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Stigma and Discrimination

Discrimination: The way people living with mental illness are treated, intentionally or unintentionally, due to stigma. People with mental illness are often treated with disrespect, experiencing such behaviours as exclusion, bullying, aggression, ridicule and devaluation. Such discrimination can result in limits and barriers to many of life’s opportunities.[1]

Stigma: The negative and prejudicial ways in which people living with mental illness are labelled. Often that means being labelled as nothing more than the disease itself. Stigma is an internal attitude and belief held by individuals, often about a minority group such as people with mental illness.[2]

  • 50 percent of Canadians would tell friends or co-workers that they have a family member with a mental illness, whereas 68 percent would disclose a family member’s diagnose of diabetes and 72 percent for cancer.[3]
  • 12 percent of Canadians said they would hire a lawyer who has a mental illness.[4]
  • 49 percent of Canadians say that they would socialize with a friend who had a serious mental illness.[5]
  • 46 percent of Canadians think people use the term mental illness as an excuse for bad behaviour.[6]
  • 27 percent are fearful of being around people who suffer from a serious mental illness.[7]

In the workplace, attitudes toward mental health and mental illness make a big difference for all employees but especially for those experiencing mental health issues.

Mental illness is often called an invisible illness. Often, the only way to know whether someone has been diagnosed with a mental illness is if they tell you. The majority of the public is unaware of how many mentally ill people they know and encounter every day. And, mental illness doesn’t discriminate; anyone can develop a mental illness or experience poor mental health (languishing). People facing these issues often face discrimination due to stigma.

An organization may need to address stigma and discrimination before its members would be willing to talk about mental health and to make positive changes. Mental health literacy in the workplace is critical to combating stigma.[8]

Self-stigma, or embarrassment about having a mental illness, often keeps people from seeking treatment for what is often a very treatable illness. Organizations that are committed to the mental health of their employees are pro-active in implementing policies and programs that promote the positive mental health of employees and support early identification, treatment and recovery of employees experiencing mental illness.

The consequences of stigma

Stigma is deeply discrediting and isolating and causes feelings of guilt, shame, inferiority and a wish for concealment.[9] Canadians acknowledge that they exhibit stigma towards people with serious mental illnesses such as schizophrenia.[10] Stigma and discrimination in the workplace causes negative repercussions for individuals experiencing mental health problems as well as for the rest of the staff team. Some of the negative repercussions include:[11]

  • delayed access to treatment that promotes disability and impedes recovery;
  • weakened social support;
  • hindered social integration;
  • the prevention and obstruction of the performance of social roles;
  • reduced quality of life;
  • diminished self-esteem;
  • increased unemployment.

Anti-stigma: knowing the facts and speaking with dignity and respect[12]

Stigma is not just a matter of using the wrong word or action. Stigma is about disrespect. It is a personal attitude and belief that negatively labels a group of people, such as those with mental illness. Stigma creates fear and consequently results in discrimination which discourages individuals and their families from getting the help they need. One study found that 30 percent of people who experience mental illness have experienced stigma in the workplace.[13]

Anti-stigma: speaking with dignity and respect

There are many ways to describe people; some are respectful, sensitive and provide dignity, while others do not. It is important that organizations ensure everyone within a workplace is treated with respect. Often people are unintentionally or intentionally exposed to stigma through words. The following are some examples of ways to show sensitivity through words:[14]

Do… Do NOT…
  • Use respectful language.
  • Emphasize abilities, not limitations.
  • Refer to the person not the disability or illness (e.g., “person with schizophrenia” rather than the “schizophrenic”).
  • Tell people when they express a stigmatizing attitude.
  • Portray successful people with disabilities as the exception.
  • Use generic labels such as “retarded” or “the mentally ill.”
  • Use term like “crazy,” “lunatic,” “manic depressive,” or “slow functioning” in general conversation and much less when speaking to the individual with a lived experience in mental illness. The term “insane” (unsound mind) should only be used in a strictly legal sense.
  • Stigma and Mental Illness, by CMHA, Ontario, provides organizations with more information on stigma, its effects, and how to stop it. See http://www.ontario.cmha.ca/fact_sheets.asp?cID=2795.
  • Stigma: The Facts, by the Mental Health Commission of Canada, provides a brief printer ready PDF describing stigma and its effects.
  • A Way with Words and Images is a resource developed by Human Resources and Skills Development Canada to provide information on how to speak with dignity. See http://www.hrsdc.gc.ca/eng/disability_issues/reports/way_with_words/page09.shtml .
  • Stigma: Understanding the Impact of Prejudice and Discrimination on People with Mental Health and Substance Use Problems is a PDF brochure by CAMH. See http://www.camh.net/Care_Treatment/Resources_clients_families_friends/stigma_brochure.pdf .

[1] Mental Health Commission of Canada, “Countering stigma and discrimination: Operational plan” (Mental Health Commission of Canada 2008).

[2] Ibid.

[3] Canadian Medical Association, “8th Annual National Report Card on Health Care,” (2008) http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Annual_Meeting/2008/GC_Bulletin/National_Report_Card_EN.pdf (accessed January 6, 2010).

[4] Ibid

[5] Ibid

[6] Ibid

[7] Ibid
[8] Canadian Alliance for Mental Illness and Mental Health (CIMIMH), “National integrated framework for enhancing mental health literacy in Canada,” (2008) www.camimh.ca/mental_health_literacy.html (accessed January 6, 2010).

[9] Erving Goffman, Stigma: Notes on the Management of Spoiled Identity (Englewood Cliffs, NJ: Prentice-Hall, 1963).

[10] Heather Stuart and Julio Arboleda-Florez, “Community Attitudes toward People with Schizophrenia,” Canadian Journal of Psychiatry 46 (2001):245.

[11] Heather Stuart, “Stigma and Work,” Healthcare Papers 5 (2004): 100.

[12] SAMHSA, “Anti-Stigma: Do You Know the Facts?” Mental Health Information Network, (1999) http://mentalhealth.samhsa.gov/publications/allpubs/OEL99-0004/default.asp (accessed Sept 18th, 2009).

[13] Sarah Wright and Paul De Ponte, “Pull yourself together: A survey of people’s experience of stigma and discrimination as a result of mental distress.” Mental Health Foundation, (2000) http://www.mentalhealth.org.uk/search/?q=Pull+Yourself+Together (accessed January 6, 2010).

[14] Modified from:  Human Resources and Skills Development Canada, “A Way with Words and Images,” (2006). http://www.hrsdc.gc.ca/eng/disability_issues/reports/way_with_words/page08.shtml (accessed: September 11, 2009).