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    Culture of Silence: The Negative Impact of Stigma and Discrimination on Mental Health

    There are many public initiatives and awareness campaigns regarding mental health; however, attitudes within most societies and cultures frequently foster stigma and discrimination.  Misunderstandings surrounding mental health are widespread, and despite the effective treatments, there is still the belief that some individuals may be untreatable, or simply need to deal with the issues on their own.

    One in five Canadians will experience a mental health problem every year.  That’s about 7 million of us.  Yet, despite the prevalence, mental health continues to be met with stigma in hospitals, workplaces, schools, rural and urban communities, and even among close friends and families.  In 2001, the World Health Organization (WHO) identified stigma and discrimination towards individuals with mental health concerns as, “the single most important barrier to overcome in the community.” According to WHO and the World Economic Forum (WEF), these concerns represent the biggest economic burden of any health issue in the world, costing $2.5 trillion in 2010.  It is projected to cost $6 trillion by 2030, with two thirds of the costs attributed to disability and loss of work.

    How does culture affect our understanding of mental health?  Culture is a shared set of beliefs, meanings, values, and behaviours through which experience is interpreted and carried out.  It is the ‘lens’ through which we see the world.  Our cultural beliefs contribute to our attitudes, or pre-existing ideas we may have about mental health.  Negative beliefs, or stigma, reinforce stereotypes and discrimination toward individuals with mental health concerns.  For example, studies show the use of language and terms such as ‘crazy,’ ‘weird,’ or ‘different’ can fuel stereotypes that may negatively impact whether or not people choose to access services.  The social effects can result in abuse, isolation, exclusion, poor social supports, low self-esteem, and low quality of life.

    Culture of silence around mental health

    Openly talking about mental health may be very difficult, and silence is an active barrier.  Silence can reinforce negative labels, stigma, and shame, which can result in reluctance for people to access resources.  We have to ask ourselves why we are okay with discussing physical health concerns, yet struggle to talk openly about mental health.  In Asia for example, where many cultures value conformity to norms, emotional self-control, and family recognition through achievement, mental health concerns and clinical diagnoses are often stigmatized.  This may be viewed as socially damaging and regarded as a source of shame.  In some cultures, there is the belief that depression is a ‘personal weakness,’ and that an individual struggling with it can just ‘get through it.’  Stigma can be so extreme in some cultures, it is thought to reflect poorly on family lineage, can diminish marriage and economic prospects for family members also, and pose risk to a family’s reputation and status.

    What can you do?

    Education is the first step toward combating stigma.  People need to be equipped with appropriate tools to help themselves and others when dealing with mental health concerns. Reducing stigma requires making a change toward acceptance, respect, and equal treatment of people.  Struggling with mental health is not a choice, and it can affect anyone regardless of gender, age, SES, or background.  Recovery is possible with appropriate treatment, education, and support.  Take the time to be proactive about your mental health matters and to be supportive of family and friends who may be suffering.  Together, we are stronger.

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