Mental Health, & Stigma as a Barrier to Social Support
Jill Stoddard
Written by Lauren Helm, M.A.
In honor of the National Alliance on Mental Illness (NAMI) San Diego's Mental Health Awareness Walk, this blog delves into the importance of social support for those with mental illness, and how stigma may become a barrier to the support that is needed by so many.
image source: http://blogs.princeton.edu/aspire/2012/04/group_hug.html
Social Support
The support we receive from others in our lives can significantly impact our wellbeing. A large number of studies have found that social support reduces and buffers (prevents) stress, thereby leading to numerous psychological and physical benefits. In fact, the quality of the social support that we receive has been linked to the appearance and duration of illness and disability, mortality rates, and psychological soundness (Berkman, 1995; Lin, Ensel, Simeone, & Kuo, 1979; see review by Uchino & Kiecolt-Glaser, 1996).
Our social networks often provide support by offering useful resources, such as emotional, informational, material, or tangible support, which help us in dealing with stress (Cohen, 2004). Stressful life circumstances have been found to have detrimental effects on our health if we do not manage them well, and social support from others helps to reduce the negative effects that stress can have on overall health (Berkman, 1995).
Individuals who have been diagnosed with a mental disorder can be quite vulnerable to experiencing an increased risk of distress, anxiety, and depression (Carter, Mackinnon, Copolov, 1996; Huang, Sousa, Tsai, & Hwang, 2008) often due to mental disorder-related stressors (Carter et al., 1996), and they may be particularly in need of the stress-buffering effects of social support from those in their lives.
In fact, studies have found that social support may even help improve the outcome of mental disorders (Huang et al., 2007; Warren et al., 2007). For example, social support has been linked to the occurrence of mental disorder symptoms. Higher levels of social support are related to improved psychological functioning (Warren et al., 2007), better integration into the community, and less psychological hospitalizations (Huang et al., 2007). The wellbeing of those with mental disorders is greatly influenced by their access to beneficial social support.
Stigma as a Barrier to Social Support
Social interactions, like social support, can alter the course of our health and functioning, and thus alter the course of our lives. Social support can have a multitude of positive effects on health, for the general population and for those experiencing a mental disorder.
However, negative social interactions can have an equally large effect on health in a much less desirable way. Negative social interactions, such as when others withdraw social support, can increase our risk for disease, our stress levels, and our experience of psychological despair (Cohen, 2004). Furthermore, the withdrawal of social support can lead to maladaptive coping and feelings of low-self esteem and competence in the face of stressful circumstances (Schreurs & de Ridder, 1997).
Given that social support may be an essential factor in the recovery and reduction of symptoms for those that have a mental disorder, it is important to take into account what factors may serve as barriers to social support.
One possible barrier to social support is stigma. Stigma is a mark of deviance from social norms. Stigmatized individuals are often classified as “outcasts” who are perceived as deserving less of the benefits that society offers (Cumming & Cumming, 1965; Fife & Wright, 2000; Goffman, 1963; Jones, Farina, Hastorf, Markus, Miller, & Scott, 1984).
Individuals who are stigmatized are looked down upon by society and lose social status (Cumming & Cumming, 1965). Social rejection makes it difficult for stigmatized individuals to continue to interact with their social world, and often those who are stigmatized become socially isolated (Goffman, 1963; Jones et al., 1984), which puts them at risk for developing a negative sense of self, low feelings of competence, and low feelings of control (Goffman, 1963).
Ultimately, stigma impairs the well-being of “outcast” individuals because it acts as a barrier to important types of social interactions and resources and becomes a source of stress within itself.
Since those with mental disorders are often categorized by society as “different,” they become stigmatized and thus denied the societal resources that are needed to achieve an optimal outcome with their disease (Roeloffs, Sherbourne, Unutzer, Fink, Tang, & Wells, 2003). Negative attitudes towards those with mental disorders are common, and discriminatory labels such as “psycho” or “loony” directed at still occur to this day (see review by Putnam, 2008).
The stigma that those with mental disorders experience is evidenced by not only the negative labels they receive, but also by the behaviors and beliefs that others hold towards individuals with a mental disorder. Crisp, Gelder, Rix, Meltzer, and Rowlands (2000) found that people prefer to keep their distance and avoid interactions with those with mentally illness.
Fear and misunderstanding color the general public’s justification for rejecting individuals with mental disorders. People hold numerous negative misconceptions of those with mental disorders, believing that those with mental disorders are “to blame for their disease,” “weak,” and “don’t deserve sympathy” (Putnam, 2008, p. 688).
Furthermore, people frequently hold beliefs that those with mental disorders or mental illness are likely to be violent, even though research has found that generally, those with mental illness are not more likely to be violent, and are actually more likely to be the victims of violence than who do not have a mental disorder (Crisp et al., 2000; Putnam, 2008).
Unfortunately, individuals with a mental disorder often feel the unfair sting of social distance. Findings have provided overwhelming evidence that the widespread negative attitudes of the public reinforces the stigmatization of mental disorders and causes increased distress (Putnam, 2008) and social isolation (Crisp et al., 2000) for those who have mental disorders. If those who experience mentally disorders are kept at a distance from the rest of society, their ability to receive quality social support is greatly at risk.
By being labeled as “different,” these individuals have a decreased chance of managing their disorder, and succeeding with their lives. Studies have found that those with mental disorder report receiving much less social support than those without mental illness (Kilbourne, McCarthy, Post, Welsh, & Blow, 2007).
Because social support plays a potentially crucial role in the improvement of symptoms and the recovery from disease, it is imperative that we continue to find ways to effectively reduce mental health stigma.
Learn more about initiatives that combat mental health stigma:
https://www.nami.org/Find-Your-Local-NAMI
If you or a loved one would like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety or depression, please click here.
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