Is there something wrong with anti-stigma campaigns? Watch

username861942
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Over the years I have come to feel that the way we try to reduce the stigma that exists around mental health is wrong. I feel that it is ineffective and potentially dangerous. I do not feel that the current way of thinking leads to effective campaigning, and therefore, is unable to achieve its aim of reduced stigma and discrimination towards individuals with mental health difficulties. This position has come through my social work studies, experience of working with individuals diagnosed with mental illnesses, lived experience of having poor mental health and experience of volunteering in mental health charities which have a strong anti-stigma focus.

The majority of major anti-stigma campaigns in this country used what is known as the medical model or disease model as their base. This believes in identifying symptoms that are abnormal, and then make a diagnosis based on this. Depending on the diagnosis, you can then allocate a course of treatment which will make the person “better”. With this model the focus is on the fact that the person is ill, and they need to be fixed. This model dominates mental health care (and physical health care too) and is perfectly fine in some situations, for example, when treating a broken leg. Most anti-stigma campaigns believe that by portraying individuals with mental health difficulties as individuals who cannot help being ill, and who need treatment to become well again (just like individuals with physical illnesses) then individuals will become more understanding (reducing stigma/discrimination) and maybe even show sympathy.

These are the problems as I see them:
  • Attempting to reduce stigma by showing mental health difficulties as a problem that needs to be treated, just like physical illness, is not effective even in physical illnesses. There remains a massive stigma towards individuals with some physical illnesses such as epilepsy, HIV/AIDS, leprosy, and in the past, cancer.
  • It emphasises that those with mental health diagnoses are different, they are “broken” and need to be “fixed”, therefore, they are not like “normal” people. This is something I hear so often when individuals are being discriminated based on their mental health, for example, “they are different, they cannot work in a normal workplace environment”.
  • It reinforces the mistaken belief that all individuals with mental health difficulties require medication (the most obvious form of treatment) – this is something I have heard often even in the mental health profession – for example, when an individual comes to our service and they are not taking medication there is an assumption that they will be unstable.
  • The names used for diagnosis contain stigma in themselves. The terms “schizophrenia” and “personality disorder”, for example, contain a large amount of stigma just attached to the name.

I feel that moving away from this approach can greatly benefit the fight against stigma. Embracing a model where we can move away from diagnoses and focus instead on experiences brings many benefits, not just to anti-stigma campaigns. Instead of preaching that those with mental health difficulties are different, lets focus on our common experiences. For example, we all have periods of low mood, for some it will be more extreme but we can all relate to that general feeling. The same can be said for anxiety. I will admit that it becomes more difficult with the traditional “psychotic disorders”, however I have found success by explaining the feelings and experiences that come with “psychosis” and relating it to the experience of having a very high temperature, where we become delirious and confused. It is important to explain that these experiences exist upon a continuum. Using a social model to explain these experiences will enable us to focus on the multitude of causes of mental distress, and the many ways to respond to this. I believe this will enable us to promote empathy, rather than sympathy.

Opinions?

