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  • Writer's pictureAndré Delicata

The problem of stigma in mental health

Mental Health

Stigma is a burden to people with a mental health difficulty they can certainly do without. It makes the person feel ashamed, weak, and different from the rest of society.

It prevents people from reaching out for help from professionals or from support from family and friends. More than half of people with mental illness don't receive help for their disorders. In fact, locals take an average of 6.25 years before seeking help, with fear of isolation, embarrassment, and shame being significant contributing factors

Stigma comes in different forms. The term stigma originated in ancient Greece, where it referred to symbols burned into the skin of enslaved people and people judged as criminals or traitors. These symbols, or stigmas, suggested the person was “blemished” and that others should avoid and shun them.

Stigma can exhibit in the form of behaviours and attitudes born out of prejudice and stereotyping, discriminatory behaviour, marginalisation and labelling.

Another type of stigma is self-stigma:

"One area which stigma affects deeply is the self, as individuals with mental illnesses come to believe stereotypes and stigmatizing attitudes, such as being weak, unworthy, or incapable of succeeding in life. The internalization of such beliefs is referred to as self-stigma, and often results in feelings of hopelessness, low self-esteem and low self-efficacy. This lack of self-belief has long been recognized as having a negative impact on recovery processes, independent living, empowerment, and the development of social interactions, creating a vicious cycle that further validates public stigma."

Stigma leads to worsening of symptoms, besides preventing people from reaching out for medical help and support from friends and loved ones. Effects can include:

  • reduced hope

  • lower self-esteem

  • increased psychiatric symptoms

  • difficulties with social relationships

  • reduced likelihood of staying with treatment

  • more difficulties at work

Stigma does not only affect persons having mental health difficulties, but also their loved ones, who suffer in many different ways and on different levels.

Given the magnitude of the prevalence of mental health difficulties, we afford to look away from the problem. The reported local percentage prevalence stands at 6.6% for depression; 7.8% for anxiety, and 0.026% for schizophrenia. A further 2% of the population suffer from bipolar disorder. Approximately 25.2% of individuals under the age of 14 are at risk of developing a mental disorder, which is higher than that estimated in Europe.

In answer to a parliamentary question tabled by MP Graziella Attard Previ on the number of reported suicides in the past 10 years, Health Minister Jo Etienne Abela gave the below figures. It should be noted that there are a number of suicides that go unreported according to Professor Andrew Azzopardi, the Dean of the Faculty for Social Wellbeing

Suicide rates in Malta
Suicide rates in Malta

The National Alliance on Mental Illness (NAMI) offers some suggestions about what we can do as individuals to help reduce the stigma of mental illness:

  • Talk openly about mental health, such as sharing on social media.

  • Educate yourself and others – respond to misperceptions or negative comments by sharing facts and experiences.

  • Be conscious of language – remind people that words matter.

  • Encourage equality between physical and mental illness – draw comparisons to how they would treat someone with cancer or diabetes.

  • Show compassion for those with mental illness.

  • Be honest about treatment – normalize mental health treatment, just like other health care treatment.

  • Let the media know when they are using stigmatizing language presenting stories of mental illness in a stigmatizing way.

  • Choose empowerment over shame – "I fight stigma by choosing to live an empowered life. To me, that means owning my life and my story and refusing to allow others to dictate how I view myself or how I feel about myself." – Val Fletcher.

It's time that this mental health starts receiving the attention it deserves, that we start talking more openly and frankly about it in homes, in schools, on social media and the media at large as well as on a policy-making level.

Without the stigma.


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