Stigma and discrimination in relation to mental health
Mental health-related stigma and discrimination happen when people treat someone unfairly or think less of them due to the fact that the person has a mental health condition, symptoms that could be reflective of a mental health concern, or because they access support or services for mental health concerns.
What is stigma?
Stigma comes from misunderstandings, negative beliefs or stereotypes people have about mental health. For example, someone might think:
- that a person with depression is just lazy,
- that someone with anxiety is weak
- that disordered eating or hurting oneself is done to get attention
- that people who experience mental health concerns are dangerous or unreliable
- that it is not possible to recover from a mental health episode
Often these negative beliefs and stereotypes are not true at all, but these incorrect ideas make it hard for people who are affected to talk about their feelings or get the help they need.
What is discrimination?
Discrimination is when people act on these beliefs such as:
- a person with a mental health issue is left out, mistreated, or even bullied
- a child with ADHD might not be invited to playdates because other parents wrongly assume they will be “difficult.”
- an adult with anxiety might be passed over for an employment opportunity, even though they are perfectly capable of the job.
Are there different types of stigma?
Stigma and discrimination can take many different forms. How these influences manifest can depend on who is targeted, and by whom. Stigma can also act at different levels, resulting in various impacts.
The most common types of stigma are public stigma, self-stigma, stigma by association (also called ‘family stigma’), and structural stigma.
Public Stigma
Public stigma refers to the widespread negative attitudes, stereotypes, and discriminatory behaviours that society holds toward people with mental health conditions. It is how the general public views and treats individuals who experience mental health challenges, often based on misconceptions or fear. For example, society might label people with mental health issues as “dangerous,” “unpredictable,” or “incapable,” even though these stereotypes are often inaccurate. Public stigma can lead to people being treated unfairly, excluded, or judged, making it harder for them to be open about their struggles or seek help. This stigma reinforces negative perceptions and can affect the opportunities people have in life, like finding a job, forming relationships, or being accepted in their communities.
Self Stigma
Self-stigma happens when a person with a mental health condition starts to believe the negative stereotypes and judgments that others have about mental illness. This means they may internalise the public stigma, leading them to feel ashamed, guilty, or less worthy because of their mental health struggles. For example, if someone constantly hears that people with depression are “weak,” they might start to believe that about themselves, even though it’s not true. Self-stigma can make people less likely to seek help, reduce their confidence, and worsen their mental health condition.
Stigma by Association
Stigma by association, or family stigma, happens when the relatives or close friends of someone with a mental health condition experience negative attitudes, judgment, or discrimination because of their connection to that person. This form of stigma affects family members or caregivers who may be blamed, judged, or even avoided because society views mental illness negatively. For example:
- parents of a child with a mental health condition might be seen as “bad parents” or blamed for their child’s condition.
- siblings of someone with a mental illness might face social exclusion or feel embarrassed by the way others treat them.
Family stigma can lead to feelings of shame, stress, and isolation for those who are closely connected to someone with a mental health issue. It also discourages families from seeking support, as they may fear judgment or be worried about being seen as responsible for the mental health struggles of their loved one.
Structural Stigma
Structural stigma refers to the policies, laws, or practices within institutions (like governments, schools, workplaces, or healthcare systems) that unintentionally or deliberately disadvantage people with mental health conditions. This type of stigma is built into societal systems and can limit access to resources, opportunities, or fair treatment for individuals experiencing mental health challenges.
What are the consequences of stigma and discrimination?
Stigma and discrimination can cause a lot of harm. People might feel ashamed or embarrassed about their mental health struggles and might avoid talking about them or seeking help. This can make their situation worse and lead to more suffering. Mental health stigma and discrimination are especially important to consider and address when it comes to younger age groups, as children and young people are still developing emotionally and socially. If they face judgment or exclusion due to mental health issues, it can deeply affect their self-esteem, relationships, and overall well-being.
Here are a few key reasons why these issues are particularly relevant for children and young people:
Emotional and Social Development. Kids and teens are still figuring out who they are, and their self-worth is often shaped by how others see them. If they are stigmatised because of mental health challenges—like anxiety, depression, or ADHD—they may start to believe negative things about themselves.
