The word ‘stigma’ comes from the Greek root word, which referred to the mark or symbol placed on slaves and criminals in order to identify them. As time progressed from the late 16th century, stigma has adopted a sociological meaning, defined by Cambridge dictionary as “a strong feeling of disapproval that most people in a society have about something”.
In popular culture, the media depictions of mental illness often show someone who is violent, unreliable or seeking attention. Depending on the illness itself, the illustrations of it differ. For instance, what do you think of when you hear the word Schizophrenia? Images of someone with a ‘split-personality’, someone talking to people who aren't really there and being violent because ‘the voices told them to’ may come to mind. Even in western society, we tend to push those with ‘extreme’ mental disorders to the margins, something that is distressing for that suffering individual. This feeling I know all too well, and I’m sure others from ethnic backgrounds agree. The feeling of being pushed to the margins, just because you’re struggling mentally.
Although disorders like anxiety and depression are typically less extreme than schizophrenia, equally negative images come to mind. Especially if you’re from a, quote, ‘ethnic’ background, like I am, issues of mental health are almost always viewed negatively. Without bashing the culture I come from, I do believe there are problems that aren’t talked about enough. The one I’m tackling here, talking about mental health.
When I grew the courage to talk to some Jamaican family members about my mental health, I was faced with unwelcoming arms and treated coldly. From that point on, I felt like I had a red-hot label branded on my head saying ‘unstable’. The days I spent bound to my bed I was told I was ‘lazy’. The moments I had panic attacks or breakdowns within the comfort of my home, I did so as quietly as I could to avoid attention, covering my mouth so my voice was muffled and skipping meal times to avoid my family seeing my mascara smudged eyes. Although today I don’t resort to such extreme ways to conceal my depression, I still feel my forehead shows a faint and faded mark reading ‘depressed’, even on my best of days.
As I opened up about my mental health to friends, I was astonished to hear that I was not alone in feeling that my non-western relatives judged my mental health challenges, ‘they just don’t understand’, one of my friends told me. So why is that? I began to question what exactly made my family so afraid of discussing mental health and why did they disapprove of treatment?
For me, I think that having a mental illness is seen as another barrier and struggle for 'ethnic communities'. 'BAME' communities (I use the label BAME reluctantly but unfortunately there is no other widely acknowledged term for this non-white group of people) are systematically disadvantaged in British society; more likely to experience poverty, higher unemployment and more contact with the criminal justice system. Because of this, facing struggles with mental health adds more fuel to the fire of social and economic challenges that 'BAME' individuals face. So simply ignoring mental health may place less pressure to be ‘successful’ in western society, a society which already makes it difficult for non-white people to ‘fit in’.
A large scale 2006 study assessing young Jamaicans’ attitudes towards mental illness (published by Wiley’s Journal of Community Psychology) had students view a videotaped job interview for a teacher whose history was manipulated to include a history of mental illness, or not. Students desired significantly less social distance (i.e. more contact) with the “normal” teacher compared to the teacher with a mental illness history.
I would love to scapegoat the older generation as the holders of this stigma, but this study does not allow that. Regardless of age, this stigma thrives inside the minds of young Jamaicans and perpetuates through generations. Breaking the stigma, especially within ethnic communities, starts with us, as unjust as it sounds.
Why is research into mental health stigmas important?
Taking a perspective from someone with experience with mental illness, as large or small as it may be, stigma may not only act as a barrier to them seeking help and treatment, but also heighten the individual’s low self-esteem and insecurity. On top of that, research has found that stigma negatively affected the course and prognosis of the mental illness itself, (Corrigan & Klienlein, 2005) meaning that mental health professionals from ethnic backgrounds might allow unconscious bias to seep into their treatment and practices.
This is extremely dangerous, as misdiagnosis can create irreversible consequences for a person, both health-wise and for their social relationships. Being labelled as something that you're not can impact relationships, especially those you have relationships with already have preconceptions.
Although, stigma did still very much add to my anxiety and depression. The elephant in the room within my family, being my mental health, did indeed heighten my sense of insecurity within myself and made me feel almost ‘mad’. I’m sure I’m not alone with the feeling of delusion and inadequacy, like I had a defect that could not be fixed. Simply being told ‘other people have it worse’ and ‘you have nothing to feel sad about’ did not mend, what felt like, my broken brain.
The ‘other people have it worse’ trope
Listen, I completely understand where this idea comes from. Many of us find comfort in the knowledge that we are living in, for the most part, a safe and wealthy country. Some find tranquillity knowing their own privilege and gratitude. It’s an easy life. Those in the older generation of my West Indian family sure love that phrase, as for them the journey to Britain, a suitcase and purse of foreign currency, arriving lost and alone in not only a new country, but one 4700 miles away, does create anxiety and depression that seem alien to the kind I felt. Why be depressed when you have a roof over your head and food on your plate? But this is just another thread in the stigma that blankets discussions of mental health.
Other people do have ‘it’ worse but others also have it better. You should not compare your struggle to someone else's, nor should you equate your mental health with your socio-economic privilege.
The ‘madness’ trope
The term ‘mental health’ is associated with the extreme end of the spectrum, madness. A study into mental illness in Jamaica (by Arthur et al.) found that the ‘upper social class urban residents group’ expressed views of mental illness as ‘madness’, one said...
The term ‘mental health’ is associated with the extreme end of the spectrum, madness. A study into mental illness in Jamaica (Arthur et al.) found that the ‘upper social class urban residents group’ expressed views of mental illness as ‘madness’, one said...
. . . I think in Jamaica there is a conviction generally, widely believed that once yuh gone yuh gone, they can help me out a little but . . . that’s a strong feeling I believe generally. It might be less intense in the more educated people. Another participant generally agreed, stating “You are going to carry that stigma until you die, once yuh mad yuh mad.”
“Once yuh mad yuh mad”. Reading this gave an unsettling feeling in me, as I mentioned earlier, I still feel branded as ‘unstable’ and ‘depressed’, like I’ve been tagged for life in the eyes of my relatives. Unlike disorders like schizophrenia which are incurable, although can be managed, things like anxiety and depression can, and do, go away. (not for everyone, of course) Finding out that I am not permanently marked, despite what my relatives think, can give a flicker of hope in what feels like an endless mental health tunnel. It is relieving to see others talk about their experiences of mental health, be it friends or public figures, especially those who aren’t white.
Despite endless headaches about my head and continuous anxiety about my anxiety, I finally realised that talking about my mental health shouldn’t be deemed as inappropriate.
Everyone’s perspective on mental health is subjective, so perhaps if you do come from a ‘BAME’ community, your relatives' views won’t be so drenched in stigma. If they are, I can not promise they will come around, but starting discussions with them may be the way forward. As the 2006 study on young Jamaican’s found, the stigma is intergenerational. Breaking this stigma starts with us, so everyone can breathe a little more easily and talk a little more freely.
Some helpful links
· Nafsiyat is pioneering charity offering intercultural therapy in over 20 languages to people from diverse cultural communities.
· Young Minds published an article about mental health within British black communities, with help sites for those who wish to get in touch.
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