Our attitude to mental health is hurting us all

Last month Time to Change released the results of a survey into the impact of stigma in mental health.

Stigma is the process of outcasting people from society because they do not fit with the idea of what is ‘normal.’   It has existed in all societies and all ages, taking different forms depending on the cultural norms in a time or place.

There are many examples. For example overweight or obese people are stigmatised in a culture that worships physical perfection. They are stereotyped as a group as lazy or greedy, a process which makes it easier to separate ‘them’ from ‘us.’ They lose respect and status and become easy victims of discrimination.

The important thing to notice is that the stereotyping occurs after a group is identified as not fitting in. It is not fact-based but a device to justify the stigma. Think of any persecuted group throughout history. In my own time in Bosnia, people were reduced to the status of animals as a device to harm or kill them.

A recent article in the Observer discussed the disturbing level of violence against disabled people in Britain. It described the violence and hate thrown at a man with MS.

It also pointed to a work-based survey on attitudes to disability carried out by BT in which 65 per cent of respondents said they avoided disabled people because they didn’t know how to behave around them.

A visual difference from what is perceived as ‘normal’ quite easily leads to marginalisation. However stigmatisation goes beyond that. For example, 38 per cent of those who responded to the BT survey thought disabled people were a burden on society, a negative stereotype justifying their victimisation.

Another feature of branding people with health problems is to blame them for their misfortune (see obesity, above) or secretly believe they are making up or exaggerating their condition. This is particularly so in the realm of mental health. Classifying people with depression as 'weak' is a permission to discriminate against them, even though it has no basis in reality.

An unfortunate side effect is that people who develop symptoms of say depression fear a diagnosis in part because of the stigmatising consequences. It is estimated by NICE that only about 50 per cent of people with depression see a GP. In a society that has normalised excessive drinking and drug-taking, self-medication is a less shameful response – around 5 million Britons drink every day to feel less anxious or depressed.

According to the Time to Change survey, 80 per cent of respondents had experienced stigma or discrimination in some sphere of their life because of a mental health problem, while 67 per cent would not tell their employer.

As depression and anxiety are the most common health issues of any type at work, this is a serious issue that can only be addressed by bridging the confidence gap that exists between employees and their organisations.

This begins at the top, where management culture is formed.