I recently read a great research paper titled “The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care” by Patrick Corrigan and colleagues and wanted to share. I felt that the authors did a great job of breaking down the complexities of stigma and really emphasizing how it creates huge barriers for people. I don’t think any of this is new to those of us who have felt the ever-present black cloud of stigma every time you go to the psychiatrist or pharmacy… however, it really brings home the importance of the work we do to combat stigma.

The authors categorize barriers to treatment into two areas: (a) personal-level – attitudes and barriers that affect decision making, poor mental health literacy, and lack of support network; (b) system-level barriers – workforce limitations, cultural incompetence and lack of appropriate insurance – all impacted by stigma.

They also describe the lack of knowledge among primary health care providers, although it may be getting better, as another source of covert stigma. In other words, they aren’t actively discriminating based on mental health diagnoses but it can impact decision-making.

Case-in-point: For about one year during graduate school I experienced horrific pain that radiated in my chest off and on but mostly after eating (I almost passed out several times from the pain – it was 9 out of 10). I went to urgent care at least a dozen times and each time they ruled out a heart condition and said that I was having a panic attack. I knew that in this particular instance it was not the cause and told them this diagnosis was not acceptable. Finally someone got me in to see a specialist at the hospital, my Mom drove down to accompany me because I could barely function.

After many tests the specialist said to my Mom “this is all in her head” to which she responded, “my daughter is in serious pain this is not in her head”. Eventually I had an ultrasound and sure enough my gallbladder was packed full of stones! I can’t help but wonder if my diagnoses of bipolar disorder and GAD were the reason for multiple doctors to dismiss the cause of my physical pain as something I was imagining.

Time and time again I experience similar stereotyping – to a lesser degree thankfully – whenever I or my loved ones with mental health histories, have a medical issue. No doubt my own self stigma contributes to my perception that medical professionals don’t take me seriously. Nonetheless it is something we’ve all experienced and while its not malicious it is a dangerous side effect of stigma.

Ways to combat this issue include; self-advocacy, education of health care providers (there are lots of fact sheets and literature out there you can share with your doctor), story sharing (the more we talk about our experiences with others the more we will elevate the awareness and light bulbs will start going off!), and hopefully the move toward integrated care will help!

What else can we do? It seems like such a daunting issue to take on, and it is, but every little step towards awareness and literacy makes a difference! Please share your suggestions with us and lets continue the dialogue.

Amanda Kearney-Smith, Executive Director

The Impact of Stigma: The Facts & The Stories