Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

Grant Activity: Current Activity Impacting Communities

Stigma Reduction in Philadelphia via

Article Appears in The Spring 2014 Edition of The Philadelphia Social Innovations Journal (click below for full article)
Written by Timothy Clement
 
And yet, we whisper about mental health issues and avoid asking too many questions. The brain’s a body part, too. We just know less about it. There should be no shame in discussing or seeking help for treatable illnesses that affect too many people that we love.  We’ve got to get rid of that embarrassment. We’ve got to get rid of that stigma.  —Barack Obama 6/3/2013
 
What is mental health stigma? It is obviously an important topic in mental health if the President of the United States saw fit to mention it in his opening remarks at the National Conference on Mental Health. But if you ask ten people, even ten mental health professionals, you will get ten different responses. The Scattergood Foundation knows the answer to the question and knows that reducing stigma is of paramount importance to improving outcomes for people with diagnosable mental health conditions. That is why we have a Fellow on Stigma Reduction.
 
Is stigma shame or embarrassment, as the President implied in the above quote? Shame and embarrassment are certainly part of the stigma equation, but stigma is not equivalent to shame or embarrassment, nor does it comprise those two things. Shame and embarrassment are effects of stigma, not stigma itself.
 
So what is stigma then? The research community defines stigma as stereotypes, prejudice and discrimination (Corrigan & Watson, 2001). Shame, embarrassment and even fear can and often do result from stigma, but they are some of its outcomes, not its components. While this may seem captious, it is actually critically important that stigma not be conflated with its effects. Without proper problem definition, an adequate solution is unlikely. Take the following analogy:
 
A car accident is a phenomenon that involves at least one car colliding with another object. The object could be a car, a guardrail, a tree or even the road itself if the car happens to overturn. Death and injury can result from a car accident, especially when the accident is serious. But what if someone chose to actually define a car accident as death and injury? That is a different definition than what is listed above and can reasonably be dismissed as incorrect, but it is the working definition for this particular person. 
 
Now, let’s say that this same person wants to reduce car accidents, so he focuses on improving seatbelts and airbags, which certainly do reduce death and injury. Improving seatbelts and airbags is very worthy, and should be pursued regardless, but how many car accidents will be averted with this approach? The answer, of course, is that he will never prevent a single car accident by improving seatbelts and airbags. He will reduce death and injury to be sure, but many accidents will still result in death and injury even with optimal seatbelt and airbag technology. While this may be a sound approach for saving some lives, it is a fundamentally ineffective way to reduce car accidents. In fact, it does not work at all for that purpose.
 
By defining stigma as shame or embarrassment, as the President and many others seem to do, there is very little chance in reducing what actually comprises stigma—stereotypes, prejudice and discrimination. Focusing efforts on easing embarrassment and diminishing shame is noble and important, but it does not have any effect on the public stigma that is woven into the fabric of our culture.
 
Stigma reduction is so important because...READ MORE HERE