Self-stigma Of Mental Illness Research Articles

The general impact of self-stigma of mental illness on adult patients with depressive disorders: a systematic review

BackgroundMental illness stigma is often common among mentally ill patients. This stigma can come from others or the patients themselves, which is called ‘self-stigma’. The present study explored the widespread impacts of self-stigma on adult patients with depression. Additionally, this review compared the severity of self-stigma levels among psychiatric disorders and to review and update thoughts about self-stigma of depression.MethodsAn etiology and risk systematic review was conducted using the Joanna Briggs Institute (JBI) approach as a guideline. The search process was performed via research databases including MEDLINE, EMBASE and CINAHL. The inclusion criteria are studies include participants diagnosed with depressive disorders, both genders, participants’ exposure to mental illness self-stigma, participants’ experience of self-stigma consequences and any geographical site or clinical settings are included, the type of the included studies must be observational studies. The included studies were limited to the English language studies that were published from 2016 and onwards. Patients with depression under the age of eighteen and patients diagnosed with multiple mental illnesses were excluded. The JBI critical appraisal checklist were adopted to assess the risk of bias.ResultsIn December 2022, a comprehensive search yielded eight cross-sectional studies that were included in this systematic review, involving a total of 783 patients diagnosed with depression, and 28 studies were excluded for not fulfilling the inclusion criteria of the review. The findings were extracted and synthesized through textual narrative synthesis into three main categories negatively affected by self-stigma of depression. These are: (1) the impact on the quality of life, (2) the impact on self-esteem and (3) the impact on self-worth. Moreover, in regard to the comparison of self-stigma levels among psychiatric disorders, self-stigma for people with schizophrenia was higher than self-stigma of depression.ConclusionSelf-stigma of depression has negatively impacted multiple aspects of the patient’s life. Thus, the review brings the following recommendations: increase community awareness, educate the healthcare providers, include the topic of mental illness stigma in academic curriculums. The main limitation of the review is the limited number of included studies.Trial registrationThe research proposal for this review has been registered to Prospero (ID number: CRD42022366555).

Samostigma med strokovnjaki na področju duševnega zdravja v Sloveniji

Public and self-stigma substantially hinder seeking of help during times of psychological distress. Stigma can occur during mental illness or be anticipated when mental illness is not yet present. An important and vulnerable group, but one that is often neglected, are professionals working in mental health field. Using a sample of mental health professionals from Slovenia (N = 93), we focused on the relationship between personal experiences of mental disorders and suicidal behavior and different types of anticipated self-stigma (mental illness and help-seeking self-stigma). About half of the participants (49%) had past or current experience of mental illness, and 56% of them sought help. One sixth of participants (16%) reported having had suicidal ideation in the past or currently, but only 20% sought help for this. Gender was not significantly related to any type of stigma. Age was negatively correlated with personal experience of mental illness and anticipated self-stigma of mental illness. Individuals with personal experiences of mental illness showed higher self-stigma of mental illness than individuals without such experiences. Self-stigma of mental illness correlated slightly with self-stigma in help-seeking. Based on the results we conclude that in mental health professionals, experiences with one’s own mental health issues are related to higher self-stigma of mental illness and this is related to higher self-stigma in help-seeking. Hence, specific interventions should be developed to destigmatize mental illness among professionals and promote help-seeking in this group. Further research is warranted.

Latent profile analysis of veterans' psychological risk and protective factors: Associations with nonroutine military discharge.

Veterans with nonroutine military discharge (NRD) often have worse psychosocial outcomes than their routinely discharged peers. However, little is known about how subgroups of veterans vary regarding risk and protective factors like PTSD, depression, self-stigma of mental illness, mindfulness, and self-efficacy, and how subgroup characteristics relate to discharge status. We applied person-centered models to detect latent profiles and associations with NRD. A total of 485 post-9/11 era veterans completed online surveys, and a sequence of latent profile (LPA) models were fitted to the data and examined for parsimony, profile separation, and substantive utility. Following LPA model selection, we applied a series of models to analyze demographic predictors of latent profile membership and associations between latent profiles and the outcome NRD. LPA model comparison supported a 5-profile solution for the data. We identified a Self-Stigmatized (SS) profile comprising 26% of the sample with mindfulness and self-efficacy below full sample averages and self-stigma, PTSD, and depressive symptoms above sample averages. Those in the SS profile were significantly more likely than a profile approximating full sample averages on indicators to report nonroutine discharge (OR = 2.42, 95% CI [1.15, 5.10]). Meaningful subgroups were present in this sample of post-9/11 service-era military veterans with respect to psychological risk and protective factors. The SS profile had over 10 times the odds of nonroutine discharge compared to the Average profile. Findings suggest that veterans most in need of mental health treatment face external barriers from nonroutine discharge and an internal stigma barrier to obtaining care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-stigma of mental illness among Latino people on the U.S.-México border.

