whilst responsible and nuanced reporting had been shown to help reduce stigma, particularly around suicide.

The authors’ concluding recommendations are to draw heavily on those people with lived experience of mental health issues in a variety of programmes – education, training and support. 

The report also highlights how 41 of 43 studies reviewed found that public awareness and information programmes on suicide and depression had helped to improve “attitudes”.

Comment

With a recent global Gallup poll highlighting that 92 % of those surveyed now regarded mental health as important as physical health, it appears clear that the population is keen and willing to promote equality in treatment for those with mental as well as physical ill health. 

However, with mental health funding commonly comprising less than 3 % of the health budgets of most developed countries, the difference in the way that mental and physical health is treated both in terms of financial resource and “health priorities” is significant.

In previous articles, we have seen how largely pandemic-induced factors have led to a 25% rise in depression and anxiety compared to that seen in 2019. Continuing to stigmatise those with mental health issues will simply aggravate a problem which is already presenting as a significant burden in society. Mental health will remain an issue that will exercise the thoughts and financial resources of governments and healthcare providers both now and in future years.