Talking about mental health and mental well-being is vital, yet it often comes with challenges due to the stigma surrounding it.
In this fourth installment in our blog series, Foundations of Mental Health: A Beginner’s Guide, we aim to break barriers and encourage open, honest conversations about mental health. Rogers’ Emily Jonesberg, MSW, LCSW, program manager for Community Learning and Engagement and WISE, will:
- Explore stigma and how it affects those who struggle with mental health
- Share 7 promises for being a supportive person
- Provide practical advice for sharing your mental health story
By fostering understanding and empathy, we hope to create a community where discussing mental health is embraced and encouraged.
Emily, how do you define stigma that surrounds mental health?
Stigma is a mistreatment of someone based on their group membership, typically surrounding social identity, such as one’s race, sexual orientation, religion, a mental health challenge, or something along those lines.
Stigma can be broken into three parts:
- Stereotypes: Generalizations of an individual based off their group membership.
- Prejudice: Stereotypes that are internalized into a belief system.
- Discrimination: Action taken because of the beliefs someone holds.
A person doesn’t necessarily move from one to the other. Oftentimes we’re engaging in cultural or socialized behaviors that we pick up and learn along the way and aren’t aware of them.
Additionally, stigma comes in three forms. Public stigma is a belief held by the broader community. An example is the belief that someone struggling with mental health is weak or fragile. It becomes internalized stigma when people take what they’ve heard and believe it about themselves. It causes a person to make different choices about what they feel they’re capable of. Structural stigma involves policies and procedures. It’s when an organization asks about someone’s mental health history in the interview process, or at any time during employment, then makes decisions based off the answers.
Emily, what is the impact of stigma on people with mental health challenges?
Stigma prevents individuals, young and old, from accessing the care they need, which has many consequences. For example, children experience lower self-esteem and may resort to isolating, while adults may have fewer employment opportunities. Research shows that adults with mental health disorders are three to five times more likely to be unemployed. It also depends on the diagnosis. People with schizophrenia, for example, have the highest rate of not being able to access employment, with 80 to 90% being unemployed. 
If you consider how stigma affects a person’s well-being and access to opportunities, it also influences how people live their lives and approach their treatment and recovery.
Emily, what can we do to reduce stigma?
We can do small things every day to avoid acting in a way that reinforces stigma. If everyone engages in these things, it can have a domino effect.
- Try and maintain a recovery perspective. Intentionally seek out stories of recovery. So often people have ideas that they’ve seen in media or in movies about what mental health is, or someone’s experience with mental health, or a treatment center, and they’re not accurately portrayed. When we proactively seek out recovery stories, we not only hear about people’s mental health and recovery journeys, but also their strengths, the lessons they’ve learned, and the things that they wouldn’t change about the journey. Get to know individuals for who they are and all that makes them unique.
- Create curiosity and speak out. When you start to see or hear things that seem like they may be rooted in stigma, examine them a little more. Be prepared to speak up as best you can and when you feel comfortable doing so. Conversations can challenge some of your own stigmatizing beliefs that you might unknowingly carry. It’s a good opportunity to look inward.
- Tend to your own well-being. Research shows that people who are feeling stigmatized often experience it from people we would least expect it from, including doctors, teachers, caregivers, parents, and loved ones. Usually, it’s rooted in caring for someone else, giving them a lot of energy, and not being able to fully show up. When that happens, we unintentionally engage in behaviors that perpetuate stigma. For example, if therapists don’t tend to their own well-being, they may avoid the patients who need the most attention and support because they don’t have it to give.
Emily, explain the Safe Person 7 Promises that can reduce stigma
We created the Safe Person 7 Promises out of our desire to provide support for people who want to show up for others in need. We know that when individuals get to know each other, particularly across differences, they can help reduce stigmatizing beliefs. We encourage people to tell their story as much as they’re comfortable doing so, but then naturally, we also want to make sure individuals who are listening can show up in the least stigmatizing, and most supportive way possible.
- ACKNOWLEDGE THAT REACHING OUT FOR SUPPORT IS A STRENGTH.