Self-stigma of mental illness among Latino people on the U.S.-México border.

Self-stigma in suicide prevention of mental health professionals

Abstract Introduction Stigma is one of the main factors hindering help-seeking, which can have debilitating effects on mental health and even lead to suicidality. Stigma can affect the general public but also mental health professionals. In this study we examined mental-illness and help-seeking self-stigma as well as public stigma of suicidal behavior among suicidologists. Methods Invitation to participate in the study was sent to 518 member of the Internat.l Assoc. for Suicide Prevention. 89 participants (55 female, 34 male; 17% response rate) completed the survey. We gathered sociodemographic data, data on personal history of mental illness and suicidal behavior and on different types of stigma. We hypothesized that help-seeking self-stigma is predicted by sociodemographic attributes and personal history of mental illness and that self-stigma related to mental illness and suicide act as mediators. Results Personal experience with mental illness predicted mental illness self-stigma. There was no significant predictive value of other variables (age, gender, years working in suicidology) for self-stigma of mental illness and suicide behavior. Both types of self-stigma (mental illness and suicide behavior) were correlated. Mental-illness self-stigma was shown to be a stronger predictor of help-seeking self-stigma than self-stigma of suicide behavior, though the effect did not reach statistical significance. Self-stigma of suicide behavior showed no independent contribution to help-seeking self-stigma. Conclusions Mental healthcare professionals represent a particularly vulnerable group for developing mental health issues and suicidality. However, due to fear of being perceived less competent by colleagues and the public, they often disguise their mental struggles and are reluctant to seek help. These pilot findings warrant further research to better understand self-stigma and its impact on help-seeking behavior in order to prevent suicidality in this population.

Direct and indirect effects of mindfulness, PTSD, and depression on self-stigma of mental illness in OEF/OIF veterans.

Two of the most common and costly mental health diagnoses among military veterans who served in the post-9/11 conflicts in Afghanistan and Iraq are posttraumatic stress disorder (PTSD) and depression, but over half of veterans who screen positive for these problems do not seek treatment. A key barrier is self-stigma of mental illness. Mindfulness has shown promise as an explanatory variable in the context of mental health symptoms and self-stigma, but these associations are underexplored in the veterans' literature. This study examines direct and indirect effects among mindfulness, PTSD and depression, and self-stigma in post-9/11-era military veterans. A sample of 577 veterans from 3 large American cities completed surveys capturing mindfulness, symptoms of PTSD and depression, and self-stigma. A structural equation modeling approach was used to examine direct and indirect effects among study variables. Mindfulness was associated with less PTSD and depression and indirectly with less self-stigma through the PTSD pathway. PTSD was associated with more depression and self-stigma, and depression was not significantly associated with self-stigma. PTSD is strongly associated with self-stigma in military veterans, many of whom do not seek mental health treatment. Findings show that mindfulness is a promising intervention target for reducing symptoms of PTSD directly and reducing associated self-stigma of mental illness indirectly. Additional investigation of links between mindfulness, PTSD and depressive symptoms, and self-stigma in military veterans is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Anticipated Self and Public Stigma in Suicide Prevention Professionals.

