Book contents
- The Cambridge Handbook of Stigma and Mental Health
- The Cambridge Handbook of Stigma and Mental Health
- Copyright page
- Contents
- Figures
- Tables
- Contributors
- 1 Introduction to the Handbook of Stigma and Mental Health
- Part I Understanding Stigma and Mental Health
- Part II Impact of Stigma on Mental Health
- 5 Time Trends in Public Stigma
- 6 Consequences of the Self-Stigma of Mental Illness
- 7 Self-Stigma of Seeking Help
- 8 Stigma and Suicide
- 9 Intellectual Disability Stigma
- Part III Stigma and Mental Health in Specific Contexts
- Part IV Reducing Stigma to Promote Mental Health
- Index
- References
6 - Consequences of the Self-Stigma of Mental Illness
from Part II - Impact of Stigma on Mental Health
Published online by Cambridge University Press: 28 July 2022
Book contents
- The Cambridge Handbook of Stigma and Mental Health
- The Cambridge Handbook of Stigma and Mental Health
- Copyright page
- Contents
- Figures
- Tables
- Contributors
- 1 Introduction to the Handbook of Stigma and Mental Health
- Part I Understanding Stigma and Mental Health
- Part II Impact of Stigma on Mental Health
- 5 Time Trends in Public Stigma
- 6 Consequences of the Self-Stigma of Mental Illness
- 7 Self-Stigma of Seeking Help
- 8 Stigma and Suicide
- 9 Intellectual Disability Stigma
- Part III Stigma and Mental Health in Specific Contexts
- Part IV Reducing Stigma to Promote Mental Health
- Index
- References
Summary
The literature on the internalized stigma (or self-stigma) of mental illness has been expanding rapidly. We review the key findings of two meta-analyses of the correlates and consequences that occurred a decade apart (Livingston & Boyd, 2010, Del Rosal et al., 2020), showing that internalized stigma is related to less self-esteem, quality of life, and hope; and related to greater experienced stigma, perceived stigma, and symptom severity. For empowerment, the relationship of internalized stigma was somewhat weaker in 2020 than in 2010. Neither found significant relationships with sociodemographic variables. Although more longitudinal studies are needed to better test the causal direction of these relationships, the overall findings are consistent with the idea that internalized stigma impedes recovery and adds to the burden of mental illness. While, more work needs to be done to understand the effects of internalized stigma on people with a variety of intersectional identities. we briefly describe the literature on a few contrasting types of marginalized identities: gender (female and transgender), race/ethnicity (African Americans), and profession (mental health professionals with a lived experience of mental illness). These summaries highlight that the consequences of internalized stigma may vary across intersectional identities. We conclude with suggestions for future research.
- Type
- Chapter
- Information
- The Cambridge Handbook of Stigma and Mental Health , pp. 88 - 110Publisher: Cambridge University PressPrint publication year: 2022
References
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). www.apa.org/ethics/code/Google Scholar
Americans with Disabilities Act of 1990, Pub. L. No. 101-336, § 2, 104 Stat. 328 (1991).Google Scholar
Appleby, D. C., & Appleby, K. M. (2006). Kisses of death in the graduate school application process. Teaching of Psychology, 33(1), 19–24.CrossRefGoogle Scholar
Asrat, B., Ayenalem, A. E., & Yimer, T. (2018). Internalized stigma among patients with mental illness attending psychiatric follow-up at Dilla University Referral Hospital, Southern Ethiopia. Psychiatry Journal, 2018, 1987581. https://doi.org/10.1155/2018/1987581Google Scholar