If you’re engaging in a conversation with someone who’s telling their story and asking for your support, the first thing you want to do is say that you really appreciate that they’re sharing their story with you and acknowledge that asking for help is a really hard thing to do.
- LISTEN AND REACT NON-JUDGMENTALLY.
This may mean that you have to put other things aside, whether that’s physically or mentally, so that you can be fully present for the person in front of you and give them your full attention. Even if things come up that may feel surprising or they bring up strong emotions in you, do your best to try to stay in that non-judgmental place so that the person continues to feel comfortable sharing.
- RESPOND IN A CALM AND REASSURING MANNER.
Besides thanking the person for sharing, say reassuring things like, “I can see the strength in you.” “I’m here to support you.” “We’ll figure this out with other people to get you the support that you need.” Additionally, make sure that you are staying calm and not heightening the energy around whatever the person is telling you.
- REFLECT BACK THE FEELINGS, STRENGTHS, IDEAS I HEAR WHEN LISTENING.
Reflecting back helps individuals feel heard. Repeating some of the strengths you heard can help the person apply them to their current situation.
- ASK HOW I CAN BE HELPFUL AND RESPOND AS I’M ABLE.
It’s very likely that a person will ask for a certain level of help that you may not feel equipped to provide, whether that’s because you don’t have the skills, the time, or the energy. It’s much more compassionate and supportive to share your limitations. Perhaps offer an alternative that you can provide as a support to that person.
- DO WHAT I CAN TO CONNECT TO OTHER SUPPORTS IF ASKED.
If this is a heavy burden for you, make sure that you’re connecting the person to additional people, and discuss that with the person you are supporting ahead of time. You can say, “Because I care about you and it seems that this is a really tough thing that you’re going through, let’s make sure that you get some additional support in place beyond me. Can we brainstorm? Who may some of those people or resources be?” Ask if the person would like to hear about other support options before you offer. If they accept, connect them to outside resources that may provide further assistance.
- MAINTAIN CONFIDENTIALITY AND COMMUNICATE IF EXCEPTIONS EXIST.
There may be times when someone talks to you about harming themselves, someone else, or they’re being harmed. In those instances, make sure you tell someone else to get some supports in place to keep the person and others safe. Otherwise, maintain confidentiality.
No one is going to do all this perfectly 100% of the time, but if we do our best to lean into them, then we are showing up as a safe, supportive person for someone in need.
Safe Person decals are free to download or order in English or Spanish, by clicking here.
Emily, what advice do you have for someone who wants to share their mental health story?
Research shows one of the best ways to reduce stigma is by sharing your story. Our free Up to Me curriculum helps people think through which aspects of their story they feel ready to disclose.
I think oftentimes people feel like it’s all or nothing — either they’re keeping completely quiet and not sharing any aspect about their recovery, mental health journey, or current state, or they have to share every detail about it. In reality there’s a lot of different factors that can go into that decision. What’s your goal for sharing your story? Who are you talking to? What is the setting? The version of your story that you would tell your employer to get an extension on a deadline may look different than what you share with your close friend.
There’s a lot of value in going through the curriculum and thinking about the different ways you tell yourself your story, which impacts how you believe other people are going to respond.
Emily, any advice on sharing your loved one’s mental health story?
I think the number one thing to keep in mind is there’s not a one size fits all for any situation.
Although the loved one, caregiver, friend, or family member has a version of the story that this person has existed in, it’s their version of the story. What’s being asked here is sharing someone else’s lived version of the story. It’s important to have a conversation with the person whose story intersects with the story you’d like to share and ask permission.
An example is a child who is receiving long-term mental health care. The parent or caregiver is going to have to talk with school administration at some point. If the child is old enough, and seems like they’re in a place to be able to talk about it, ask them, “How do we want to address this? We have to talk to school and let people there know. Are you comfortable with me sharing where you are and what’s going on? Or what part of your story feels comfortable for you to share right now?” The information people are comfortable having others share can change, so it’s a good idea to check in as different situations arise.
You can find resources and information in the parent and caregiver version of Up to Me on our website by clicking here.
Next in Foundations of Mental Health: A Beginner’s Guide: How to support your mental health while supporting another person