BackgroundStigma about mental illness—both public and self—is one of the most important factors hindering help-seeking. Stigma can occur during an acute episode of mental illness or be anticipatory. One group affected by stigma, but often neglected, is mental health professionals. This study examined the anticipated form of mental-illness and help-seeking self-stigma and the anticipated form of public stigma of suicidal behavior among members of the International Association for Suicide Prevention. We hypothesized that suicidologists with a history of suicidality or mental illness would anticipate greater stigma from the public and self.MethodsThe study received ethical approval from the Commission for Medical Ethics of the Republic of Slovenia. Data from 83 participants who completed an online survey (February to May 2020) with informed consent were analyzed using path analysis. We tested a model predicting help-seeking self-stigma based on (i) personal experience of mental illness using anticipated self-stigma of mental illness as a mediating variable and (ii) history of suicidal behavior using anticipated public stigma of suicidal behavior as a mediating variable.ResultsPersonal experience of mental illness predicted anticipation of self-stigma of mental illness (β = 0.26). History of suicidality predicted anticipation of public stigma of suicidal behavior (β = 0.29). Anticipated self-stigma of mental illness proved to be a stronger predictor of help-seeking self-stigma (β = 0.40) than anticipated public stigma of suicidal behavior (β = 0.07).ConclusionsIt is important to intentionally support the mental health of suicide prevention professionals, as they are not immune to mental illness or various types of stigma. Because our sample was small and diverse, further research to better understand stigma concepts in this population is warranted.

A self-help app for Syrian refugees with posttraumatic stress (Sanadak): results of a randomized controlled trial

Abstract Background Syrian refugees often develop posttraumatic stress as a result of the Syrian civil war and migration stressors. However, there is a lack of adequate treatments. The smartphone app Sanadak was developed and evaluated to provide cognitive behavioral therapy-based self-help in the Arabic language for Syrian refugees with posttraumatic stress. Methods In a randomized controlled trial, eligible individuals were allocated to the intervention group (IG; app) or control group (CG; psychoeducational reading material). Data were collected during structured face-to-face interviews at 3 assessments (preintervention/baseline, postintervention/after 4 weeks, follow-up/after 4 months). Using adjusted mixed-effects models, changes in posttraumatic stress and secondary outcomes were investigated as intention-to-treat (ITT) and per-protocol (PP) analysis. Results Of 170 screened individuals (aged 18-65 years), 133 were eligible and randomized to the IG (n = 65) or CG (n = 68). Although there was a pre-post reduction in posttraumatic stress, ITT showed no significant differences between IG and CG after 4 weeks (Posttraumatic Diagnostic Scale for DSM-5, Diff -0.90, 95%CI -0.24 to 0.47; P=.52) and after 4 months (Diff -0.39, 95%CI -3.24 to 2.46; P=.79). The same was true for PP. Regarding secondary outcomes, ITT indicated a treatment effect for self-stigma after 4 weeks (Self-Stigma of Mental Illness Scale/SSMIS-stereotype agreement: d = 0.86, 95%CI 0.46 to 1.25; stereotype application: d = 0.60, 95%CI 0.22 to 0.99) and after 4 months (d = 0.52, 95%CI 0.12 to 0.92; d = 0.50, 95%CI 0.10 to 0.90). Conclusions Sanadak reduced mild to moderate posttraumatic stress in Syrian refugees, but not superior to the control condition. Therefore, Sanadak may not be suitable as a standalone treatment. However, as the app usability was very good, no harms detected, and stigma significantly reduced, Sanadak has potential as a bridging aid within a stepped and collaborative care approach.

Intersectionality, Gender, and the Self-Stigma of Mental Illness

Introduction: This study sought to examine self-stigma at the intersection of two identities: mental illness and gender. Methods: Using an MTurk panel, 100 self-identified men and women with and without mental illness (total N = 400) completed the Difference and Disdain Self-Stigma Scale. Results: Significant effects were found for mental illness (participants with mental illness reported greater perceptions of being different from the population and disdain themselves because of that) but not for gender or the interaction. Discussion: Failure to find intersectionality may reflect classic findings from social psychological research that suggests people do not necessarily diminish self-esteem because of socio-demographic identity (I am a woman or African American). Future studies need to test for an intersection effect for public stigma.

A Self-Help App for Syrian Refugees With Posttraumatic Stress (Sanadak): Randomized Controlled Trial.