Balsam, K. & D’Augelli, A. (2006). The victimization of older LGBT adults: Patterns, impact, and implications for intervention. In Kimmel, D. (Ed.), Lesbian, Gay, Bisexual, and Transgender Aging: Research and Clinical Perspectives (pp. 110–130). New York Chichester, West Sussex: Columbia University Press. https://doi.org/10.7312/kimm13618-007Google Scholar
Bamgbade, B. A., Ford, K. H., & Barner, J. C. (2016). Impact of a mental illness stigma awareness intervention on pharmacy student attitudes and knowledge. American Journal of Pharmaceutical Education, 80(5), 1–11.CrossRefGoogle ScholarPubMed
Bender, C. E., Heilbrun, M. E., Truong, H. B., & Bluth, E. I. (2015). The impaired radiologist. Journal of the American College of Radiology, 12(3), 302–306.CrossRefGoogle ScholarPubMed
Beran, R. G. (2014). Mandatory notification of impaired doctors. Internal Medicine Journal, 44(12a), 1161–1165.Google Scholar
Bike, D. H., Norcross, J. C., & Schatz, D. M. (2009). Processes and outcomes of psychotherapists’ personal therapy: Replication and extension 20 years later. Psychotherapy: Theory, Research, Practice, Training, 46(1), 19.Google Scholar
Bowleg, L. (2012). The problem with the phrase women and minorities: Intersectionality – An important theoretical framework for public health. American Journal of Public Health, 102(7), 1267–1273.Google Scholar
Boyd, J. E., Adler, E. P., Otilingam, P. G., & Peters, T. (2014). Internalized Stigma of Mental Illness (ISMI) scale: A multinational review. Comprehensive Psychiatry, 55(1), 221–231.Google Scholar
Boyd, J. E., Graunke, B., Frese, F. J., Jones, J. T., Adkins, J. W., & Bassman, R. (2016). State psychology licensure questions about mental illness and compliance with the Americans with Disabilities Act. American Journal of Orthopsychiatry, 86(6), 620.Google Scholar
Boyd, J. E., Zeiss, A., Reddy, S., & Skinner, S. (2016). Accomplishments of 77 VA mental health professionals with a lived experience of mental illness. American Journal of Orthopsychiatry, 86(6), 610.Google Scholar
Briggs, H. E., Banks, L., & Briggs, A. C. (2014). Increasing knowledge and mental health service use among African Americans through evidence-based practice and cultural injection vector engagement practice approaches. Best Practices in Mental Health, 10(2), 1–14.Google Scholar
Byrne, L., Happell, B., & Reid-Searl, K. (2016). Lived experience practitioners and the medical model: Worlds colliding? Journal of Mental Health, 25(3), 217–223.Google Scholar
Castelein, S., van der Gaag, M., Bruggeman, R., van Busschbach, J. T., & Wiersma, D. (2008). Measuring empowerment among people with psychotic disorders: A comparison of three instruments. Psychiatric Services, 59(11), 1338–1342.Google Scholar
Cheng, H. L., Kwan, K. L. K., & Sevig, T. (2013). Racial and ethnic minority college students’ stigma associated with seeking psychological help: Examining psychocultural correlates. Journal of Counseling Psychology, 60(1), 98–111.Google Scholar
Chrostek, A., Grygiel, P., Anczewska, M., Wciórka, J., & Świtaj, P. (2016). The intensity and correlates of the feelings of loneliness in people with psychosis. Comprehensive Psychiatry, 70, 190–199.CrossRefGoogle ScholarPubMed
Cohen, D., Winstanley, S. J., & Greene, G. (2016). Understanding doctors’ attitudes towards self-disclosure of mental ill health. Occupational Medicine, 66(5), 383–389.CrossRefGoogle ScholarPubMed
Corrigan, P. W., Bink, A. B., Schmidt, A., Jones, N., & Rüsch, N. (2016). What is the impact of internalized stigma? Loss of self-respect and the “why try” effect. Journal of Mental Health, 25(1), 10–15.Google Scholar
Corrigan, P. W., Larson, J. E., & Rüsch, N. (2009). Internalized stigma and the “why try” effect: Impact on life goals and evidence-based practices. World Psychiatry, 8(2), 75–81. Masson SpA. https://doi.org/10.1002/j.2051-5545.2009.tb00218.xGoogle Scholar
Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D., & Rüsch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–973.Google Scholar
Corrigan, P. W., & Shapiro, J. R. (2010). Measuring the impact of programs that challenge the public stigma of mental illness. Clinical Psychology Review, 30(8), 907–922.Google Scholar
Corrigan, P. W., & Watson, A. C. (2002a). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1(1), 16-–20.Google ScholarPubMed
Corrigan, P. W., & Watson, A. C. (2002b). The paradox of self‐stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35–53.Google Scholar
Curcio, C., & Corboy, D. (2020). Stigma and anxiety disorders: A systematic review. Stigma and Health, 5(2), 125–137. https://doi.org/10.1037/sah0000183Google Scholar
David, E. J. R., Schroeder, T. M., & Fernandez, J. (2019). Internalized racism: A systematic review of the psychological literature on racism’s most insidious consequence. Journal of Social Issues, 75(4), 1057–1086.Google Scholar
Del Rosal, E., González-Sanguino, C., Bestea, S., Boyd, J., & Muñoz, M. (2020). Correlates and consequences of internalized stigma assessed through the Internalized Stigma of Mental Illness scale for people living with mental illness: A scoping review and meta-analysis from 2010. Stigma and Health. Advance online publication. https://doi.org/10.1037/sah0000267Google Scholar
Drapalski, A. L., Lucksted, A., Perrin, P. B., et al. (2013). A model of internalized stigma and its effects on people with mental illness. Psychiatric Services, 64(3), 264–269.CrossRefGoogle Scholar
Forrest-Bank, S., & Jenson, J. M. (2015). Differences in experiences of racial and ethnic microaggression among Asian, Latino/Hispanic, Black, and White young adults. Journal of Sociology & Social Welfare, 42, 141.CrossRefGoogle Scholar
Fox, A. B., Earnshaw, V. A., Taverna, E. C., & Vogt, D. (2018). Conceptualizing and measuring mental illness stigma: The mental illness stigma framework and critical review of measures. Stigma and Health, 3(4), 348–376. https://doi.org/10.1037/sah0000104. Epub 2017 Sep 21. PMID: 30505939; PMCID: PMC6261312.CrossRefGoogle ScholarPubMed
Fredman, S. (2016). Intersectional Discrimination in EU Gender Equality and Non-discrimination Law. Bericht im Auftrag der Europäischen Kommission. https://doi.org/10.2838/241520Google Scholar
Gilroy, P. J., Carroll, L., & Murra, J. (2002). A preliminary survey of counseling psychologists’ personal experiences with depression and treatment. Professional Psychology: Research and Practice, 33(4), 402.Google Scholar
Hammer, J. H., Vogel, D. L., & Heimerdinger-Edwards, S. R. (2013). Men’s help seeking: Examination of differences across community size, education, and income. Psychology of Men & Masculinity, 14(1), 65–75. https://doi.org/10.1037/a0026813Google Scholar
Hansson, L., & Björkman, T. (2005). Empowerment in people with a mental illness: Reliability and validity of the Swedish version of an empowerment scale. Scandinavian Journal of Caring Sciences, 19(1), 32–38.CrossRefGoogle ScholarPubMed
Harris, J. I., Leskela, J., & Hoffman-Konn, L. (2016). Provider lived experience and stigma. American Journal of Orthopsychiatry, 86(6), 604.CrossRefGoogle ScholarPubMed
Harris, J. I., Leskela, J., Lakhan, S., et al. (2019). Developing organizational interventions to address stigma among mental health providers: A pilot study. Community Mental Health Journal, 55(6), 924–931.Google Scholar
Hasson-Ohayon, I., Ehrlich-Ben Or, S., Vahab, K., et al. (2012). Insight into mental illness and self-stigma: The mediating role of shame proneness. Psychiatry Research, 200(2–3), 802–806. https://doi.org/10.1016/j.psychres.2012.07.038Google Scholar
Hugo, M. (2001). Mental health professionals’ attitudes towards people who have experienced a mental health disorder. Journal of Psychiatric and Mental Health Nursing, 8(5), 419–425.CrossRefGoogle ScholarPubMed
