Let’s Face It, No One Wants To Talk About Mental Health

Understanding the Family’s Role in Mental Health Stigma

Family members can also experience stigma, both real and perceived. It’s common to fear that society or people in our communities will blame us for causing a loved one’s condition or will reject our family socially.

Family members may internalize public stigma and blame themselves. This can lead to social isolation and resistance to reaching out for help.

In family dynamics, it’s important that stigma and its rippling effects be addressed.

Approximately 50% of people will be diagnosed with a mental health condition at some point in their lifetime. Even if half of a family experiences a mental health disorder, the whole family feels its impacts.

How Does Gender Impact Mental Health Stigma?

Many societies expect men to be tough and to hide their emotions. This expectation means men are far less likely to seek help than women, but also have increased rates of depression and suicide.

Women are often expected to show traditional feminine traits, such as gentleness and emotionality. They are criticized for being “hysterical,” but also for displaying traditional masculine traits, such as competitiveness or aggression.

Women are also often judged more harshly for struggling with issues related to addiction, such as substance use and gambling. These conditions are linked—unfairly—to men.

Women with children can fear being labeled unfit mothers if they are experiencing depression or anxiety.

Mental Health in the LGBTQ, Black, and Asian Communities

Stigma is even more difficult in communities or cultural groups where people experience additional, unique stressors.

What follows is not an exhaustive list that covers every community or every barrier they face, but rather, broad descriptions to show cultural patterns.

LGBTQ+ Mental Health

The stigma, prejudice, and discrimination members of the LGBTQ+ community face can lead to unhealthy coping tactics and a range of health conditions, including mental health issues.

A recent study found that one in three LGBTQ+ adults experienced mental health disorders as compared to one in five heterosexual adults.

LGBTQ+ individuals also experience barriers to care for several reasons. The National LGBT Health Education Center revealed that members of the LGBTQ+ community are:

• Less likely to have health insurance
• More likely to experience discrimination from health care staff
• More likely to discover that clinicians do not have knowledge in caring for them

According to the 2015 National Transgender Discrimination Survey, in the previous year:

• 33% of transgender people had at least one negative experience with a health care provider, such as being refused treatment because of gender identity
• Nearly a quarter of transgender people reported not seeking needed health care due to fear of such gender-related mistreatment
• 39% of respondents reported serious psychological distress in the previous month

There is a 40% lifetime suicide attempt prevalence among transgender people. For comparison, the U.S. population’s lifetime suicide attempt rate is 4.6%. This rate drops dramatically when transgender people can access gender-affirming medical care.

Mental Health in the Black Community

Although stigma regarding mental health issues is universal, research shows that it is higher in the black community.

For example, it can be unacceptable to talk about one’s mental health issues, even within the family. Family and faith are traditionally sources of strength for members of the African American community, but their emphasis can prevent people from seeking professional help when needed.

Black men, especially, receive the message to be strong and to deal with problems on their own. This masking of issues can lead to greater symptoms of anxiety and depression and to self-medicating through substances, such as drugs or alcohol.

Disparities in health care can prevent people from the African American community from receiving care. Approximately 30% of Black adults receive treatment each year compared to 43% of white adults.

Asian American Pacific Islander Mental Health

Asian American Pacific Islander (AAPI) communities face discrimination and also struggle with the model minority myth: the idea that all AAPI are well-adjusted and successful. This myth overlooks the challenges faced by this population, with research showing a relationship between discrimination and the mental health challenges faced by Asian Americans.

While Asian Americans have many strengths to draw on, such as family, community, and religion, they can face their own unique challenges.

Among AAPI folks, mental health issues can be seen as a source of shame. Using mental health services may be seen as an admission that something is wrong not just with an individual, but the whole family.

Traditionally, the connection between mind and body is strong within Asian culture. People may present mental health issues as physical complaints, such as a stomachache or dizziness.

By seeking care for a physical concern rather than a mental concern, it lessens the shame felt about seeking psychological care.

However, the stigma around seeking help appears to be shifting between generations. Research shows that a person’s comfort level with U.S. mental health treatment can vary by generation. U.S.-born, third-generation AAPIs access more health care than first- or second-generation family members.

