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How to overcome mental and behavioral health stigma

May 19, 2020

Mental illness is perhaps the most under-discussed medical issue in our country. Despite the fact it affects nearly 50 million Americans every year, it’s not a common topic of conversation at the dinner table, the hair salon, or in casual catch-ups with friends.

While you might not think twice about sharing that you have diabetes or that your partner has high blood pressure, it’s rare for an individual to divulge that they’re struggling with depression or that their daughter has anxiety or is in rehab.

“Whether it’s a matter of shame or fear, the resulting lack of openness and candid conversation has a negative impact that reaches far beyond the confines of any single conversation,” says Baystate Behavioral Health psychiatrist Dr. Barry Sarvet.

In fact, the stigma that’s created through silence and shame self-perpetuates in a sort of ripple effect. Over time, a mental health problem becomes the “thing” we don’t talk about. Add on more time and it becomes the thing we can’t talk about because we don’t have the language to talk about it because we don’t talk about it. And on and on.

So how do you fix the problem or help the person with the thing that can’t be discussed?

In short, you don’t.

And that is why we NEED to talk about mental illness and behavioral health issues, especially now. The whole world is currently dealing with a traumatic event—we’re all affected by COVID-19 differently, but we're all having to learn to cope. It is especially important to pay attention to mental health during this period of isolation and uncertainty.

In order to make headway in helping the nearly 50 million people affected by mental illness each year, we need to start breaking down stigma. Here are some ways we can all help.

Begin the conversation with yourself

Before you can start having conversations with others about mental health, you need to have one with yourself.

We all carry biases that we’ve learned or developed over our lifetime. Some are based on our own experiences with people with mental health issues, including substance use disorders, and some we’ve simply absorbed from entertainment and media sources.

It’s important to get to an understanding of what you actually know and what you think you know about mental health.

Let’s say you’ve come to believe that depression is something people choose to engage in and simply need to “get over it.” But if you learned that depression can be biologically caused — much like diabetes or heart disease — there’s probably a good chance you might change your mind on the “get over it” attitude.

Basic information about conditions, how prevalent they are, and the fact that they’re treatable can be extremely helpful in shifting attitudes and shedding biases. Once you realize that a given condition is not hardwired into a person but rather it’s something they’re dealing with — like hypertension or migraines — then, and only then, can you really start to empathize and have candid conversations with that individual.

A great source for learning more about mental and behavioral health issues is the National Alliance on Mental Health Issues (NAMI).

Use and encourage non-judgmental language

While you would never call someone living with hypertension “hypertensive” or someone with cancer “canceric,” it’s not uncommon to hear words like crazy, addict, or schizo being used to describe people living with mental and behavioral issues.

“Labels like these are derogatory and hurtful to the individual and only serve to limit our understanding of the whole person we’re discussing”, says Dr. Sarvet.

The key point here is that people are not their illnesses. They’re people living with an illness. Be it ADHD, an addiction, depression, or cancer.

When discussing individuals living with an illness, always recognize person first. That is, instead of saying someone IS schizophrenic or an addict, refer to them as someone living with schizophrenia or living with addiction. This subtle change of language acknowledges and places value on the person as opposed to the illness.

When you hear others throwing around labels, make an effort to reframe their statement. For example, if you someone is described as a “big time alcoholic,” you might say, “It must be hard for (name) to have lived with (his/her) addiction for so long.” A simple change of script can shift the focus to the individual and create an opportunity for broader thinking and understanding by those engaged in the conversation.

Engage with people who are struggling

If you know or suspect someone is dealing with an issue, make an effort to engage and validate what they’re experiencing. While your intentions may be good, avoid expressions like “you’ll be fine” or it’s “not that bad” which minimize or even call into question what the person is experiencing. Instead, be supportive. Let the individual know that you recognize that what they’re dealing with is real and difficult. Ask how you can be supportive.

In much the same way that you can’t fix cancer with a conversation, you can’t relieve someone of a mental or behavioral health issue with a conversation. But you can help them through it by being available; reaching out via text, email or with a card; running errands or helping with household tasks; and asking questions and talking with the individual as desired.

Share your own story

If you have a mental or behavioral health condition, you know how lonely it can be. Sharing your personal experiences with mental health challenges is one way to connect with and help others with similar experiences. Plus, sharing your story can actually help in your own recovery.

If and when you’re comfortable, try sharing your experiences and perspective with others. What has been most discouraging about your condition? What has given you hope? What has helped? What hasn’t?

Embrace mental health as part of overall health

Because mental and physical health are so inextricably connected, Baystate Health is working to integrate behavioral health care services into its primary care practices.

Dr. Sarvet explains that this effort involves educating providers on the standards of care for behavioral health and familiarizing them with available resources.

“Our hope is that, in the familiar setting of their primary care office, patients will be more open to discussing their mental health concerns and accepting the advice and direction of a provider with whom they have an established relationship."

Of course, in order to provide the best information and guidance, your doctor needs to fully understand your concerns and symptoms. Before your appointment, prepare a list of what you’re experiencing and how long you’ve been experiencing it. The more specific you can be, the easier it will be for your doctor to recommend the right course of action.

The importance of talking about mental health — your own and that of others — cannot be overstated. Open dialogue is an important first step toward healing for everyone. Let’s start talking.

Talk to your doctor about your mental health concerns and questions, and learn more about behavioral health services at Baystate Health.