Individuals with Disabilities Employment Program. www.diversity.va.gov/programs/pwd.aspx. Retrieved on June 22, 2020.Google Scholar
Kendi, I. X. (2017, February 22). A history of race and racism in America, in 24 chapters. The New York Times.Google Scholar
King, W. M., Hughto, J. M. W., & Operario, D. (2020). Transgender stigma: A critical scoping review of definitions, domains, and measures used in empirical research. Social Science & Medicine, 250, 112867. https://doi.org/10.1016/j.socscimed.2020.112867Google Scholar
Lannin, D. G., Vogel, D. L., Brenner, R. E., & Tucker, J. R. (2015). Predicting self-esteem and intentions to seek counseling: The internalized stigma model. The Counseling Psychologist, 43(1), 64–93.Google Scholar
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363–385.CrossRefGoogle Scholar
Livingston, J. D., & Boyd, J. E. (2010). Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science & Medicine, 71(12), 2150–2161. https://doi.org/10.1016/j.socscimed.2010.09.030Google Scholar
Lysaker, P. H., Roe, D., & Yanos, P. T. (2007). Toward understanding the insight paradox: Internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophrenia Bulletin, 33(1), 192–199.CrossRefGoogle ScholarPubMed
Mashiach-Eizenberg, M., Hasson-Ohayon, I., Yanos, P. T., Lysaker, P. H., & Roe, D. (2013). Internalized stigma and quality of life among persons with severe mental illness: The mediating roles of self-esteem and hope. Psychiatry Research, 208(1), 15–20. https://doi.org/10.1016/j.psychres.2013.03.013Google Scholar
McCall, L. (2005). The complexity of intersectionality. Signs: Journal of Women in Culture and Society, 30(3), 1771–1800. https://doi.org/10.1086/426800Google Scholar
Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36(1), 38–56.CrossRefGoogle ScholarPubMed
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674Google Scholar
Nachshoni, T., Abramovitch, Y., Lerner, V., et al. (2008). Psychologists’ and social workers’ self-descriptions using DSM IV psychopathology. Psychological Reports, 103(1), 173–188.Google Scholar
Oexle, N., & Corrigan, P. W. (2018). Understanding mental illness stigma toward persons with multiple stigmatized conditions: Implications of intersectionality theory. Psychiatric Services, 69(5), 587–589.Google Scholar
Peris, T. S., Teachman, B. A., & Nosek, B. A. (2008). Implicit and explicit stigma of mental illness: Links to clinical care. The Journal of Nervous and Mental Disease, 196(10), 752–760.Google Scholar
Picco, L., Lau, Y. W., Pang, S., et al. (2017). Mediating effects of internalized stigma on the relationship between perceived stigma and psychosocial outcomes among psychiatric outpatients: Findings from a cross-sectional survey in Singapore. BMJ Open, 7(8), e018228. https://doi.org/10.1136/bmjopen-2017-018228Google Scholar
Psychopathology Committee of the Group for the Advancement of Psychiatry. (2001). Reexamination of therapist self-disclosure. Psychiatric Services, 52(11), 1489–1493.Google Scholar
Repper, J., & Carter, T. (2011). A review of the literature on peer support in mental health services. Journal of Mental Health, 20(4), 392–411.CrossRefGoogle ScholarPubMed
Ritsher (Boyd), J. B., Otilingam, P. G., & Grajales, M. (2003). Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Research, 121(1), 31–49. www.ncbi.nlm.nih.gov/pubmed/14572622CrossRefGoogle Scholar
Ritsher (Boyd), J. B., & Phelan, J. C. (2004). Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Research, 129(3), 257–265.CrossRefGoogle Scholar
Rogers, E. S., Chamberlin, J., Ellison, M. L., & Crean, T. (1997). A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatric Services, 48(8), 1042–1047. https://doi.org/10.1176/ps.48.8.1042Google ScholarPubMed
