what is stigma?  

Stigma is a strong negative attitude around something. Stigma is best understood as a process made up of these three parts: 

Stereotypes (beliefs) 

These are the thoughts or assumptions we form about a group of people. An example of stigma could be thinking people with mental health conditions are dangerous or weak. 

Prejudice (emotional reaction) 

This is when someone agrees with a stereotype and reacts with fear, anger or pity. An example of this could be someone feeling uncomfortable or scared around someone who experiences poor mental health. 

Discrimination (negative behaviour) 

Acting on prejudice, resulting in unfair treatment. An example of this would be
not hiring someone, excluding them socially or denying them housing or services because of their mental health status. 

Importantly, stigma is not limited to mental health. It can affect any group that is perceived as being outside of societal norms. This includes, for example, people who use substances, those with diverse sexual orientations or gender identities, as well as individuals from different racial, ethnic or religious backgrounds.  

Most importantly, stigma is avoidable. While our brains are likely to categorise, generalise and use shortcuts – processes that can lead to bias and stereotyping, we also have the capacity to think critically and rationally. This means we can reflect on our assumptions and respond with empathy. 

This quote sums up the experience of mental health stigma. Sometimes the thought about how other people will react and the consequences of disclosure are worse than the actual poor mental health symptoms a person experiences. 

mental health stigma in Scotland 

The Scottish Mental Illness Stigma Study, by See Me, has shed light on how people with mental health conditions who live in Scotland experience stigma:  

• 92% say that they have experienced stigma in relationships with family and friends in the last year. 
• 53% said they respected themselves less because they think they will not recover or get better. 
• Of those who had faced stigma in relationships, 82% expected others would not want to be their friend due to their mental illness. 
• 77% said they had been treated unfairly at work. 
• Of those who had faced stigma in mental healthcare services, 58% had avoided calling an ambulance or attending A&E in relation to emergency mental healthcare. 

types of mental health stigma

Stigma can be differentiated into four different types.  

1. Self-stigma (internalised stigma)

This is when a person with a mental health condition starts to believe the negative stereotypes about themselves. This kind of stigma can lower self-esteem, increase shame and stop people from seeking help. They may think they are weak or incapable because of their mental health.

2. Stigma by association

Also called affiliate stigma, this happens when family members, carers, friends or professionals connected to someone with a mental health condition are also judged or blamed. This kind of stigma can increase stress for carers and discourages people from working in mental health roles. An example might be that a parent is blamed for their child’s condition or a mental health worker being seen as less respected than other health professionals. 

3. Public or interpersonal stigma

This refers to widespread attitudes in society when people hold stereotypes, prejudices or act in discriminatory ways towards those with mental health conditions. That can include avoiding someone with a diagnosis. This type of stigma affects how people are treated in everyday life: at work, in school, in healthcare and in relationships. 

4. Structural (or systemic) stigma

This happens when rules, laws or institutional practices put people with mental health conditions at a disadvantage. Systemic stigma may include lack of funding for care or policies that restrict job opportunities. 

effects of stigma

Stigma can lead to many negative effects, including: 

• Increased negative feelings: People may experience shame, secrecy, loneliness and rejection – from society, family and even themselves. 
• Greater risk: More chance of psychological distress and risk of suicide, especially among young people. 
• Delayed help-seeking: Fear of being judged often prevents people from accessing mental health services when they need them. 
• Workplace discrimination: Many avoid disclosing their diagnosis due to fear of stigma, which can lead to being passed over for promotions or even job loss.  
• Worsened physical health: Stigma is linked to more severe physical symptoms, longer illness duration and increased hospitalisations. 
• Housing discrimination: Many landlords refuse to rent to people with mental health conditions, limiting their housing options.  
• Challenges for young people: They often face exclusion from school activities, bullying and fear rejection from peers and family members. 

how to combat mental health stigma? 

We all have a role to play in reducing mental health stigma and creating a more understanding and supportive world. Here are some effective ways we can make a difference:

Be mindful about language

Language matters. The words we choose can shape attitudes around mental health. Using non-stigmatising, person-first language (e.g., “a person with a mental health condition” or “someone with lived experience”) helps avoid defining people by their condition and promotes respect and dignity.

Support accurate and responsible media portrayals

The media is hugely influential. Unfortunately, it sometimes perpetuates stigma by depicting people with mental health conditions as dangerous or unpredictable. But it can also be a powerful ally when reporting is accurate, responsible and nuanced. 

Increase mental health literacy

Education, especially psychoeducation, improves knowledge and attitudes about mental health. 

Promote social contact with people with lived experience 

Direct social contact with lived experience experts produces meaningful and lasting improvements in attitudes and behaviours. Positive, personal interactions help break down barriers and humanise mental health challenges.

Mental health training 

Programmes like Scottish Mental Health First Aid (SMHFA) and mental health awareness training improve knowledge and attitudes around mental health. If you are an employer, work in a school setting or elsewhere, consider training employees, managers or whole teams. 

Change Mental Health delivers a variety of mental health training courses, including a tailored Signs, Stigma and Support training, as well as SMHFA training.  

Engage in anti-stigma campaigns and programmes

National campaigns have demonstrated the power of collective action. In Scotland, See Me is the national programme to end mental health stigma and discrimination. They are encouraging people to take action to make a difference. You can be part of that change by getting involved with See Me.

Approaches to address self-stigma

Addressing self-stigma is equally important. Peer support, self-help initiatives and engaging in advocacy can be particularly effective to combat negative self-perceptions.  

Our National Advice and Support Service can help you and people you care for with mental health concerns and money worries.

We can link and signpost you to relevant local and national support, including our own Change Mental Health services, as well supporting with debt, grants and benefits.

The service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm to 1.30pm). Contact 0808 8010 515, email advice@changemh.org or fill in the form on the service webpage.

For full details about the service, visit the National Advice and Support Service webpage.