Stigma has serious health and social consequences

Link: Stigma has serious health and social consequences


· Mental illness and addiction is common (one in five Canadians) however because of stigma and the fear of discrimination only one third seek treatment. [ii]

· People deny painful symptoms and are reluctant to seek help at an early, more treatable phase of their condition, resulting in delays in beneficial treatment making treatment more complicated, less effective resulting in greater disability.

· The drop-out rate for psychiatric treatment is estimated to be one half because people do not want to be seen attending psychiatric treatment - leading to relapse and greater disability. [iii]

· People with mental illness and addictions often hold the same negative attitudes of society at large and blame themselves for their illness and the resulting social and economic losses.

· The major way people cope with the effects of self-stigma and shame is by withholding information from family, friends, employers and treatment providers, leading to feelings of emptiness, alienation and rejection which can further trigger depression and substance abuse and relapse. [iv]

· Consumers expect to be rejected by the community. This perception interferes with their sense of belonging and is more acutely felt by those with less social support and greater social skills deficit. [v]

· Stigma, discrimination and the resultant social withdrawal has been found to have a greater impact on the quality of life than the actual symptoms of illness. The loss of friendships and socio-economic status affects people long after their symptoms are treated.

· The elderly experience the double stigma of being old and mentally ill. Although they have high levels of illness they are also the least likely to seek medical treatment because of feelings of embarrassment and shame. They also have the lowest rates of detection of a mental illness because the belief that depression and anxiety are a normal part of the aging process[vi].[vii]

· Family members are also harmed by stigma and are blamed for causing or contributing to the illness with the result that they will also withdraw from social engagement, become isolated and experience higher levels of depression, anxiety and substance abuse.[viii]
· Community attitudes and discriminatory behaviours can negatively influence the degree and speed of recovery.

· Mental Health professionals are also stigmatized holding a diminished status in the eyes of other medical professions making recruitment challenging.[ix], [x]

· Many mental health professionals share negative attitudes towards people with mental illness and addictions and hold a reduced belief in their capacity to work, cope with stress, achieve advanced education or make a contribution to their community. These diminished views contribute to propagating self-stigma.

· The diminished attitude towards consumers is applied to self-help and peer-support programs. Identified as an element of ‘best practice’ this modality is ignored by clinicians, consistently under-funded by governments, and an under researched area of practice.

· People with mental disabilities suffer “double disadvantage”, having to cope not only with the disability itself, but with the added burdens of compromised health and inaccessible, inadequate health-related services. People with mental illness and addictions are less likely to be treated for medical conditions and research identified that they are more vulnerable to poverty and not treated equitably across health care systems.[xi], [xii]

· Institutions, governments and policy makers also contribute to stigma by systematically under-funding mental health and addictions services proportional to their degree of prevalence, morbidity and mortality.

· Discrimination towards people with mental illness and addictions is widespread resulting in diminished employment opportunities and educational opportunities including unemployment, lack of career advancement, hostility in the workplace resulting in increased self-stigma and increased disability. Although most people with mental illness and addictions are willing and able to work the rate of unemployment is estimated to be between 80% and 90%.[xiii]

· Discrimination is also experienced through a loss of human rights including forced treatment, finding or keeping housing, the right to parent, access to loans, immigration, denial of insurance coverage, and over representation in the criminal justice system.

· Stigma contributes to persistent under-funding of research and treatment services. Despite extremely high burden of illness, research funding has lagged behind other diseases such as cancer and heart disease when considering morbidity and mortality. This is particularly true in research about addictions and co-occurring disorders. [xiv]

· Canada’s Aboriginal, Inuit and First Nations Communities suffer a disproportionate burden of the stigma and discrimination of mental illness, mental health and addictions that exists.

· Stigma and discrimination occurs in many different guises throughout Canada, in our urban centres, our rural communities, our ethnic communities, among others and thus, regional consultations are a necessity.