Challenging Stigma

Apr 13, 2013 | 2013 Articles, Mental Health, Muffy Walker

by Muffy Walker, MSN, MBA

Muffy Walker, of the International Bipolar Foundation, writes a mental health column for KRL every other month.

Stigma, although powerful, does not have to be inevitable. Countries around the world are joining forces to combat stigma and its harmful effects. Anti-stigma campaigns, legislation, public education, mobilizing communities in anti-stigma efforts, and personal commitments to end stigma are all underway. Changing the belief systems of those who inflict stigma is only one aspect to producing change, the second of which is to challenge the internalized negative beliefs of the stigmatized.

Why should we be concerned?

Mass media are those sources that reach vast audiences on a daily basis and include television, film, radio, newspapers, advertising, and the Internet:

• The average American watches 4 hours of TV each day.
• 1.36 billion movie tickets were sold in 2008.
• 1.71 million DVDs were rented and over one billion sold in 2007.
• The average Internet user spends 61 hours/month on the Internet (February ?2009) (8) Mass media tend to inaccurately show people with mental illness as violent & dangerous.
• “Dangerousness is the most common theme of newspaper stories related to mental illnesses.” (1)

One study of prime time television programming found that people depicted with mental illnesses were 10 times more likely to be shown as a violent criminal than non-mentally disordered television characters.(2) Not only does the media depict criminals as being mentally ill, they further expound on the stigma by showing the mentally ill as unlikely to recover. Use of cartoons, advertisements, and films ridicule the mentally ill and make light of their issues. Journalists in all forms of media play an increasingly important role in shaping public understanding and debate about health care issues. The Rosalynn Carter Fellowships for Mental Health Journalism program, created in 1996, is part of a national effort to reduce negative attitudes and discrimination associated with mental illnesses. The fellowship program aims to increase accurate reporting on mental health issues; help journalists produce high-quality work that reflects an understanding of mental health issues through exposure to well-established resources in the field; and develop a cadre of better-informed print and electronic journalists. (3)

Unfortunately, a joint study by Indiana University and Columbia University researchers found no change in prejudice and discrimination toward people with serious mental illness or substance abuse problems despite a greater embrace by the public of neurobiological explanations for these illnesses. (4)

Recent research has found that:

• 48.6 percent of the public are unwilling to work closely on a job with someone with depression.
• The percentage of people associating mental illness with violence has doubled since 1956. (5)

“Prejudice and discrimination in the U.S. aren’t moving,” said IU sociologist Bernice Pescosolido, a leading researcher in this area. “In fact, in some cases, it may be increasing. It’s time to stand back and rethink our approach.”

“Often mental health advocates end up singing to the choir,” Pescosolido said. “We need to involve groups in each community to talk about these issues which affect nearly every family in America in some way. This is in everyone’s interest.”

The research article suggests that stigma reduction efforts focus on the person rather than on the disease, and emphasize the abilities and competencies of people with mental health problems. Pescosolido says well-established civic groups–groups normally not involved with mental health issues–could be very effective in making people aware of the need for inclusion and the importance of increasing the dignity and rights of citizenship for persons with mental illnesses. (6)

Combating stigma

So, what can we do to combat stigma? SAMHSA has a “4-Ps” approach: Praise, Protest, Personal Contact & Partnership. Here are some specific do’s and don’ts:

1. In a recent survey by the American Psychiatric Association, 79% percent of those surveyed believed that seeking and receiving support from family and friends reduced feelings of stigma.
2. Share your experience with mental disorder. Your story can convey to others that having a mental disorder is nothing to be embarrassed about.
3. Help people with mental disorder reenter society. Support their efforts to obtain housing and jobs.
4. Watch the language you use:
a. don’t use generic labels:“retarded”, “our mentally ill”
b. don’t use psychiatric diagnoses as metaphors: “schizophrenic situation”
c. don’t use offensive words: “psycho”, “loony”, “crazy”, “wacko”, “slow”, “crackpot”
d. don’t refer to a person as a diagnosis: “he’s bipolar”, instead say, “he has bipolar disorder”
5. Document stigma in the media whenever possible
6. The media also offers our best hope for eradicating stigma because of its power to educate and influence public opinion, so remember to thank journalists when they get it right.
7. Send letters, make phone calls, or e-mail the offending parties
8. Ask your local, regional, and national leaders to take a stand
9. Support efforts to actively expose stigma in the media
10. Educate yourself – the elimination of stigma begins with you
11. Volunteer, join a campaign

(1): Wahl, O., Wood, A., & Richards, R. (2002). Newspaper coverage of mental illness: Is it changing? Psychiatric Rehabilitation Journal, Vol. 6, 9-31.

(2): Don Diefenbach (2007). Journal of Community Psychology, Vol. 35, 181-195.


(4): Pescosolido, B.A., J.K. Martin, J.S. Long, T.R. Medina, J. Phelan, B.G. Link. 2010. ‘A Disease Like Any Other?’ A Decade of Change in Public Reactions to Schizophrenia, Depression and Alcohol Dependence. American Journal of Psychiatry 167(11):1321-1330.

(5): Link, B.G., Phelan, J.C., Bresnahan, M., Stueve, A. & Pescosolido. B.A. (1999). Public conceptions of mental illness. American Journal of Public Health, Vol. 89, 1328-1333.

(6): Pescosolido, B.A., J.K. Martin, J.S. Long, T.R. Medina, J. Phelan, B.G. Link. 2010. ‘A Disease Like Any Other?’ A Decade of Change in Public Reactions to Schizophrenia, Depression and Alcohol Dependence. American Journal of Psychiatry 167(11):1321-1330.

(7) Ghanean, H., Nojomi, M., Jacobsson, L. Internalized stigma of mental illness in Tehran, Iran. Stigma Research and Action, North America, 1, Feb. 2011.

Check out KRL’s Mental Health section for more mental health related articles.

Muffy Walker was born and raised outside of Philadelphia, PA. She currently resides in Rancho Santa Fe with her husband John C. Reed and their three sons. In 1983, Walker graduated with a Master’s of Science in Psychiatric Nursing from the University of Pennsylvania. She worked in the mental health field for over 18 years until she moved to California when she obtained her MBA with a focus in marketing from the University of California-Irvine. Walker is the founder and President of International Bipolar Foundation (IBPF). After learning that her youngest son had Bipolar Disorder, Walker joined other mental health boards and ultimately started IBPF. She has served on a plethora of boards including Children’s Hospital, Kids Korps USA, NeighborHelp, ChildHelp USA, and has dedicated the past 10 years of her life championing the education of the public about mental illness.

1 Comment

  1. The admitting nurse at the mental health hospital my son was being put in, mumbled under her breath, “Wow, that’s crazy. ” referring to what my response was when asked the family background, history, etc. Something I found/find incredibly disturbing-especially given her profession.


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