This can lower their confidence, make them feel isolated, or lead them to withdraw from social activities and friendships, which are vital for healthy development.
Fear of Seeking Help. Young people who worry about being judged might hide their mental health struggles rather than ask for help. If they internalise the stigma, they may avoid talking to parents, teachers, or even mental health professionals.
This can lead to issues becoming more severe over time, as untreated mental health problems can worsen and interfere with school, friendships, and family life.
Bullying and Exclusion. Children and teens with mental health conditions are often at a higher risk of being bullied or excluded by their peers. This kind of discrimination can happen directly—through teasing or rejection—or indirectly, when other kids treat them differently. Bullying or exclusion can intensify feelings of loneliness, anxiety, or depression.
School Performance and Future Opportunities. Mental health issues that go unnoticed or untreated due to stigma can impact school performance. Children may struggle with concentration, motivation, or interacting with others. When a child’s mental health challenges are misunderstood, they might be labelled as “troublemakers” or “lazy” instead of receiving the support they need. This can affect their academic success and limit future opportunities.
Long-term Impact. The way children experience and deal with mental health issues in their early years can shape their attitudes toward mental health throughout their lives. If they learn early on that mental health struggles are shameful or something to be hidden, they may continue to avoid seeking help as adults. On the other hand, if they grow up in an environment where mental health is treated openly and without judgment, they are more likely to develop healthy coping strategies and ask for help when needed.
What is the role of family in a young person’s mental health?
Family dynamics significantly shape a person’s mental and emotional well-being. Whilst family plays an essential role in supporting loved ones with mental health challenges, they can also be an unintended source of stigma.
- Preconceived ideas held about mental health can cause family members to apply stigmatising views, language and behaviour towards others.
- Negative perceptions and a lack of understanding, likely influenced by societal, cultural and generational attitudes, can deter open discussion, make a child or young person feel misunderstood or even pushed away, and worsen the situation.
- Additionally, home environments that discourage or shame conversations of mental health, feelings and emotions can cause internalised feelings of shame, as well as lead to a person’s inability to manage their own emotions healthily.
When families are supportive, empathic and non-judgmental, this is an incredibly impactful source of support for children and young people as they navigate their challenges.
What kind of influence can peers have on stigma?
Peers hold a significant influence on the lives of children and young people – including around coping with mental health challenges – given the amount of time spent at school, doing hobbies, and with friends.
- Children often find it easier to talk about their mental health challenges to peers rather than adults, as they may think their friends and others of a similar age can better relate to and understand their experiences.
- Although it is great when children have close friends that they can confide in, it can be an issue if concerns and worries are not shared beyond the peer group, as this could lead to their parents and other adults being unaware of what is going on. This can eventually lead to delays in accessing other forms of appropriate support if needed, such as connecting a young person with formal support from healthcare providers.
- The peer group can also be a source of stress and worry for a child or young person navigating mental health concerns.
- Peers can be a source of stigma and discrimination, for example, if personal information that has been shared in confidence gets spread around. This can lead to worries about, or actual experiences of, disruptions in friendships, bullying, social exclusion, and lower self-esteem.
What is the role of the internet and social media on stigma in young people?
Children and young people can turn to the internet for mental health information, and rely on connections made through social media for support, coping strategies, and a sense of community during difficult times. The internet and social media can have a double-edged impact:
- On one hand, they act as a source of information, provide platforms for support, and connecting with others who face similar struggles.
- On the other hand, they can exacerbate issues through possible risks of cyberbullying, driving unrealistic comparisons, and the pressure to maintain a perfect online image, thus contributing to poor mental well-being.
Children and young people can also come across stigmatising views and content about mental health online, which can exacerbate worries about being treated differently by others if it becomes known that they are concerned about their mental health or accessing support for mental health-related concerns.
What is the impact of culture and religion on mental health issues?
Culture can significantly impact how mental health is perceived. In many cultures there is stigma surrounding mental health, for example in terms of beliefs that mental health challenges can be caused by spiritual possessions or are seen as a weakness and a moral failing. This can increase the risk of discrimination and social exclusion, and make it more challenging for children and young people who are struggling to feel comfortable talking about what they are going through.