BackgroundSyrian refugees residing in Germany often develop posttraumatic stress as a result of the Syrian civil war, their escape, and postmigration stressors. At the same time, there is a lack of adequate treatment options. The smartphone-based app Sanadak was developed to provide cognitive behavioral therapy–based self-help in the Arabic language for Syrian refugees with posttraumatic stress.ObjectiveThe aim of this study was to evaluate the effectiveness and cost-effectiveness of the app.MethodsIn a randomized controlled trial, eligible individuals were randomly allocated to the intervention group (IG; app use) or control group (CG; psychoeducational reading material). Data were collected during structured face-to-face interviews at 3 assessments (preintervention/baseline, postintervention/after 4 weeks, follow-up/after 4 months). Using adjusted mixed-effects linear regression models, changes in posttraumatic stress and secondary outcomes were investigated as intention-to-treat (ITT) and per-protocol (PP) analysis. Cost-effectiveness was evaluated based on adjusted mean total costs, quality-adjusted life years (QALYs), and cost-effectiveness acceptability curves using the net benefit approach.ResultsOf 170 screened individuals (aged 18 to 65 years), 133 were eligible and randomized to the IG (n=65) and CG (n=68). Although there was a pre-post reduction in posttraumatic stress, ITT showed no significant differences between the IG and CG after 4 weeks (Posttraumatic Diagnostic Scale for DSM-5, Diff –0.90, 95% CI –0.24 to 0.47; P=.52) and after 4 months (Diff –0.39, 95% CI –3.24 to 2.46; P=.79). The same was true for PP. Regarding secondary outcomes, ITT indicated a treatment effect for self-stigma: after 4 weeks (Self-Stigma of Mental Illness Scale/SSMIS–stereotype agreement: d=0.86, 95% CI 0.46 to 1.25; stereotype application: d=0.60, 95% CI 0.22 to 0.99) and after 4 months (d=0.52, 95% CI 0.12 to 0.92; d=0.50, 95% CI 0.10 to 0.90), the IG showed significantly lower values in self-stigma than the CG. ITT showed no significant group differences in total costs and QALYs. The probability of cost-effectiveness was 81% for a willingness-to-pay of €0 per additional QALY but decreased with increasing willingness-to-pay.ConclusionsSanadak was not more effective in reducing mild to moderate posttraumatic stress in Syrian refugees than the control condition nor was it likely to be cost-effective. Therefore, Sanadak is not suitable as a standalone treatment. However, as the app usability was very good, no harms detected, and stigma significantly reduced, Sanadak has potential as a bridging aid within a stepped and collaborative care approach.Trial RegistrationGerman Clinical Trials Register DRKS00013782; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013782International Registered Report Identifier (IRRID)RR2-10.1186/s12888-019-2110-y

Perceptions of difference and disdain on the self-stigma of mental illness

Background People with mental illness are viewed as different and disdained by the general population leading to public stigma. When public stigma becomes internalized, it results in self-stigma. Content-less measures of stigma have shown to benefit studying public stigma, but research on self-stigma is limited. Aims This study sought to validate the use of content-less measures (Difference and Disdain) to assess self-stigma of mental illness. Methods Participants with lived experience (N = 291) completed a survey including measures of Difference and Disdain for self-stigma and outcomes assessing depression, self-esteem, recovery and the “Why Try” effect. Factor structure of Difference and Disdain across stages of self-stigma and their effects on harmful outcomes were analyzed. Results Factor structure was not supported. Reliability analysis suggested a two-stage conceptualization of self-stigma for Difference and Disdain characterized by early (i.e. aware, agree) and late stages (i.e. apply, harm). Disdain was found to independently contribute to significant harmful outcomes, especially in the late stages. Conclusions Disdain seems to be the driver of the egregious effects of self-stigma for people with mental illness. Anti-stigma efforts should focus on stereotypes of Disdain in the future.

Rationale and design of an efficacy study of Group Prolonged Exposure for PTSD

Introduction. Among health problems in the Veteran population, the most common is posttraumatic stress disorder (PTSD) and its effect on the quality of life. Prolonged Exposure therapy, based on emotional processing theory, is a first-line treatment for reducing PTSD symptom severity when delivered in an individual format, and its efficacy is well established. The primary objective of this study is to establish the efficacy of prolonged exposure delivered in a small 3-person group modality. Quality of life should improve with decreases in PTSD symptoms such as sleep disturbance, irritability, and hypervigilance. Stigma is associated with hesitation in seeking treatment and treatment dropout. A secondary objective is to measure the effect of group treatment on reducing the stigma surrounding PTSD. Methods/design. This study is a randomized controlled trial testing the efficacy of Group Prolonged Exposure (PE) for reducing PTSD symptom severity and improving quality of life in male Afghanistan and Iraq Veterans. All participants are randomly assigned to receive Group PE or Group Present-Centered Therapy (PCT) for 10-weekly, 90-min sessions. Group PE focuses on processing trauma memories, while the goal of Group PCT is improved psychosocial functioning through management of current stressors. The primary outcome is improvement in CAPS-5 PTSD symptom severity scores and quality of life measures (WHO-QOL and SF-36) from pre-treatment to post-treatment, 3-months post-treatment, and 6-months post-treatment. A secondary outcome is reductions in perceived self-stigma of mental illness based on the Stigma Scale at baseline and follow-up points. This study is designed to expand access to this first-line treatment for PTSD by delivering PE in a small group modality while conforming to the individual PE protocol, with group treatment reducing perceived stigma of mental illness.