Segal, S. P., Silverman, C. J., & Temkin, T. L. (1995). Measuring empowerment in client-run self-help agencies. Community Mental Health Journal, 31(3), 215–227.Google Scholar
Segal, S. P., Silverman, C. J., & Temkin, T. L. (2013). Self-stigma and empowerment in combined-CMHA and consumer-run services: Two controlled trials. Psychiatric Services, 64(10), 990–996.CrossRefGoogle ScholarPubMed
Sercu, C., & Bracke, P. (2016). Stigma as a structural power in mental health care reform: An ethnographic study among mental health care professionals in Belgium. Archives of Psychiatric Nursing, 30(6), 710–716.CrossRefGoogle ScholarPubMed
Stangl, A. L., Earnshaw, V. A., Logie, C. H., et al. (2019). The Health Stigma and Discrimination Framework: A global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Med 17(1), 1–13.Google Scholar
Świtaj, P., Grygiel, P., Anczewska, M., & Wciórka, J. (2014). Loneliness mediates the relationship between internalised stigma and depression among patients with psychotic disorders. International Journal of Social Psychiatry, 60(8), 733–740.Google Scholar
Szymanski, D. M., Gupta, A., Carr, E. R., & Stewart, D. (2009). Internalized misogyny as a moderator of the link between sexist events and women’s psychological distress. Sex Roles, 61(1), 101–109.Google Scholar
Szymanski, D. M., Kashubeck-West, S., & Meyer, J. (2008). Internalized heterosexism: Measurement, psychosocial correlates, and research directions. The Counseling Psychologist, 36(4), 525–574.CrossRefGoogle Scholar
Tay, S., Alcock, K., & Scior, K. (2018). Mental health problems among clinical psychologists: Stigma and its impact on disclosure and help‐seeking. Journal of Clinical Psychology, 74(9), 1545–1555.Google Scholar
Tebbe, E. A., & Moradi, B. (2016). Suicide risk in trans populations: An application of minority stress theory. Journal of Counseling Psychology, 63(5), 520–533. https://doi.org/10.1037/cou0000152CrossRefGoogle ScholarPubMed
Thornicroft, G. (2006) Shunned: Discrimination against People with Mental Illness. Oxford: Oxford University Press.Google Scholar
Ungar, T., Knaak, S., & Szeto, A. C. (2016). Theoretical and practical considerations for combating mental illness stigma in health care. Community Mental Health Journal, 52(3), 262–271.Google Scholar
Vogel, D. L., Bitman, R. L., Hammer, J. H., & Wade, N. G. (2013). Is stigma internalized? The longitudinal impact of public stigma on internalized stigma. Journal of Counseling Psychology, 60(2), 311.Google Scholar
Vogel, D. L., Heimerdinger-Edwards, S. R., Hammer, J. H., & Hubbard, A. (2011). “Boys don’t cry”: Examination of the links between endorsement of masculine norms, internalized stigma, and help-seeking attitudes for men from diverse backgrounds. Journal of Counseling Psychology, 58(3), 368–382. https://doi.org/10.1037/a0023688Google Scholar
Vogel, D. L., Wester, S. R., Hammer, J. H., & Downing-Matibag, T. M. (2014). Referring men to seek help: The influence of gender role conflict and stigma. Psychology of Men & Masculinity, 15(1), 60.Google Scholar
Watson, A. C., Corrigan, P., Larson, J. E., & Sells, M. (2007). Internalized stigma in people with mental illness. Schizophrenia Bulletin, 33(6), 1312–1318.Google Scholar
World Health Organization. (2015). Mental health action plan 2013 – 2020. www.who.int/mental_health/publications/action_plan/en/Google Scholar
Yanos, P. T., Roe, D., & Lysaker, P. H. (2010). The impact of illness identity on recovery from severe mental illness. American Journal of Psychiatric Rehabilitation, 13(2), 73–93. NIH Public Access. https://doi.org/10.1080/15487761003756860CrossRefGoogle ScholarPubMed
Yanos, P. T., Roe, D., Markus, K., & Lysaker, P. H. (2008). Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders. Psychiatric Services, 59(12), 1437–1442. www.ncbi.nlm.nih.gov/pubmed/19033171Google Scholar