Stigma

General public definition

• Stigma is currently not listed as a diagnosis in the DSM-5-TR or ICD-11.
• Stigma is a set of highly negative ideas and beliefs that society has about something. To be stigmatized means to be symbolically marked as a disgrace.
• Mental illnesses are among the most highly stigmatized conditions in society. When a health condition is stigmatized, the person experiences not only the symptoms of the condition itself, but also the social rejection, disapproval, and the shame that the stigmatization creates.
• Because mental illnesses often have no physical manifestations, that is, they are “invisible,” people are not readily confronted by their attitudes and beliefs about them. This invisibility also encourages those who are experiencing mental illnesses and mental health conditions to continue to hide and remain silent about their condition, which adds to their feelings of shame and can prolong the stigmatized beliefs and attitudes about the condition.
• In the past few years, public health campaigns on mental illness and mental health, as well as the accounts of public figures who have been open about their mental health struggles, have helped to decrease the stigma surrounding mental illness.
• There are four types of mental health stigma:
  • Structural stigma is when organizational policies and practices are unfair to people with mental disorders.⁶⁵
  • Public or interpersonal stigma is when the public think or act negatively toward people with a mental disorders.⁶⁶
  • Self-stigma occurs when people with a mental disorder believe the negative public views and apply these views to themselves.⁶⁷
  • Stigma-by-association is when those close to or related to the stigmatized group (such as family, friends, or mental health providers) are also stigmatized.⁶⁸

Academic definition

• Stigma is currently not listed as a diagnosis in either the DSM-5-TR or ICD-11.
• “In ancient Greece, citizens pricked marks on their slaves using a pointed instrument, both to demonstrate ownership and to signify that such individuals were unfit for citizenship. The ancient Greek word for prick is ‘stig,’ and the resulting mark, a ‘stigma.’ In modern times, stigma is understood as an invisible mark that signifies social disapproval and rejection.”⁶⁹ Nowadays, to be stigmatized means to be symbolically marked as a disgrace.
• “Stigma is deeply discrediting and isolating, and it causes feelings of guilt, shame, and inferiority and a compulsion to hide or a wish for concealment.”⁶⁹
• Mental illnesses are among the most highly stigmatized conditions in our society. When a health condition is stigmatized, the person experiences not only the symptoms of the condition, but also the social rejection, disapproval, and shame that the stigmatization creates.
• A broad definition of stigma that includes multiple interrelated elements most closely fits the day-to-day experiences of people with mental health conditions.

1. • The first element involves the identification and labelling of socially salient differences (i.e. a mental illness).
   • Next, the label is linked to one or more negative stereotypes, for example, that people with PTSD are violent and unpredictable.
   • Once labelled, people are placed into a distinct social category and seen as separate from the norm (“us versus them”). They are no longer considered unique individuals but part of a homogeneous group sharing undesirable characteristics.
   • Once categorized in this way, stigmatized people experience discrimination and loss of status, which leads to social inequities in many areas of life.⁷⁰

• There are four main types of stigma:
  • Structural stigma reflects the accumulated policies and practices of organizations that intentionally or unintentionally create social inequities for people with mental disorders.⁶⁵
  • Public or interpersonal stigma reflects the negative attitudes and behaviours of members of the general public toward people with mental disorders.⁶⁶
  • Self-stigma occurs when people with mental disorders and other mental health conditions internalize the stigmatizing views of the public and apply them to themselves. As a result, they may experience diminished worth, lowered self-esteem, disempowerment, poor morale, and lowered quality of life.⁶⁷
  • Stigma-by-association occurs when negative public reactions are transferred to those close to the stigmatized individual, including the services and supports, such as mental health providers, mental health programs, and mental health research.⁶⁸

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