The right strategies can help healthcare organizations go beyond awareness and actively fight stigma when it comes to mental health conditions.
Approximately one in five Americans lives with a mental health condition, according to the National Institute of Mental Health (NIMH). Unfortunately, due to the strong stigma surrounding mental illness, many of those people will suffer in silence, choosing to forego assistance or treatment.
In response, the National Alliance on Mental Illness (NAMI) has been working to decrease stigma across the country. Its 2018 anti-stigma campaign theme is “CureStigma,” and suggests that mental health stigma is a “social virus,” that has the power to infect each and every one of us, patients and providers alike, if we are not careful.
“Stigma prevents people from getting needed treatment-or, at least, significantly delays it,” says Karen D. Lloyd, PhD, L.P., senior director of Behavioral Health and Resilience at HealthPartners in Minnesota. “What we know is that, when you avoid or delay treatment, there’s a significant risk that the condition will get much, much worse. But there are things we can do to help stop stigma and, in turn, help patients get the help they need.”
Here are four ways that managed healthcare organizations can do their part to cure stigma in their communities.
1. Education. When Stephanie Knaak, PhD, a research associate with the Mental Health Commission of Canada, conducted qualitative research on how to best de-stigmatize mental health conditions-and mental healthcare-she found that education was a key component to successful strategies.
“What we found is that there was a lack of belief in recovery. And this was something we heard from both patients and providers,” she says. “That lack of belief in recovery can lead to feelings of helplessness and hopelessness-and then disengagement. So, helping to educate healthcare providers about the recovery model, and the skills they need to interact with patients who present with a mental health condition, are very important to helping patients feel safe and understood.”
2. Advertisement. Too often, Amanda Case, LCSW, a mental health therapist at Group Health Cooperative in Madison, Wisconsin, stigma interferes with an individual’s ability to seek out help. She argues that managed care organizations are in a unique position to advertise their services-and make it easier for individuals who may be experiencing a mental health condition understand that there is treatment available.
“The idea is to make these services accessible and welcoming for patients,” she says. “When you advertise, you help mitigate the fear that someone is going to be judged. Managed care organizations can use web-based media or other mediums to advertise and, in doing so, can help normalize the idea that it’s a good idea to be proactive and take care of your mental and your physical health.”
3. Language. Knaak says that, in the course of her research, many healthcare providers were surprised that some of their terminology helped to perpetuate stigma.
“Think of some of the words we use with mental health conditions-disturbed, odd, dirty, abnormal, anti-social, troubled, or, a popular one in many emergency departments, ‘frequent flier,’” says Knaak. “Many healthcare providers don’t even realize that these terms may be perceived as negative. This kind of language is thrown around all the time. It’s important to shine a light on these blind spots to help reduce stigma in the care setting.”
She also suggests that healthcare providers remember to put the patient ahead of the illness. Instead of saying “schizophrenic” or “overdose,” it’s important to remember that a person isn’t defined by his or her condition.
“This is a problem throughout healthcare, not just when it comes to mental health conditions,” she says. “But when people feel vulnerable, referring to them as their illness can be very dehumanizing.”
4. Connection. Lloyd says that managed healthcare organizations can also benefit from working with other groups with the common goal of reducing mental health stigma. By working with these organizations, managed healthcare organizations don’t have to reinvent the wheel when it comes to education programs-and they also increase their reach into the community.
“We’ve partnered with public television in Minnesota as well as NAMI to create MakeItOK.org, a website dedicated to eliminating stigma about mental illness,” she says. “It is story-based-and offers people insight into how a mental health condition is just like any other illness. It’s a condition that you can have diagnosed and then treat so you can manage it. It’s the same whether it’s asthma, diabetes, or a mental health condition.”
Case says, taken together, these can be key ingredients to help decrease stigma-for both managed healthcare organizations and other healthcare stakeholders in the community.
“When you reduce stigma, you can start to build a rapport with patients about their mental health symptoms and have them be more open to treatments,” she says. “By making these changes, and building strong partnerships with community partners, we can work together, every single day, to de-stigmatize what are really very common conditions.”
Kayt Sukel is a science and health writer based outside Houston.