Current Understanding of Mental Health Stigma
Definition and Dimensions of Stigma
Mental health stigma can be broadly categorised into public stigma and self-stigma. Public stigma refers to the negative attitudes and beliefs held by society, leading to discrimination and social exclusion. Self-stigma occurs when individuals internalise these negative beliefs, resulting in diminished self-esteem and self-efficacy. See here our publication to support understanding of this: What is Stigma?
Impact of Stigma on Mental Health
Stigma surrounding mental health can lead to several adverse outcomes. It discourages individuals from seeking help due to fear of judgment, resulting in untreated or poorly managed conditions. Stigma also contributes to social isolation, reduced opportunities in employment and education, and poorer overall quality of life. Additionally, internalised stigma has been linked to increased symptoms of depression and anxiety. To understand this issue more, we have produced an informative guide: Let’s talk about mental illness mental illness - A guide to understanding the stigma and shame that people living with a mental illness can experience.'
Voices of People with Lived Experience
All of the research provides evidence that involving people with lived experience (PWLE) is essential in the fight against stigma. Their insights and testimonies provide a powerful counter-narrative to stigmatising beliefs and are integral to developing effective interventions. The Lancet Commission's research included a global survey of PWLE, reflecting on their experiences of stigma and discrimination. This peer-led approach ensures that the strategies for addressing stigma are grounded in the real-world experiences of those most affected .
In Ireland, much progress has been made to include the voice of people with lived experience and their family members in policy, research, and service developments. One example of this is the fact that our national mental health policy Sharing the Vision has a Reference Group of PWLE and supporters at the heart of its implementation structures. This innovative move has meant that the way information is reported and how implementation is delivered is informed by the opinions of those impacted by delivery of changes in policy. In many mental health services delivered in Ireland the importance of the voice and input of those living with mental illness is recognised and there have been significant strides made in innovating on the inclusion of the voice of people who use those services on project teams, in research panels and in the coproduction of information and reports. Shine hosts the Reference Group and holds the secretariat role in this programme. At the same time, Shine launched a project in 2023 called the Voice Platform, an organised group of people with lived experience who we support to volunteer on groups, projects and in research to enable the voice of PWLE to be heard and to have opportunities to make real change, especially to remove stigma and increase inclusion.
In our Shine Stigma Reduction programme, we support people who have experienced mental health difficulties and provide the opportunity to act as Ambassadors to share their story and help reduce mental health stigma. Ambassadors provide insight into what living with a mental health difficulty looks like and help challenge attitudes towards mental health, to help influence change. Ambassadors, who work in a voluntary capacity, take part in activities such as public speaking, television/radio/print interviews, panel discussions, research, campaign work, content creation or project work. All ambassadors receive specialised training.
The Role of Media
The media plays a crucial role in both perpetuating and combatting mental health stigma. Inaccurate and sensationalised reporting can reinforce stereotypes and contribute to public misunderstanding. Conversely, responsible and sensitive media coverage can help normalise mental health conditions and reduce stigma. The Lancet Commission's report highlights the media's potential to influence societal attitudes and calls for a new "Media Manifesto to End Stigma and Discrimination in Mental Health", encouraging journalists to commit to accurate and supportive reporting .
Shine has a national media programme, formerly known as Headline, now, following our rebrand, called Shine Media Programme, which is Ireland’s national media programme for responsible reporting, and representation of mental illness and suicide.
Readers, listeners, and viewers often form their attitudes to mental health difficulties and suicidal behaviour from the media they consume. Unintentional, irresponsible reporting or misrepresentations of mental health difficulties can have devastating effects on audiences, sometimes fatal.
Using best international practice and the most up to date research, Shine Media Programme offers guidance to anyone actively producing content on these issues. Shine Media Programme does this work by monitoring the media, offering training to students and media professionals to report responsibly on suicide and improve representation of mental illness in the media, using industry guidelines. We also provide support, contribute to knowledge through research and recognise good practice in this through our Carter Foundation Journalism Fellowships and the Shine Mental Health Media Awards.
In a joint effort between the University of Galway’s PSYcHE project, headed by professor of psychology Dr. Gary Donohoe, and Shine’s (Headline) Media Programme in recent years, researchers analysed 656 articles from 2021 that referenced schizophrenia, schizoaffective disorder, and psychosis.
They found that while most articles avoided reinforcing stigma, very few articles actively challenged negative public perceptions. Only 12% provided information that confronted stereotypes, fewer than 3% included a contribution from someone with lived experience, and just 5% supplied a signpost to relevant support services. Each year we can see improvements in this area but there is much work to be done if we are to remove stigma around mental illness, especially when the illness is more enduring, such as in schizophrenia.