Culture can also influence whether an individual receives treatment, and what type of treatment this may be. A lack of understanding of mental health in some cultures can lead to unhelpful suggestions for sources of support, potential treatments, or no treatment being given at all.
Religion and faith also shape how mental health is perceived. Within some religious communities, mental health challenges can be hidden and not openly discussed. Some religions view mental health challenges as a result of sin or a lack of commitment to faith, contributing to stigma and resistance to seeking professional help, which also may be seen as a ‘Western’ approach. Whilst religion, faith and spirituality can be a great source of support and comfort during times of difficulty, for some, the religious community and places of worship can be a contributor to stigma and lead to feelings of shame, rejection, and worsened mental health.
How can parents and families support their child?
Addressing stigma early and encouraging open conversations about mental health can help children and young people develop resilience and a healthy understanding of their emotions. Parents, teachers, and communities play a big role in creating an environment where kids feel safe to express their feelings without fear of being judged.
As parents, it is important to teach our children that mental health is just as important as physical health. If someone is struggling, it is ok to talk about it and support them, just like you would if they had a broken arm or the flu. By breaking the stigma, we can create a more understanding and supportive world for everyone.
Be there to listen without judgement
Listen more than you talk, and really pay attention to what your child is saying. Remember that it is not your job to fix all of their problems, but it is always your job to make sure your child feels heard, accepted, and loved.
Encourage conversations about emotions and feelings
Talk about times when you have felt overwhelmed or low and how you managed these situations. Regular conversations about feelings and emotions demonstrate to your child that it is ok to feel all types of emotions, and that there are healthy ways to manage any situation.
Let them know they are loved and supported
To best support your child, it is essential that they feel as though they can talk to you about anything, and that this will not change how you view them or the love you hold for them. Reminding your child that you love them unconditionally and will always be there for them helps to create a safe environment for them to come to you for support.
Model healthy coping strategies
Your child will likely model your own strategies for handling difficult emotions and situations. Ensure you are demonstrating healthy coping strategies. Deep breathing, going for a walk, listening to music, yoga, or another exercise you find relaxing can all help you regulate your own emotions in a healthy way. A habit of supportive, honest and reflective conversations and valuing emotional wellbeing creates an open environment at home.
Reach out to friends and community
Parents may be reluctant to share their concerns about their child’s mental health with their friends and community due to:
- feelings of shame
- fear of judgement
- lack of trust in others maintaining the privacy of the child’s personal challenges
However, families and parents don’t – and shouldn’t – have to find all solutions to support their child on their own. Here are some benefits to sharing about mental health and neurodivergent issues:
- Reaching out for help is a sign of strength and dedication to your child’s wellbeing, not a reflection of inadequacy or failure as a parent. Rather, it can provide the tools needed to create a supportive and healing environment for the entire family.
- Opening up about your child’s challenges is not only important in order to seek support and guidance. It also helps to create a more open environment where mental health topics are no longer a taboo.
- It can help to educate others in your social networks and community (including your child’s peers) about the challenges your child is experiencing.
- It can also be helpful to let others know what they can do to support you and your child. It will serve both parents’ and children’s mental wellbeing to have a community of people around them who are understanding and empathetic.
Connect with your child’s school
You should never feel embarrassed to reach out to your child’s teachers, or school-based support like the SENCO, if you have concerns about your child’s emotional wellbeing and coping. This can be as simple as expressing your observations in a calm and constructive way, for example:
“I’ve noticed some changes in my child’s behaviour lately, such as [describe behaviours], and I’m concerned about their wellbeing. I wanted to discuss this with you to see if you’ve noticed anything similar at school and to explore ways we can work together to support them.”
This approach invites collaboration and communication, which is essential for providing the support and resources your child may need to thrive.
Consider professional help
Remember, seeking professional help does not mean you have failed as a parent. If you are concerned that your child has been struggling for a long period of time, or you have troubling concerns about your child’s wellbeing, reaching out for professional help can help give support to your child and yourself to help you navigate through this journey.
Dr Petra Gronholm, Assistant Professor, London School of Hygiene and Tropical Medicine, Honorary Lecturer and Research Fellow, King’s College London
Beth Gallimore, MPhil, PhD Researcher, King’s College London