Mental Health — Why So Stigmatized?
Why is mental health so… “oh, I didn’t know that about her…” or “he really has a problem with that?”
As a graduate researcher and teaching assistant at Colorado State University, my thesis work is centered largely around mental health and media, and how that media can positively and negatively impact our perception of reality.
As a human being, and generally stressed-out, anxious 22-year-old, I’ve had my fair share of troubles within the scope of mental health. I’ve been face down in public bathrooms, puking my guts out, I’ve been on top of some really, really high buildings for some really, really not good reasons, and I’ve been on a fair bit of antidepressant medication that has had me feeling…pretty blehhhhh. I’ve been through it and, well, will probably go through it again at some point — but dismissing mental health troubles like it's something that the vast majority of the population doesn’t deal with is bullshit. I’m here to crack this conversation wide open.
There’s been a large amount of research on this general topic of mental health communication, but not much on the actual implications of mental health and communication — to put it more simply: not many researchers have found evidence that our mental health and likewise emotive states are concretely impacted by particular types of media — which is what I’m setting out to do. I want to know if we’re negatively impacted on a psychological level by mindlessly scrolling on Instagram, why seeing people that we perceive to have “better” bodies than us can put us in a bad mood, and what the implications of that repetitive cycle of doom-scrolling on perceived negative content can do for the development of mental health disorders.
And, most importantly: I want to use all of this information to improve and change our communication and relationship with mental health in society.
Thus, I chose Mental health sigma and communication and their intersections with education, by Rachel A. Smith & Amanda Applegate, published in the Wicked Problems Forum: Mental Health Stigma.
Throughout this paper, which functions as a stimulus essay and explanation of stigmas around mental health, the authors take a research theory approach formerly unbeknownst to me: stigma research, or stigma communication theory. In order to best understand this frame of research, I had to do a bit of extra digging on the paper’s main author’s (Rachel Smith) publications, finding Language of the Lost: An Explication of Stigma Communication on the Wiley Online Library. While the initial paper does a good job of explaining this approach, I found the diagram below illuminated the theory’s examination and respective reactions/effects much better.
The paper differentiates stigma from other words often heard (and somewhat miscommunicated, for the matter of our misinformation and disinformation tropes), such as stereotype or taboo through its etymology — comparing its modern-day definition to that of its Greek roots, where a stigma was a mark made on the skin by spears or other archaic devices — essentially a tattoo, but used with a negative connotation, marking slaves and other lower members of society. A stigma is then defined within the paper as a “standardized image of disgrace” that a society or community holds around a topic, and stigma communication is the likewise communication of those stigmas to a larger audience, arming that population with the tools on how to react justly and accordingly to those stigmas.
So, this model of stigma communication includes four frames:
marks: cues that identify membership in a group that is viewed as stigmatized
labels: how a community refers to that stigmatized group
etiology: how we explain and reason with others (and ourselves) that someone became a part of that stigmatized group
peril: how that stigmatized group threatens our overall well-being in life.
Overall, while the framework was complex and increasingly wordy the more I delved into it across multiple publications and research papers, I appreciate the model, especially for this paper. For the purposes of researching communication and related media fields, and desiring to study the behaviors that become of those communications in stigmatized fields (such as mental health), this is a really, really interesting research approach.
This was the sole theory used to look into the main topic of this essay: the intersection of mental health and higher education. The ‘stigma’ component of this comes up in accessing mental health services, specifically studying students from a K-12 and collegiate setting, and the barriers they face when, quite literally, asking for mental health help and counsel. It was saddening to read (but not surprising) that the overall fear of being stigmatized and viewed as an other group in school was the #1 reason why students avoided getting help (Bowers, Manion, Papadopoulos, & Gauvreau, 2013. The theory was also used to measure stigmatization and the behaviors individuals showed from a parental perspective, and then went on to explain how this problem only worsened for students already facing fear around stigmatization when approaching higher education.
The paper concludes with a few subjective paragraphs from the author on the problem with stigmatization in society, why labels are several detrimental to the performance and overall quality of life for students, and why we should welcome neurodiversity for autism spectrum disorders, mad pride studies, and other similar movements. The paper didn’t necessarily lack a methods section — I honestly realized while reading this publication that there was a literal pot of gold of value within the actual framework of the Stigma Communication Theory model. In the author’s analysis of the current state of stigmatization in mental health circles, the methodology and theory explained previously were utilized — it was an altogether qualitative scope and method of explaining the goals and problems of the paper it wanted to tackle.
My thoughts on this paper’s use of the Stigma Communication Model was that it was a hand-in-glove fit for analyzing a research topic that is centered around miscommunication and the negative behaviors and actions that ensue because of that respective miscommunication. In this instance, the miscommunication is on the paradigm of mental health and influencing our students and peers to seek help regardless of the stigmas they may feel surrounding the topic. The methods segment of the paper, however, was lacking, but that was mainly because this was an essay and explanation of the theory and its ongoing framework in action, so I understand the more qualitative and explanatory nature of its use here. If I could do anything different with this study, I would’ve asked Smith and her team of researchers to juxtapose more stigmatization research and framework conceptual images into this paper — it was somewhat lacking in the actual explanation of the main theory used in the paper, which I found was fundamental to understanding the just of this study.
Implications
Additionally, I feel like there is a great ability to use the Stigma Communication Model for good! In terms of utilizing this for a study, rather than just a pure essay, I could absolutely see an application in the K-12 realm. For instance, using this framework on a group of 500 high schoolers at Rocky Mountain High, and surveying them all on their perceptions of mental health, mental health communication, what it’s like to suffer from mental health issues, the differences between mental health and mental illness — there’s a great ability here to gain valuable insight to how our current education is teaching and influencing the current field of mental health communication. Then, applying the framework of the stigma model, it’s easy to see why we’re funneling these messages into actual fears and stigmas around mental health-related topics — implying that through the use of these tattoos on our students and peers that negatively define mental health, the seed for negative relationships with mental health and asking for help is planted. In my opinion, this framework offers a unique way to approach cutting off a problem in communication’s respective actions/behavior at its head (in this instance of the Stigma Communication Model, at the message choice level in marking, labeling, responsibility, and peril). I think there’s absolutely usage here to highlight why people are thinking a certain way about a perceived negative behavior, which can lead science communicators to overlay this misdefined negative behavior with hard statistics on the horrors of not asking for help in mental health (ie: suicide rates, anxiety data for college students, etc.), testimonials, and complex forms of media (documentaries and other forms of effective communication and altogether enticing content) to show why these perceived negative behaviors can and should be normalized in society.
In sum, I think the Stigma Communication Model is a great tool for outlining why we think a certain way about a stigma and perceived issue in society, which can then be used by science communicators to flip that perception on its head. Hopefully, science communicators like myself — where we can use an interdisciplinary, combined approach of STEM individuals and communicators to change our perception of mental health — for good.
Sources:
Bowers, H., Manion, I., Papadopoulos, D., & Gauvreau, E. (2012). Stigma in school‐based mental health: Perceptions of young people and service providers. Child and Adolescent Mental Health, 18(3), 165–170. https://doi.org/10.1111/j.1475-3588.2012.00673.x
Smith, R. A. (2007). Language of the lost: An explication of stigma communication. Communication Theory, 17(4), 462–485. https://doi.org/10.1111/j.1468-2885.2007.00307.x
Smith, R. A., & Applegate, A. (2018). Mental health stigma and communication and their intersections with education. Communication Education, 67(3), 382–393. https://doi.org/10.1080/03634523.2018.1465988
