Stigma and self-stigma have consequences for the person concerned, and sometimes for family and friends too. Stigma sometimes means that people do not seek help for their complaints in time.
Within psychiatry, self-stigma can become a self-fulfilling prophecy: it keeps itself going because it is seen as part of a certain clinical picture or as a sign of a lack of recovery.
“I am afraid that many people who see my Haldol way of walking, or my sometimes staring look, or my insecurity built up through years of experience with psychiatry, or who know that I have a psychiatric diagnosis, do not take me seriously (any more).”
Remco
What is stigma?
“Stigma is a negative labelling of a person, of characteristics of a person, or of a group.”
Stigma can have far-reaching consequences
In psychiatry stigma affects people with certain diagnoses, a certain social status, medication use or (visible) side effects. Or people who see or experience things differently. Stigma is closely related to prejudice and to making distinctions on grounds that the law does not allow (discrimination).
Public stigma and institutional stigma
Public stigma
Stigma comes in different forms, including public stigma and institutional stigma. Public stigma is about the opinion of the public, society or the media. Negative reporting about ‘confused persons’ is a well-known example from the sensational media.
Institutional stigma
Institutional stigma is systematic: legislation, institutions, organisations, policy. Examples can be found in disproportionate cuts to resources and services for people with psychiatric complaints compared with other health care.
Prejudice
Prejudices are unfounded judgements or predictions. Some well-known prejudices about people with psychiatric problems are that they:
- are dangerous and unpredictable
- are stuck with it for life
- have brain diseases that only lifelong heavy medication can suppress
- cannot take care of themselves
- are not intelligent
- have weak genes
Discrimination
Prejudice can lead to discrimination: making an unfounded distinction on the grounds of (chronic) illness. Many countries have laws that protect people with a disability or chronic illness against discrimination. Ask a local anti-discrimination service what applies where you live and where you can report it.
Self-stigma
This is the internalising of stigma. The negative images, the behaviour of others and reports in the media come in in such a way that your self-image is damaged. Self-stigma can have a very negative effect on the wellbeing and recovery of someone with psychiatric complaints.
Possible consequences of stigma and self-stigma:
- Low self-worth
- More mental health complaints
- More difficulty with social contacts
- Isolation
- Loneliness
- Hopelessness
- Depression
What can we do against stigma and self-stigma?
A great deal can be achieved with communication and openness about the subject. This does mean putting your own judgements aside.
With self-stigma:
- Empowerment
- Informing yourself
- Contact with peers
- Recovery colleges
- Looking for peer-run centres
- Entering into dialogue
With stigma:
- Highlighting positive examples
- Being aware of the language you use
- Giving feedback
- Speaking to others about stigmatising behaviour
Prof. dr. Jim van Os, Chair Division Neuroscience, Utrecht University Medical Centre. Jim works at the interface of ‘hard’ brain science, health services research, art and subjective experiences of people with ‘lived experience’ in mental healthcare.
Jim has been appearing on the Thomson-Reuter Web of Science list of ‘most influential scientific minds of our time’ since 2014. In 2014 he published his book ‘Beyond DSM-5‘, and in 2016 the book ‘Good Mental Health Care’. In 2026 he published 'Wat psychisch lijden is'.
Want to read more?
Blogs by Jim van Os can be read here
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