In recent years, huge advances in medical science have uncovered a variety of treatment approaches that are proven to treat young people’s mental health conditions. At the same time, many teenagers and adolescents continue to live with mental health disorders – and only a minority receive adequate treatment.
Stigma is one of many barriers that young people face when accessing mental health care. Stigma can act on several levels: young people may encounter stigma among healthcare professionals, from their parents, or internalised within themselves.
At each stage, it can discourage teenagers and adolescents from seeking help, starting a program, or remaining in treatment. Ultimately, it can prevent them from reclaiming the happy and healthy lives that they deserve.
This blog explores some of the ways that stigma can act as a barrier to young people’s mental healthcare. It also touches on the ways we can challenge stigma to help young people access the specialist treatment they need.
What Is Stigma?
According to Link (2001), stigma happens when labelling, stereotyping, separation, status loss, and discrimination exist together in a situation that allows them. This means that certain groups of people are stereotyped to be a particular way, considered to be ‘other’, and treated unfairly by other parts of society.
Mental health stigma can take various forms. People with mental health issues may be wrongly stereotyped as dangerous, incompetent, or unpredictable. This can lead to discrimination from employers who may not hire them or from healthcare professionals who may provide a lower standard of care.
Together, stereotyping and discrimination can affect a person’s self-esteem as they internalise the stigma they face and blame themselves for the consequences of discrimination.
Stigma Among Healthcare Professionals
Stigma can affect young people’s access to treatment on many different levels. Some of the most significant effects of stigma stem from stigma among healthcare professionals.
According to one survey, nearly one quarter (22.3%) of stigma experienced by people with schizophrenia and their families was related to their mental health care.
People have reported that mental healthcare professionals:
- can lack interest in themselves as a person and their individual mental health history, instead providing the same standard treatment for everyone
- may not give adequate information about the treatment they will receive or its side effects
- may not give them enough personal attention
- can have a negative outlook about their prognosis, chances of recovery, and the effects of their disorder
Other research has underlined the presence of stigmatising attitudes and behaviours among healthcare professionals. A scoping review found that among somatic health professionals, stigma may be caused by various factors, including a lack of knowledge about mental disorders, a lack of time to care for individuals who require more time and attention, and feelings of insecurity among people with mental health concerns.
These stigmatising behaviours can have a big impact on young people’s access to effective treatment. Young people may be given a standard treatment program that doesn’t suit their individual needs, making the recovery journey more difficult or even impossible.
A lack of hope for young people’s recovery may stop healthcare professionals from exploring different treatment options or offering the time and attention they deserve.
Stigma among somatic health professionals can also mean that young people do not receive adequate treatment for physical health problems, increasing the presence and severity of somatic disorders.
Stigma among healthcare professionals not only affects the quality of treatment but may prevent young people from reaching out for help, particularly if they’ve had previous stigmatising experiences.
Research on barriers to care for adolescents with borderline personality disorder (BPD) has found that negative experiences in treatment may discourage them from seeking future care.
Young people with BPD may be especially vulnerable to stigma because of their tendency to integrate negative ideas about themselves into their identity, causing them to stigmatise themselves and de-validate their own experiences.
Research also shows that clinicians hold more negative opinions about borderline personality disorder than depression and may even refuse to treat young people with BPD.
Parents as Gatekeepers of Mental Health Support
Parents play an important role in a young person’s seeking (or not seeking) treatment. Supportive parents may encourage a young person to seek professional support while others may de-validate and minimalise their experiences.
Parents also often have the final say in whether a young person can access treatment, especially if financial or other resources are required. Children and younger adolescents are rarely able to seek help alone, making parents ‘gatekeepers’ of mental health support.
Research has explored some of the reasons that parents may be encouraged or discouraged to seek treatment for their child, including reasons related to stigma.
The biggest attitudinal barrier that parents report relates to stigma among healthcare professionals. Parents describe how feeling dismissed or ‘blamed’ for a young person’s problems can discourage them from pursuing treatment for their child.
Parents have also described how negative attitudes and social stigma about mental health disorders or treatment may discourage them from seeking treatment. In a systematic review, parents reported stigma among other people as a barrier to treatment in 46% of qualitative studies across different countries and cultures.
Finally, parents’ own stigma about mental health issues may also deter help-seeking on behalf of young people. These feelings can be accompanied by discomfort talking about their child’s problems or a desire to solve family issues by themselves. Friends and other family members may also play a role in encouraging or discouraging parents to seek professional support.
Young People and Internalised Self-Stigma
When young people experience stigmatising behaviours from healthcare professionals, friends, employers, or other parts of society, they can start to internalise stigma.
Internalising stigma means believing the false stereotypes and labels that others hold about them and accepting their discrimination and mistreatment as to some extent justified.
Young people may start to believe that there is something ‘wrong’ with them because of their mental health disorders or that the chances of recovery are low or even impossible. They may begin to view themselves as a burden on society or other people and believe that they don’t deserve treatment.
These consequences cause serious damage to a young person’s self-worth and quality of life. They can also make it less likely that a young person will seek treatment and access the support they need to manage or recover from mental health disorders.
Challenging Mental Health Stigma
Research shows how stigma can act as a barrier to young people’s mental health support on many levels. This means that challenging stigma is crucial for children and adolescents to access the healthcare they deserve.
There are lots of different ways that stigma can be challenged. Anti-stigma initiatives may try to increase awareness and knowledge of mental health disorders and treatment options, improve public perceptions of people with mental illness and their families, and encourage actions that prevent discrimination and prejudice.
In the past decade, mental health professionals across the world have started many initiatives to try to combat stigma, and many have been successful. It has been noted, however, that most of these programs failed to address stigma within the psychiatric profession itself – despite the fact that stigmatising behaviours are common within it.
It’s crucial that anti-stigma initiatives continue at all levels to reduce the barriers to young people’s mental health care, improve their self-esteem, and build supportive communities and structures that are beneficial to all.
The Wave Clinic: Specialist Recovery Programs for Young People
The Wave Clinic offers specialist mental health treatment for young people, supporting them to plan and build better futures.
Our whole-person approach combines education, social responsibility, and a gap year experience with exceptional clinical care, ensuring young people receive the best treatment available while they develop skills, relationships, and interests that last for life.
At The Wave, we’re guided by our core values of inclusivity and fairness. We work with young people to build their self-confidence, challenge implicit stigmas, access experiences, and value connections. Our programs are about opening doors and building life advantage.
If you’re interested in finding out more about our programs, get in touch today. We’re here to support you.
Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).
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