by Briona Adams

Anyone who has had experience with mental illness, personally or professionally, can tell you that despite advances in psychiatry and psychology, there is a great deal of stigma that remains. One needs to only think of the book and movie One Flew Over the Cuckoo's Nest to get a feel for that stigma. The field of mental health has made some distance since that time, but the stigma continues to be a reality.

Types of Stigma

The stigma associated with mental illness can be divided into two types: social stigma, which involves the prejudiced attitudes that others have around mental illness; and self-perceived stigma, which involves an internalized stigma that the person with the mental illness suffers from. Both are very real.

A review of studies on the public stigma of mental illness shows that it is still widespread, even as the public has become more aware of the nature of different conditions. While the public may accept the medical or genetic nature of a condition and the need for treatment, many people still have a negative view of those with mental health conditions.

Perceived stigma leads to an internalized shame about having a mental illness. It has been found in a long-term study that this sort of internalized stigma leads to poorer treatment outcomes.

A Brief History

Mental illness has a long history of being stigmatized in societies around the globe. From being thought of as the mark of the devil to being considered a moral punishment, the ideologies around the etiology of mental illness have had a wide range. As a result, treatment has historically not always made scientific sense and has been brutal and inhumane. Dating back to Neolithic times, trephining, for example, involved chipping a hole in the person's skull to release the evil spirits.

Treatment of mental illness has come a long way since then, but the fields of psychology and psychiatry are relatively young ones and have a long way to go. Stigma has arisen out of fear and a lack of understanding. It has persisted even with greater knowledge about the biochemical and genetic natures of different conditions. As scientists continue to learn more about the causes of mental illness and develop effective treatment, it is hoped that stigma will decline.

The Effects

The effects that stigma has on people with mental illness and their families are extensive. With stigma comes a lack of understanding of important others, which can be invalidating and painful. This can lead to isolation and shame. Stigma can also lead to harassment, bullying, and even violence. People with mental illnesses have faced discrimination in seeking employment and even housing. Stigma also prevents people from seeking help or getting treatment, and as a result, their symptoms become worse and more difficult to treat.

How to Cope

If you have a mental illness, know that you are not alone. One in four Americans has a mental illness of some kind. Whatever you do, stay connected to others and get support. Organizations such as the National Alliance on Mental Illness (NAMI) offer educational and supportive resources for people and families who are affected by mental illness. Get treatment so that you can experience reduced symptoms and a better quality of life.


If you do not have a mental illness, educate people around you about the reality that mental illness is more common than people realize and speak out against stigma. Debunk myths about mental illness such as the idea that people with schizophrenia are usually violent. If a family member or friend makes a disparaging remark about someone with a mental illness, educate them and have a no tolerance policy. While stigma continues to exist, it can be eventually eliminated with greater education and awareness about mental illness.

Written By: Jenev Caddell, PsyD