Stigma On Mental Illness Around The World

Just a year ago, I learned that my great-aunt had passed away. Before that day, I hadn’t even known I had a great-aunt. Allow me to elaborate.

According to the limited information my mother knew and decided to tell me, my great-aunt had been living in a psychiatric hospital for decades. It had been kept a secret, and no one talked about it. But she was there, living and breathing. Nearly fifty years ago, my great-aunt was diagnosed with an undefined mental illness. She was forced to quit her job, and her family, including her brother, my grandfather, made the decision to put her in a hospital. At that time, many people living in Japan were not well-informed about mental illnesses, and there was a general stigma towards individuals with mental illnesses. My grandfather and his conservative Japanese family kept her existence a secret from my grandmother, perhaps out of fear that she wouldn’t marry him if she knew. Only after my grandmother was married to my grandfather did she eventually learn about her sister-in-law in a psychiatric hospital. And still, the entire family kept silent. They kept the secret so well that her grandnephew did not even know she lived until after she died.

Today, people are more accepting and knowledgeable about mental illnesses. However, the social stigma attached to mental illnesses still persists. The World Health Organization (WHO) identifies this stigma towards individuals with mental handicaps as “the single most important barrier to overcome in the community.”

Attitudes towards mental illnesses differ across individuals, ethnicities, and cultures. Oftentimes, religion can be a large influence that shapes a culture’s perception on mental illnesses. A society’s view on mental illnesses has a monumental impact on people with mental illnesses. If an individual with a mental health problem is living in an environment where mental illness is viewed in a negative light, he or she may be unwilling to seek for help.

It is not an exaggeration to say that the stigma societies hold toward mental health issues worsens mental health issues. Such societies inhibit suffering individuals from coming out asking for help, because they fear the response of others to themselves, once they have been labeled “mentally ill.” Because these individuals do not disclose their mental health, societies do not recognize how common mental health problems are. As a result, many individuals fall into a vicious, negative spiral of mental illness, feeling isolated, and afraid of being isolated.

It is believed that one out of every four people will experience mental health problems within their lifespan, and 450 million people worldwide have a mental health problem. With more education on mental health and treatment, societies can eliminate social stigma towards mental illness. A study on patients with mental health problems conducted by the World Mental Health Surveys revealed that 22.1% of participants from developing countries and 11.7% of participants from developed countries experience some form of anxiety or discrimination due to their mental illnesses. However, the authors believe these numbers understate the true level of stigma associated with mental illnesses, as the data collected was evaluated only by mood changes and anxiety levels.

The difference in perceived stigma between developing and developed countries may result from a difference in education in the general population about mental health and mental health problems. However, stigma towards mental illness does not only depend on the society’s economic status. For instance, many Asian countries, Japan included, have a negative view on mental health problems. This may be due to cultural emphasis on “conforming to norms, emotional self-control, [and] family recognition through achievement.” In such societies, mental illness is viewed as a weakness of the mind, as an embarrassment. Because of the strong relationship between individual and family, an individual with mental health problems may be thought to bring shame upon their family, causing him or her to suffer from unwarranted guilt, worsening his or her mental health further. Even within the United States, there are cultural differences in the perception of mental health problems. In 2010, Carpenter-Song et al. conducted a study on 25 severely mentally ill individuals in Hartford, Connecticut. European American patients seemed more eager to seek from experts in mental health care, as they had biomedical perspectives on mental illnesses. However, African American and Latino patients often sought a less-medicinal approach to mental health problems. The latter ethnic groups perceived more stigma towards mental illness, and viewed medical treatment as “potentially very damaging,” and they were less likely to seek help from health care services.

It may be important to note that cultural perspectives on mental health care may be very different from the biomedical perspective. A study was conducted comparing the perspective on mental illnesses that Indian university students had and American university students had. Indian students were more inclined to view depression as a personal issue that could be fixed and confronted not with medication, but with social interaction and relaxation.

Attitudes towards mental illness greatly differ among cultures for various reasons. As a result, it is crucial to create mental health care programs that account for the many different perspectives of mental health among cultures and help individuals with mental illness through culturally-sensitive methods. This starts with helping suffering individuals understand that they are not alone in their struggle with mental health, and improving general understanding about mental illness and treatments.

References:

  • https://www.psychologytoday.com/blog/culture-in-mind/201109/the-culture-mental-health

  • http://www.uniteforsight.org/mental-health/module7#_ftn7

  • https://www.mentalhealth.org.uk/a-to-z/s/stigma-and-discrimination

  • https://www.everydayhealth.com/depression/mental-health-stigma-and-prejudice-strong-around-the-world-8505.aspx

Mary Yoshikawa