Difference as an indicator of the self-stigma of mental illness

Background People with mental illness are viewed as different from the general population resulting in public stigma. When public stigma becomes internalized, it leads to self-stigma. The most distal stage of self-stigma is harm which can lead to negative self-concepts that inhibit recovery. Aim This study examines how perceptions of “differentness” reflect self-stigma. We developed the Differentness Self-Stigma Scale (DSSS) to assess four regressive stages of self-stigma – awareness, agreement, application, and harm – and aimed to see whether DSSS scores predict self-stigma more effectively than the Self-Stigma of Mental Illness Scale (SSMIS). Method Participants with lived experience (N = 291) completed a survey including the DSSS, SSMIS and outcomes assessing depression, self-esteem, recovery and the “why try” effect. Results DSSS scores differed significantly from the SSMIS in the agreement and harm stages of self-stigma. Higher self-stigma scores on the DSSS harm subscale predicted lower self-esteem and higher depression scores. However, the DSSS did not demonstrate a regressive pattern between all four stages of self-stigma like the SSMIS. Conclusion The increase of DSSS scores at the application stage may be explained by perceived public stigma (i.e. how the public understands differentness). Future research should unpack the effects of perceived difference on self-stigma for the DSSS.

Knowing so much, yet knowing so little: a scoping review of interventions that address the stigma of mental illness in the Canadian context

Stigma can have detrimental effects on the health and wellbeing of individuals living with a mental illness. This scoping review describes the nature, range, and extent of intervention research aimed at reducing public and self-stigma of mental illness in the Canadian context. The review was guided by Arksey and O’Malley’s framework. A search of databases and relevant websites identified 35 primary studies. Most studies used quantitative research methods and included predominantly youth or middle-aged adults, women, and white Canadian-born people. Guided by different conceptualizations of stigma, direct or indirect contact, education, and advocacy-focused interventions, aimed to provide information, and/or develop skills to address self and public stigma. Most studies evaluated interventions’ effectiveness short-term. Of the few studies that followed-up participants long-term, some were able to reduce stigmatizing attitudes post-intervention, however, these targeted only specific groups such as students or health care professionals. Lack of diversity among the samples, and limited evidence of long-term effectiveness of interventions, were some of the studies’ limitations. What is currently known about interventions aimed at reducing the stigma of mental illness in the Canadian context is not informed by research among vulnerable groups, such as people living with a mental illness, older adults, immigrants, and people of diverse ethnic backgrounds. Interventions that are informed by clear conceptualizations of stigma and rigorously evaluated in a range of ethno-cultural groups would create a knowledge base that is useful for policy-makers, community leaders, and agencies serving various ethnic communities in Canada.

Self-Esteem, Self-Stigma, and Stigmatization among People with Mental Illness in Japan Who Have Work Experience

Self-stigma of mental illness hinders work and reduces self-esteem. The aim of the study was to examine self-esteem, self-stigma, and stigmatisation among people with mental illness in Japan who had work experience. Survey respondents were 191 patients with mental illnesses in Japan. Self-esteem and self-stigma were measured, and associations between participants’ characteristics and these variables were explored. Most study participants were males (69.1%); 103 participants had schizophrenia (53.9%). Self-esteem differed significantly by type of support facility, age at onset, psychiatric hospitalisation, income, part-time work, treatment at work, consultation, reasons for unemployment and motivations for employment. Significant negative influences on self-stigma were not living alone, not disclosing the illness to colleagues, not citing mental illness as a reason for unemployment and not working for a living. It is necessary to improve working environments to ensure that people with mental illnesses can work by introducing anti-stigma countermeasures.