Mental Health in Latinx/Spanish-Speaking Communities

The Latinx community is diverse and includes people from 20 different countries, including the U.S.

One of the challenges around understanding mental health statistics in Spanish-speaking communities is that early studies examined numbers of symptoms and not the number of disorders in these communities.

There are also few accurate studies on mental health in many Latinx countries. Many research studies included just a few hundred to a few thousand participants. Because of this, it’s difficult to get exact numbers on just how many Latinx individuals live with mental health conditions.

A 2018 SAMHSA report revealed that 8.6 million Hispanic adults in the U.S. had either a mental health disorder, including substance use disorders, with 1.5 million of these adults having a serious mental illness. Of adults with serious mental illness, 57% of those under the age of 25 did not get any treatment (approximately 276,000). Of those ages 26-49, 40% had no treatment (approximately 308,000).

Some studies have indicated that the rates of psychiatric disorders in the Latinx community vary between ethnicities as well as where the person was born. Individuals born outside of the U.S. reported lower rates of mental health conditions than U.S.-born Latinx community members.

Some Latinx people have lived in the U.S. for many generations, while others are recent immigrants. First- and second-generation immigrants often experience challenges with combining their former and new cultures they’ve lived in. The difficulties of blending cultures can pose unique mental health challenges for Latinx folks.

The community’s strong emphasis on family and social connections may cause folks struggling with mental health issues to not seek care.

While religion can be a source of strength, it can also cause shame in those who experience mental health struggles. In addition, it can cause stigma in those seeking diagnoses and treatment. The explanation: belief in demons as the cause of mental health conditions.

Often members of the Latinx or Hispanic communities are very private. They may not want to publicly discuss difficulties at home, work, or within the family. This may lead to people not getting information they need to care for their mental health or may contribute to additional stigma around the subject.

Like other communities, Latinx people face disparities in access to care. Health care costs and poor communication from providers can be issues for some, as there is a known shortage of Spanish-speaking or bilingual providers.

Similarly to the AAPI community, Latinx community members may describe their mental health symptoms as physical ailments. This cultural difference in explaining symptoms to a provider can lead to a misdiagnosis or overlooking a mental health condition altogether.

Mental Health in the Media: TV, Movies, and More

News, television programs, and films often show people with mental health conditions as dangerous. Research shows news outlets are more likely to cover dramatic crimes committed by people with mental health disorders instead of similar crimes done by those who are not formally diagnosed.

When considering violence and mental health issues, studies indicate those with mental illnesses are more likely to be victims rather than perpetrators of violence. The vast majority of people with mental health disorders are not violent, not criminal, and not dangerous.

Common media portrayals of people with mental health struggles include, but are not limited to:

• Being homicidal or extremely dangerous
• Being “psychopaths” or “maniacs”
• Being responsible for their condition or behaviors related to their condition

Irresponsible media portrayals include coverage of mental health challenges, such as depression and suicide, without discussion of struggles that led to suicidal behavior or education about what to do if someone is struggling.

The National Action Alliance for Suicide Prevention makes nine recommendations to help content creators craft stories about survival, hope, and healing:

1. Convey that suicide is complex and often caused by multiple factors
2. Show that help is available and identify how to seek it
3. Portray characters with suicidal thoughts who do not go on to die by suicide
4. Connect viewers to resources
5. Portray everyday characters who can be a lifeline
6. Depict the grieving and healing process of people who lose someone to suicide
7. Avoid showing or describing the details about suicide methods
8. Consult with suicide prevention messaging experts and people with personal experience
9. Use nonjudgmental language

Members of the media can be strong allies in fighting stigma. Programs connecting mental health educators with journalists can get topics covered accurately.

The media can educate the public on facts about mental health. They can reduce stigma by sharing stories of everyday people with mental health challenges.

There’s a silver lining to having so much media readily available to us. Folks are starting to use it as a way to destigmatize mental health conversations. From educational webinars to story submissions, people are turning to social media and their social circles to help debunk long-standing false impressions of mental health.