Discrimination and social responses to mental health problems

The way in which people with severe mental health problems are viewed by others can affect their ability to find work, develop relationships, and build the self-confidence and self-esteem that people say is essential to the recovery process.

The people we talked to spoke about the ‘stigma‘ around mental health problems, and how this affected them and made it difficult to talk about their experiences. The term ‘stigma’ refers to a characteristic of certain people that others think marks them out as different. Being stigmatised often leads to social exclusion when people discriminate against others who are different to them. Many people felt there was a stigma attached to mental illness and some people felt they were treated differently to others because of this. People recalled instances where they had felt ignored, passed over by someone, or experienced a negative judgement in terms of their capabilities. These examples indicate discriminatory behaviour towards them and raise concerns about equal treatment and human rights in the context of severe mental health problems.

Feeling that they were not being treated as an equal by mental health professionals was a concern for some of the people we talked to. You can read more about that here: Experiences with mental health practitioners: Psychiatrists, counsellors, and others. Some people recognised that they themselves often anticipated a negative response, including Jenny who said, ‘I was self-stigmatising’. This resulted in some people questioning their perception of how other people interacted with them. Alice reflected, ‘I don’t know whether I’ve become more supersensitive to the judgments that are put on me’.

Looking back to when she diagnosed with schizophrenia, Luana thought her doctor was ‘paternalistic’. She hadn’t realised you could be diagnosed with schizophrenia and still be ‘functioning and well and able to do things’.

Perceived stigma often became an issue from the moment of diagnosis. When Carlo received his diagnosis of bipolar disorder he felt the burden of an ‘added kind of weight of probably years and centuries I guess worth of perception’. Jenny was ‘terrified’ of being diagnosed as ‘schizophrenic’ because of people she’d seen on TV and on ‘the street’, whom she had previously regarded as ‘dehumanized’. Some admitted to their own confusion about mental health problems when they were first diagnosed (see also Experience of receiving a diagnosis).

People talked a lot about their discomfort or fear at letting other people know. Cindy said, ‘I don’t very much share it because I don’t want anyone to know’. Ann still had friends she hadn’t told because she thought ‘they wouldn’t get it and they’d probably treat me differently’. Ann told her parents and her brother about her diagnosis over e-mail but told them not to ask her about it.

Brendan described finding it difficult to speak to friends when he was feeling unwell. He experienced ‘shame’ and ‘guilt’ because he felt like he was letting others down.

Several people said the feeling of not being able to talk about their experience of mental health problems was based on the struggle to meet their perception of other people’s expectations of them. People worried about not meeting social expectations, or being unable to contribute to family and community life. Ann said that she felt ‘useless’ when she was unable to do household chores. She described how she also felt guilty because her husband at the time had to look after her because ‘he didn’t marry a patient’.

David felt there was stigma attached to not living up to the ‘stoic male stereotype’. He said he learnt through his illness that ‘you’re allowed to experience emotions’.

The people we spoke to talked about feeling concerned about how other people would react to finding out they took medication for severe mental health problems, had to attend therapy, or had to be hospitalised. Lisa said, ‘I felt really uncomfortable, like saying, “Well, hey, I’m going to be an inpatient”‘. Brendan felt taking medication indicated that there was ‘something wrong’. David described how he hadn’t sought therapy when he was at school because he had been fearful that ‘there’d be a bit of bullying and teasing around being at the counsellor’. In prison, Brian said you were a seen as a ‘wuss’ if you took medication.

When people did tell others, the way they responded could be upsetting, even if they meant well.

Lisa said she didn’t generally speak to people about her illness because of the responses she had received.

A few people spoke about times when they had experienced rejection from others. Vanessa described how people she knew would ‘cross the road rather than speak to [her] and none of them ever kept in touch’. Helen recalled a priest visiting the hospital where she was staying and said he went to everybody’s bed except hers. She remembers thinking that it was because she’d attempted suicide, but another priest who had helped her told her not to worry because the priest who avoided her was ‘of the old school’. Alice remembered feeling ‘judged’ by a support worker when she worked in a mental health organisation. She thought this was possibly because she had shown ‘signs of vulnerability’.

Anna didn’t think she could work because she had to take regular time off. She spoke to someone from a mental health organisation but felt they didn’t understand her problem.

A lot of people talked about how their mental health problems had affected their relationship with family members (see also Family and Friends). It could be difficult talking with parents who grew up with different ideas about severe mental health problems and how to deal with them. Taylor said she thought the older generation didn’t believe in ‘mental illness’ and instead would think, ‘Well, what have you got to be depressed about?’ Allen said his mother and uncle were ‘not very well informed’ and took a ‘One Flew Over the Cuckoo’s Nest type approach to mental health’.

When Jenny first heard voices she was ‘terrified’ she would be rejected by her family. She remembered visiting an uncle in a mental institution and thought she would end up like him.

Some people had spoken to someone close to them about being unwell and felt ‘accepted’, which was a very positive experience. Ann ‘blurted it out’ to a friend who was very supportive. She said it ‘felt like a big weight was lifted off my shoulders’.

Paddy said he didn’t like hiding his condition and tried not to judge others if they didn’t understand.

Quite a few people felt it was important for those experiencing severe mental health problems to find ways to come to terms with their experiences and be more open. Carlo described it as ‘busting out of [his] own self-stigma’. But people also identified a need to ensure better awareness and more positive media coverage of mental health problems. Allen pointed out that newspaper reporting about incidents in which mental health had been a factor could be unhelpful: ‘like “Mad loon kills person in psych ward”‘. Anna said mental health was ‘something that needs to be talked about, and talked about, and talked about, until the stigma goes’.

Evan thought people, including doctors who experienced mental health problems, should be more open about being unwell.

Luana described wanting to be a peer support worker because she thought there was a lack of positive role models for people with severe mental health problems.