Should youth disclose their mental health challenges? Perspectives from students, parents, and school professionals

Purpose – Disclosure seems to be a useful strategy for adults to deal with both the public and self-stigma of mental illness. However, youth may face a different set of risks when coming out with their experiences. The purpose of this paper is to examine youth, parent, and teacher perspectives on the costs and benefits of disclosure by middle- and high school-aged youth to better understand these risks. Design/methodology/approach – Focus groups were conducted with questions framed to elicit the different ways mental health challenges are discussed in schools and families. Findings – Surprisingly, the benefits of disclosure seemed to far outweigh the costs across groups. Benefits included ways to deal with stigma, reducing isolation, and “differentness,” as well as the pursuit of mental health services if needed. Costs included harsh responses to disclosure by peers and family members. Participants shared strategies used to minimize risk, including where and with whom youth might share their stories. Social implications – The results suggest many youth have disclosed their experiences with mental health challenges and have received mixed responses; these reactions often serve as the barometer for future disclosure decisions. Other youth are considering disclosure in a variety of settings, but are unsure how to go about it safely. Implications for addressing stigma are discussed. Originality/value – To our knowledge, this is the first qualitative research study conducted with youth about disclosure of mental illness experiences. These results will help guide modification of programming that could be beneficial in aiding disclosure decisions and reducing disclosure-related risks for youth who come out.

Diminishing the self-stigma of mental illness by coming out proud

This randomized controlled trial examined the impact of the Coming Out Proud (COP) program on self-stigma, stigma stress, and depression. Research participants who experienced mental health challenges were randomly assigned to a three session COP program (n=51) or a waitlist control (n=75). Outcome measures that assessed the progressively harmful stages of self-stigma, stigma stress appraisals, and depression were administered at pre-test, post-test, and one-month follow-up. People completing COP showed significant improvement at post-test and follow-up in the more harmful aspects of self-stigma compared to the control group. COP participants also showed improvements in stigma stress appraisals. Women participating in COP showed significant post-test and follow-up reductions in depression after COP compared to the control group. Men did not show this effect. Future research should determine whether these benefits also enhance attitudes related to recovery, empowerment, and self-determination.

Predicting Self-Esteem and Intentions to Seek Counseling

This investigation introduced the Internalized Stigma Model to test the mechanisms by which the stigma of mental illness and of seeking psychological help affect self-esteem and intentions to seek counseling. We hypothesized that both stigmas would predict decreased self-esteem, but only stigma of seeking psychological help would predict decreased intentions to seek counseling. Furthermore, we predicted that these links follow a process wherein people’s perceptions of societal stigma are fully mediated by internalization of that stigma. Public stigmas predict their respective self-stigmas, which subsequently predict self-esteem and intentions. Using structural equation modeling, we tested the hypothesized relationships in a sample of undergraduates ( N = 448). Results supported the hypotheses. Self-stigma mediated the relationship between public stigma and both outcomes; both self-stigma of mental illness and self-stigma of seeking psychological help predicted decreased self-esteem, but only self-stigma of seeking psychological help predicted decreased intentions to seek counseling.

Self-Stigma of Mental Illness in High School Youth

Despite the prevalence of mental health problems, society continues to stigmatize and discriminate against people with mental illness and in particular, schizophrenia. Among the negative consequences of stigma, is that some individuals with mental illness internalize negative stereotypes about themselves, referred to as self-stigma, which is associated with a reluctance to seek needed treatment. The challenge to overcome mental illness stigma has led to the development of global anti-stigma initiatives, which effectively engage young people in school-based programs. The present study examines the effectiveness of a single-session anti-stigma intervention with high school youth ( n = 254). The findings replicate and extend previous work demonstrating that a brief anti-stigma initiative can produce significant improvements in knowledge, social distance, and self-stigma. Self-stigma was found to be associated with low self-esteem and factors affecting self-disclosure were identified. Implications for school curricula, mental health policy, and future research are discussed.

On the Self-Stigma of Mental Illness: Stages, Disclosure, and Strategies for Change

People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result. In our article, we more fully define the concept of self-stigma and describe the negative consequences of self-stigma for people with mental illness. We also examine the advantages and disadvantages of disclosure in reducing the impact of stigma. In addition, we argue that a key to challenging self-stigma is to promote personal empowerment. Lastly, we discuss individual- and societal-level methods for reducing self-stigma, programs led by peers as well as those led by social service providers.