TL;DR – viewing those with mental health difficulties as “broken” and “ill” re-enforces stigma. Reduce the emphasis on diagnosis and focus on experiences to combat stigma.
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EmmaCx
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One of my friends pointed out to me that mental health anti-stigma campaigns put a massive emphasise on how your life will change if you reach out to people - which just isn't the case. Not everyone has someone to reach out to, or the confidence/motivation to reach out. Definitely think that anti-stigma campaigns are important in terms of raising awareness of support systems / resources etc, and ensuring that it's not seen as something 'bad. Don't think we should be saying that bad mental health problems aren't something that are normal though, think it's dangerous in the fact that people may not seek out help when they really do need it.
A lot of people I know are scared to seek out help incase they get medication forced on them or institutionalised. A lot of people just aren't really sure on mental health issues are addressed, and I think that's something that needs to be focused on. There's more options than institutionalising someone or medicating them.
I think perhaps raising awareness of different mental health issues & tackling the myths surrounding them is important. If we shy away from calling illnesses what they are, then that won't help people. We should fight to remove the stigma from those names, and I do believe it's something that's achievable. I remember at one point when my mental health was really bad, people used to joke about symptoms that I experienced. I thought it meant that what I was going through was 'normal' and I was coping with it wrong, which just isn't the case.
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username861942
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(Original post by EmmaCx)
One of my friends pointed out to me that mental health anti-stigma campaigns put a massive emphasise on how your life will change if you reach out to people - which just isn't the case. Not everyone has someone to reach out to, or the confidence/motivation to reach out. Definitely think that anti-stigma campaigns are important in terms of raising awareness of support systems / resources etc, and ensuring that it's not seen as something 'bad. Don't think we should be saying that bad mental health problems aren't something that are normal though, think it's dangerous in the fact that people may not seek out help when they really do need it.
A lot of people I know are scared to seek out help incase they get medication forced on them or institutionalised. A lot of people just aren't really sure on mental health issues are addressed, and I think that's something that needs to be focused on. There's more options than institutionalising someone or medicating them.
I think perhaps raising awareness of different mental health issues & tackling the myths surrounding them is important. If we shy away from calling illnesses what they are, then that won't help people. We should fight to remove the stigma from those names, and I do believe it's something that's achievable. I remember at one point when my mental health was really bad, people used to joke about symptoms that I experienced. I thought it meant that what I was going through was 'normal' and I was coping with it wrong, which just isn't the case.
I guess for a change in attitude to be effective, the attitude towards responding to mental health difficulties need to change too (which, in my opinion, needs to happen). Diagnoses can be really misleading - if you have a group of people diagnosed with Schizophrenia they can have wildly different experiences. I hope that one day individuals will be able to hear the term mental illness or schizophrenia and not have negative views. However, the emphasis will remain that these individuals are ill and different from you, which I still think is stigmatising views to hold.
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EmmaCx
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(Original post by bullettheory)
I guess for a change in attitude to be effective, the attitude towards responding to mental health difficulties need to change too (which, in my opinion, needs to happen). Diagnoses can be really misleading - if you have a group of people diagnosed with Schizophrenia they can have wildly different experiences. I hope that one day individuals will be able to hear the term mental illness or schizophrenia and not have negative views. However, the emphasis will remain that these individuals are ill and different from you, which I still think is stigmatising views to hold.
That's very true. You can end up with people self diagnosing themselves with issues that they don't actually have, or assuming that they don't actually have a mental health issue because of their experiences. Always important to say that even though there is a criteria of diagnosis, people with the same diagnosis can have vastly different experiences. I think if people were more widely educated on mental health, then there would be less need for these anti-stigma campaigns. In my high school, we received zero education in regards to mental health. This meant for a long while I suffered because I didn't know how to reach out, and I didn't know that I had to reach out. Which meant issues that could have been addressed a lot earlier, were allowed to grow. It's hard to seek out help for something if you don't know of it's existence.
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username861942
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(Original post by EmmaCx)
That's very true. You can end up with people self diagnosing themselves with issues that they don't actually have, or assuming that they don't actually have a mental health issue because of their experiences. Always important to say that even though there is a criteria of diagnosis, people with the same diagnosis can have vastly different experiences. I think if people were more widely educated on mental health, then there would be less need for these anti-stigma campaigns. In my high school, we received zero education in regards to mental health. This meant for a long while I suffered because I didn't know how to reach out, and I didn't know that I had to reach out. Which meant issues that could have been addressed a lot earlier, were allowed to grow. It's hard to seek out help for something if you don't know of it's existence.
I totally agree - education in the first place would really reduce the need for such campaigns. It is such a shame than so many people find out about mental health through personal experiences - like myself. Open and honest discussions about our mental health in primary and secondary school would be so useful!
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Sabertooth
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(Original post by EmmaCx)
That's very true. You can end up with people self diagnosing themselves with issues that they don't actually have, or assuming that they don't actually have a mental health issue because of their experiences. Always important to say that even though there is a criteria of diagnosis, people with the same diagnosis can have vastly different experiences. I think if people were more widely educated on mental health, then there would be less need for these anti-stigma campaigns. In my high school, we received zero education in regards to mental health. This meant for a long while I suffered because I didn't know how to reach out, and I didn't know that I had to reach out. Which meant issues that could have been addressed a lot earlier, were allowed to grow. It's hard to seek out help for something if you don't know of it's existence.
I agree that schools definitely need to be better equipped to educate young people on mental illnesses. I had depression for many years before seeking help just because I didn't realize that what I was feeling wasn't normal - and I only realized that there might be help available when my girlfriend told me so after just a few weeks dating. It can be very hard to work out that something may be wrong if you've never been told that these are abnormal ways of thinking/acting and I think, correct me if I'm wrong here bullettheory, that telling people that they're not experiencing something abnormal that needs treatment could be dangerous. I do see mental health conditions as abnormal.
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username861942
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(Original post by Sabertooth)
I agree that schools definitely need to be better equipped to educate young people on mental illnesses. I had depression for many years before seeking help just because I didn't realize that what I was feeling wasn't normal - and I only realized that there might be help available when my girlfriend told me so after just a few weeks dating. It can be very hard to work out that something may be wrong if you've never been told that these are abnormal ways of thinking/acting and I think, correct me if I'm wrong here bullettheory, that telling people that they're not experiencing something abnormal that needs treatment could be dangerous. I do see mental health conditions as abnormal.
I feel that mental health difficulties are normal reactions to difficult or extreme situations. From what I have seen or read in literature, there is a lot of evidence that abuse, social situations, difficult experiences etc. are very important factors in the development of our overall mental health.

