Culture, Mental Health Stigma, and How We Can Tackle It

Stigma is when society sees you negatively due to a particular characteristic or attribute. For example, in previous centuries, there was a strong stigma against people with leprosy — if society knew or noticed you had leprosy, you might be rejected and marginalized. You might need help to maintain relationships, find employment, and more.

Today, one of the biggest stigmas we face as a global community is against people with mental illness. Mental health stigma is present around the world and is dangerous because it can prevent people with mental health concerns from getting needed treatment.

Although every community has some sort of stigma against mental health issues, the way this stigma manifests can differ depending on cultural beliefs. Today, we’ll examine how culture affects stigma and how you can overcome stigma to get treatment.

How does culture impact mental health stigma?

Every culture around the world has some sort of stigma against people who live with mental illness. Although the reasons for the stigma and the consequences may vary across communities, as the authors of a 2016 study concluded^[1]: “There is no country, society or culture where people with mental illness have the same societal value as people without mental illness.”

In other words, stigma is a global phenomenon and epidemic keeping people everywhere from getting the treatment they need.

However, there are cultural considerations to think about when discussing mental health stigma across diverse communities. Research studies have identified several different factors that come into play when studying mental health stigma across different cultures^[1]. Let’s take a look.

Collectivism vs. individualism

Studies have shown cultural values that place collectivism over individualism have a lot to do with how mental health stigma manifests. Cultures that value collectivism highly emphasize harmonious coexistence between all groups. These cultures may have difficulty with anyone exhibiting behavior outside the norm.

Since these cultures value harmonious relationships within society, if mental health issues get in the way, there may be a solid adverse reaction. On the other hand, in places like the U.S., where individualism is highly valued, people may not be as concerned about harmonious relationships. These cultures may be less disrupted when someone struggles with their mental health.

Face concern

Face concern is an essential concept in many different cultures around the world. Cultures that value “face” want to put their best self to other people, especially those outside the family. Maintaining a positive impression on your social network and being in good standing within society is essential to life in these cultures.

There may be a strong stigma against anything that causes you to “lose face” in front of others, including having mental health issues. If you hold this cultural value, you may be reluctant to seek help because you fear what others may think.

This fear of “losing face” often has far-reaching consequences. For example, people may not want to marry members of a particular family if it’s known one of the family members has a mental illness. Admitting to mental health issues may be seen as bringing shame onto your family. Because of this, people from cultures who value saving face may not want to seek treatment or talk to professionals outside of their family about personal issues.

Public stigma

Studies have found in most cultures around the world, there is a public stigma against people who live with mental illness. This means the public’s general perception of people with mental illness is negative overall. We see this over and over again across a wide variety of cultures.

In some countries, like the United States or Australia, people with mental illness can be viewed as being dangerous, unpredictable, or more likely to commit violent crimes. In other cultures like Japan and China, mental illness is more likely to be seen as a sign of weakness or the family’s failure to care for mentally ill members appropriately.

Either way, public stigma against mental illness is one of the most dangerous forms of cultural stigma. Not only does it prevent people with mental illness from seeking the treatment they need, but often, it also marginalizes them within society itself. For example, living in a country with high public stigma may mean people with mental illness are less likely to gain employment, be approved for housing, and so on.

Social image

There are also many cultural values related to social image and gender roles that contribute to mental health stigma within particular societies. The classic example of this is the cultural value of “Machismo” in many Latin American countries.

These cultural values regarding social image cause people of certain groups to feel even more stigmatized for struggling with their mental health. Men in cultures that value machismo and masculinity may not feel they’re able to admit to having mental health issues for fear of being judged as “feminine” or “weak.”

Religion and spirituality

Lastly, religion and spiritual beliefs are a core part of any culture. In some cases, religious values may contribute to mental health stigma within particular cultures. For example, Roman Catholics have historically interpreted people with certain mental illnesses as being possessed. In one study, Latin American Catholics were more likely to attribute symptoms of mental illness to a lack of faith, punishment, or demons.

This may cause people who hold religious beliefs to delay getting treatment. Although religious leaders can and do provide mental health treatment, they are not professionals and may not provide appropriate treatment. For example, people who believe in devil possession may treat symptoms of mental illness with an exorcism ritual rather than medication or therapy.

Religious beliefs can also make people feel any misfortunes in life, including mental illness, are some sort of divine punishment. This can significantly increase the level of shame and guilt people feel when struggling with their mental health. These beliefs can also lead to a fatalistic view of mental health; people may believe their mental health problems are “God’s will” and be more reluctant to take action to improve their symptoms.

What you can do about stigma within your community

If you come from a culture with a high level of stigma against mental health — to some degree, all of us — it can be more difficult to heal from mental health issues.

However, there are ways to fight mental health stigma within your community and bring the global conversation about mental health forward.

• Find ways to let people know you’re open to discussing mental health. You don’t have to reveal your most profound mental health symptoms to everyone you meet. But by making simple comments like, “I believe mental health is just as important as physical health,” you can let others around you know you’re a safe person to talk to about these issues.
• Join a local advocacy group. Almost every culture and community has some sort of group advocating to eradicate mental health stigma. By joining these groups worldwide, we can make it easier for people everywhere to access the treatment they need.
• Start within. Often, when our culture surrounds us, it’s hard to see how our worldview has been influenced. Many of us have a self-stigma against mental illness, even if we live with mental illness. Start fighting against stigma by looking within. Is there any part of you who feels weak for struggling with your mental health? Any part that feels like you should be able to deal with this on your own, that you shouldn’t talk to people outside of the family about your problems or any other common beliefs that stigma causes?

At The Center • A Place of HOPE, we understand how deeply stigma can get in the way of healing. It takes courage to reach out for help, even when your cultural values tell you to hide these problems.

The shame and guilt from your cultural beliefs about mental health struggles can be very damaging. But it doesn’t have to hold you back from receiving the help you need and deserve.

Our team will work with you to uncover cultural stigmas that may have made you feel ashamed about having mental health concerns. Revealing cultural stigmas doesn’t mean dismissing your cultural values. Instead, we’ll help you find ways to embrace them and understand how the cultural beliefs have shaped your understanding of mental health — for better or worse.

1 – https://www.psychiatry.org/patients-families/stigma-and-discrimination
2 – https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02991-5