No shame in mental ill-health

Paradoxically, stigma about mental health disorders remains widespread even among mental healthcare professionals. With the current increase in prevalence of such disorders among both the general public and healthcare workers, anti-stigma campaigns led by healthcare professionals with relevant personal experience may help harness the trauma and bridge the barriers to receiving care.

The coronavirus crisis poses the greatest threat to mental health since World War II. Modelling by the Centre for Mental Health predicts that, in England alone, as many as 10 million people, including 1.5 million children, will need new or additional mental health support as a direct result of the crisis1, reported Dr Ahmed Hankir, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK in his presentation at EPA Virtual 2021.

 

The terrible toll on healthcare workers

COVID-19 is having an enormous adverse effect on the mental health of healthcare workers. In an anonymous web-based survey of 709 healthcare workers from intensive care units across England in June and July 2020, 45% met the threshold for probable clinical significance on at least one of the following measures: depression (6%), post-traumatic stress disorder (40%), severe anxiety (11%), or problem drinking (7%). Thirteen percent of respondents reported frequent thoughts of being ‘better off dead’, or of hurting themselves in the past 2 weeks.2

Mental illness is terribly debilitating – but stigma can be worse

 

Stigma prevails among mental health professionals

Mental illness is terribly debilitating – but stigma can be worse, claimed Dr Hankir.

Stigma refers to ignorance (problems of knowledge), prejudice (problems of attitude), and discrimination (problems of behavior). In a survey of more than 2100 physicians who met the diagnostic criteria for a mental health disorder, 50% were reluctant to seek professional help because of fear of stigmatization.3

Healthcare professionals with personal experience of mental illness are ‘experts by experience’

 

Reducing stigma - the power of contact

In terms of reducing stigma among the public, three broad approaches have been proposed – protest (or social activism), education, and (social) contact with the people with the mental illness.4

In a systematic literature review and meta-analysis examining the effects of anti-stigma approaches, contact was the most effective method for reducing stigma in adults - and contact with an ‘expert by experience’ (a mental healthcare expert with personal experience of a mental health disorder) was the most effective.5 Interestingly, evidence is emerging that virtual contact is as effective as face-to-face contact for reducing stigma in mental health, said Dr Hankir; and virtual anti-stigma campaigns can easily be scaled up and disseminated worldwide.

Experts by experience are an asset to be embraced and should be in the vanguard of anti-stigma campaigns

There are six key components of a successful anti-stigma campaign said Dr Hankir.6

  • Emphasis on recovery
  • Testimony from an expert by experience
  • Multiple forms of social contact
  • Taught communication skills
  • Myth busting
  • An enthusiastic facilitator

A lived experience of a mental health problem is an asset to be embraced.

There should be no shame in having a mental health disorder.

 

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Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

References

  1. https://www.centreformentalhealth.org.uk/publications/covid-19-and-nations-mental-health-october-2020
  2. Greenberg N et al. Occup Med (Lond) 2021;71:62-67
  3. https://www.medscape.com/viewarticle/896257
  4. Thornicroft G et al. Br J Psychiatry 2007;190:192-3
  5. Corrigan P et al. Psychiatr Serv 2012;63:963-73
  6. Knaak S et al. Can J Psychiatry 2014;59(10 Suppl 1):S19-26