So I am not saying that you shouldn't seek help when your mental health becomes poor at all. It's all about how it affects you. Some people will need some support, whilst others may not. Labelling someone as abnormal means that they definitely need fixing, when for some people, they do not want this, and they are perfectly able to say so.

I do believe that you can say that mental health is a normal reaction to extreme circumstances and also promote access to support to aid in recovery.
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JordanL_
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(Original post by bullettheory)
  • It reinforces the mistaken belief that all individuals with mental health difficulties require medication (the most obvious form of treatment) – this is something I have heard often even in the mental health profession – for example, when an individual comes to our service and they are not taking medication there is an assumption that they will be unstable.


I find the opposite. There's too much focus on portraying mental illness as not being a real illness, just a problem with your lifestyle.

My uni did a mental health campaign and chose the theme "healthy body, healthy mind", handing out apples and bottles of water.

I go to the gym 3 times a week, I eat well, but (surprise surprise) I still have bipolar. It's a :dolphin::dolphin::dolphin::dolphin:ing joke. I'm ill and I need medication, there's absolutely nothing wrong with that, and I'd prefer to be treated like I have an illness than like I just need to do some exercise and it'll go away. In my experience even doctors are quick to dismiss genuine mental illness as lifestyle problems.
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username861942
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(Original post by JordanL_)
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I find the opposite. There's too much focus on portraying mental illness as not being a real illness, just a problem with your lifestyle.

My uni did a mental health campaign and chose the theme "healthy body, healthy mind", handing out apples and bottles of water.

I go to the gym 3 times a week, I eat well, but (surprise surprise) I still have bipolar. It's a :dolphin::dolphin::dolphin::dolphin:ing joke. I'm ill and I need medication, there's absolutely nothing wrong with that, and I'd prefer to be treated like I have an illness than like I just need to do some exercise and it'll go away. In my experience even doctors are quick to dismiss genuine mental illness as lifestyle problems.
Interesting. Personally, I have always found it the other way round. In my opinion there is a strong difference between wanting to focus less on diagnoses and a total rejection of the experiences of individuals. This social model approach aims to focus more on the experiences of an individual without trying to classify it as a certain illness. That is not saying that the person's experiences aren't real or are invalid, it just aims to view it outside of a purely medical context. I would never say to anyone that it is purely a problem with your lifestyle - lifestyle may play a part but there are many components, including trauma, life experiences and social injustice. So I am definitely not saying lets focus on just making lifestyle changes. But lets not focus just on medication. Or assume that a person definitely needs medication.
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