By Stigma-based communication has significant effects on mental health. What are they? What can we do? We will discuss them in this text.
Many of the expressions and phrases we use when talking about mental health can cause discomfort. In fact, when we say words that are associated with stigma, it has a harmful effect . Unwittingly, we can encourage people not to ask for help when they need it most.
Stigma-based language (e.g., “he’s crazy” or “he’s depressed”) has a clear impact on the decrease in patients’ quality of life. It can be defined as “the negative attitude, belief and judgment towards these people, with distinctive health characteristics .” As we see, words have practically unlimited power, both to do good and to impress the most painful regrets.
“There is nothing braver than asking for help when you feel vulnerable.”
-Robin Williams-
What is the impact of using stigmatizing language on mental health?
A study published in the journal Neuropsychopharmacology has sought to analyse this fact (Volkow et al., 2021). In the healthcare context, we professionals can, with our language, contribute to reducing stigma . It seems counterintuitive, but the use of technical terms and the imposition of complex clinical labels (for example, ” pseudocyesis “) would encourage and further increase stigma.
The way we communicate in a healthcare context can be a real vehicle for the chronicisation of stigma in mental health. It is important to emphasise that the power of words is immense and we know that it is related to the emergence of thoughts as well as to the beliefs and certainties of patients (Volkow et al., 2021).
In recent years, we have made efforts to reduce stigma at multiple levels of mental health, both at the individual level and at the institutional level. However, the weight is persistent and continues to poison everyday and scientific language.
According to a study in the journal Substance Abuse and Rehabilitation , highly stigmatized language is one of the factors that make people who need help avoid coming into contact with mental health services. In the specific case of alcohol , the probability of someone deciding to seek professional help is 50% lower, compared to other patients (Hammarlund et al., 2018). We must change this.
Language guidelines to reduce mental health stigma and communicate better
By using scientifically accurate expressions and words, we can define and validate the emotional and phenomenological experience of patients with mental health problems. Using language well would have a positive impact on the treatment and the professional-patient relationship; an impact that can be transferred to society as a whole (Volkow et al., 2021). Below, we will look at some guidelines in this regard.
“Even health care providers sometimes stigmatize people with mental illness.”
-Nora D. Volkow-
1. If you are a professional, be careful with the language you use
Despite our best efforts to avoid stigmatising messages, health professionals, as human beings, sometimes fall into the trap of biased language. When this happens, people who are thinking of putting themselves in our hands may cancel appointments with specialists.
One way to help in this context is found in a research published in the International Journal of Environmental Research and Public Health , led by Cori L. Tergesen. The experiment consisted of students watching videos of people with mental health problems undergoing treatment during their medical studies. The results led to a reduction in stigmatizing language among these students (Tergesen et al., 2021).
“It’s not the burden of mental illness that breaks families apart, it’s the stigma surrounding it.”
-Dawn Barker-
2. Fight against “self-stigma”
Language can be so meaningful and important that we end up taking it for granted. When a person with mental health issues receives negative and stigmatising messages, day after day and month after month, they end up believing the content. This is called self-stigma.
It is important that if we detect that we are transmitting messages that revolve around stigma, using terms such as “I am sick” or “I am a problem”, we stop it and tell people we trust, to obtain other points of view that allow us to change these beliefs. In turn, self-stigma also reduces the likelihood that the person will go to a mental health specialist (Jennis et al., 2015).
“Self-stigma has a negative impact on the recovery of people with serious mental illness by lowering their self-esteem.”
-Nora D. Volkow-
3. Avoid focusing on the person
It is common to find expressions that merge a person with a clinical entity that they suffer from. For example, “you are anorexic”, “you are a drug addict” or “you are schizophrenic”. This combination of the verb ‘to be’ and the noun ‘disorder’ acts like a Molotov cocktail. People are “not” a “cold” or “a stroke”. Why, when it comes to mental health, does it seem that way? We have a dignity that should be respected.
It is essential to use expressions that include verbs such as “have” or “suffer” from an entity; instead of the above phrases we could say “you have an eating disorder”, “you have a substance-related disorder” or “you have a psychotic disorder”. The mental health problem is far from being the only characteristic of the person and much less is it the characteristic that defines them the most.
When we use language well, it has the power to give hope or sorrow to patients. It is in our hands to take care of the words we choose with delicacy, because the person in front of us is in an equally delicate moment.