Stigmatisierung – das größte Hindernis bei der Behandlung psychischer Störungen?

In 2019, 970 million people had a mental health disorder globally.1 The stigma and discrimination experienced by people with mental health disorders affects not only those with a disorder, but also their families and support networks. Join us in celebrating World Mental Health Day 2021 and fighting mental health stigma.

A personal, public, and systemic issue

Stigma is a key barrier to seeking care for mental health disorders.2 Stigma, at the personal level, may lead individuals to experience shame or reduced self-esteem, and to develop a ‘why try?’ attitude to the treatment of their mental health disorder.3

Stereotypical beliefs still exist that people with mental health disorders are dangerous, incompetent, or to blame for their disorder.3 These prejudices can affect a person’s employment, housing, and healthcare prospects.3

On a systemic level, outdated legislation and policies can discriminate against people with mental health disorders.4 In many countries, people do not have access to the basic mental health care that they require.5 In other countries, the only care available is in psychiatric institutions, which can be associated with gross human rights violations.5 Outside health care, across the world, many people with mental health disorders are denied the right to vote, marry, and have children.5

Stereotyping plays a large role in the stigma surrounding mental health disorders3

  Who is most affected by stigma?

Stigma is an important issue for everyone affected by mental health disorders. However, stigma related to mental health disorders can be exaggerated in certain populations.

Associations between stigma and help-seeking behaviour may disproportionately affect certain cultures due to factors such as perceived shame, desire to protect family reputation, and personal dignity.2,6

Gender disparities also exist, with men more likely to report feelings of personal stigma associated with their mental health disorder.7 People identifying as LGBTQI+ may face a lack of awareness and sensitivity towards their mental health needs by healthcare practitioners.8

Stigma can prevent people from seeking and accessing help, especially vulnerable groups and marginalised populations8

  Stigma in the clinic

Healthcare practitioners should be aware that they can inadvertently exacerbate stigma in the clinic.3 For instance, patients have identified that, by focusing on the disorder rather than the person, doctors may become the source of the stigma.3

Additionally, some healthcare practitioners have been found to endorse, rather than expel, harmful stereotypes about mental health disorders, and to adopt a pessimistic attitude to treatment.3

Resource provision within the clinic and signposting towards other useful sources of information can equip patients with the knowledge and skills to discuss their mental health with confidence. Empowering patients through mental health literacy helps to normalise conversations about mental health and, ultimately, reduce the stigma surrounding mental health disorders.3

References

  1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396(10258):1204-1222.
  2. Clement S, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med 2015;45(1):11-27.
  3. Corrigan PW, et al. The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychol Sci Public Interest 2014;15(2):37-70.
  4. Henderson C, Gronholm PC. Mental Health Related Stigma as a 'Wicked Problem': The Need to Address Stigma and Consider the Consequences. Int J Environ Res Public Health 2018;15(6):1158.
  5. Organisation mondiale de la santé. Mental health, human rights & legislation. A global human rights emergency in mental health. Disponible sur : https://www.who.int/health-topics/mental-health#tab=tab_1, accès le 1 juin 2021.
  6. Javed A, et al. Reducing the stigma of mental health disorders with a focus on low- and middle-income countries. Asian J Psychiatr 2021;58:102601.
  7. Judd F, et al. How does being female assist help-seeking for mental health problems? Aust N Z J Psychiatry 2008;42(1):24-29.
  8. Nakkeeran N, Nakkeeran B. Disability, mental health, sexual orientation and gender identity: understanding health inequity through experience and difference. Health Res Policy Syst 2018;16(Suppl 1):97.