Stigma and how to overcome it

One in five people worldwide experiences a mental health disorder each year, yet about eight out of 10 won’t reach out for support, largely because of mental health stigma. The stigma of mental illness isn’t just an individual problem; it’s a workplace issue.

Unfortunately, many businesses aren’t effectively addressing mental health stigma at work. A survey by McKinsey found that while most employers acknowledge the problem, less than one in 10 employees say their workplace is free of the stigma about mental health.

What is mental health stigma?

Experts define stigma as a negative attitude toward someone based on a distinguishing characteristic. It can relate to a health condition or disability, as well as characteristics like race, religion, gender, sexuality, and culture. One of the most common types of stigma is mental health stigma.

So, what is stigma in mental health? It’s the negative beliefs and attitudes people have about what it means to struggle with mental health, including what it means to be diagnosed with a mental health disorder or seek treatment.

What are some examples of behaviors that reinforce mental health stigma?

• Treating people as weak or needy when they seek professional mental health support
• Using harmful, inaccurate terms like “crazy” when referring to people with mental health conditions, or making insensitive jokes or comments
• Judging or oversimplifying someone’s symptoms, such as saying someone with depression should “snap out of it” or “just exercise more”
• Berating or judging yourself because of your condition

The stigma surrounding mental health can impact our lives in different ways. The four main types of stigma are:

Why is mental health stigmatized?

What causes mental health stigma? The problem dates back at least to the 19th century when mental health treatment was separated from mainstream health care. For much of history, people with mental health conditions were imprisoned, institutionalized, tortured, or killed rather than treated for an illness. While our understanding of mental health conditions and mental health care has improved over time in many parts of the world, a number of factors still contribute to the stigma behind mental health:

• Lack of awareness and understanding of mental health and mental illness
• Limited access to mental health education, including in schools and communities
• Stereotypes, or generalized beliefs about whole groups of people, which often reinforce mental illness stigma
• Misinformation about mental health conditions and exaggerated, inaccurate media portrayals of people with mental illness
• Judgmental language or labels that sensationalize mental health, such as calling someone “crazy”
• Cultural messages that religion and spirituality cannot coexist with mental health care or should be used instead of mental health care

Messages that reinforce the stigma about mental health can come from many sources, including family, friends, health care providers, media, and the workplace.

What are the effects of mental health stigma?

Research shows that many people—even some trained medical and mental health professionals—hold negative beliefs that contribute to the stigma around mental illness and mental health. In contrast to the public’s more sympathetic attitudes toward physical health conditions, people often perceive those with mental health conditions to be in control of their illness, responsible for causing it, and undeserving of help. We know now that workers and their employers pay a hefty price for mental health stigma in the workplace.

How the stigma of mental health affects individuals

Stigma as a barrier to mental health care

How does stigma affect mental health? As a result of stigma, many employees suffer in silence, often for fear that their reputation, relationships, or job status could be in jeopardy if they disclose they’re struggling with their mental health or have a mental health condition. This can worsen their symptoms and make them less likely to take steps to support their mental health, seek resources or treatment, or recover.

Limited support and life opportunities

Perceived stigma can prevent people from talking about their mental health and seeking support because they’re worried about negative consequences. It can also lead people to avoid pursuing other important life opportunities, such as seeking a promotion at work because they’re worried they may be judged unfairly or discriminated against due to their mental health condition.

Likewise, structural stigma, also called institutional stigma, can make it hard for people to get support for their mental health in the workplace. It can also limit sources of support available to employees and make it difficult to access treatment.

Personal suffering

Untreated mental health conditions can cause immense suffering for employees, including difficulty sleeping, work and relationship problems, substance use, and worsening mental health. The stigma surrounding mental health can fuel common misconceptions, such as the false idea that people with mental health conditions are weak, flawed, irresponsible, or incapable of being productive employees. Stigma about mental health has also been associated with:

• Higher suicide rates
• Decreased rates of medication use
• Financial instability
• Higher medical spending
• Homelessness
• Incarceration

Some people with mental health conditions may interact less with others because of the negative reactions they experience. In turn, isolation can reduce self-esteem and make people more vulnerable to the effects of stress.

Mental health discrimination

Personal stigma can lead people to make unfair and incorrect assumptions, like assuming that someone with a mental health condition isn’t able to do certain types of tasks at work. This can unfairly affect decisions about what type of work to assign, whether to promote this person, or even whether to hire them in the first place.

Mental health discrimination can take many forms, including employers refusing to hire people with a mental health condition, other people avoiding close relationships with them, and landlords declining to rent to them. Mental health discrimination can reduce self-esteem, make people’s mental health worse, and even change the way the brain processes information.

How the stigma of mental health affects employers

Mental health stigma is also an organizational problem. About half of employees are concerned about discussing mental health issues at work, citing worries about retaliation or job loss if they seek care. For employers, untreated mental illness contributes to a host of problems that could be prevented with effective care, including:

Higher health care costs 

Employees and dependents with mental health conditions drive a large portion of employers’ health care spending. In addition to the emotional toll, people with mental health conditions are more likely to suffer from serious physical health issues, such as heart disease and diabetes. They’re also more likely to seek care for mental health symptoms in the emergency department, which can be costly and ineffective.

Lost productivity 

The World Health Organization estimates that lost productivity due to depression and anxiety alone costs the global economy $1 trillion each year.

Disability claims

Mental health disorders are also a leading cause of worker disability. In addition to a high volume of claims, disability episodes for mental health disorders can be longer than those for other types of conditions (67 days vs. 33.8 days).

Higher employee turnover

Employees with depression experience higher job turnover than those without it. This means more recruiting, hiring, and training, which conservative estimates put at 50 percent or more of an employee’s annual salary.

Given the price of stigma around mental illness, companies can’t afford not to address it. Mental health conditions are treatable. And with effective treatment, workers with mental health challenges can thrive.

Benefits of addressing the stigma of mental illness in the workplace

Employers can be a powerful force in breaking the stigma of mental health—and the rewards for doing so are great. When employees can raise their hands to say they’re struggling, they’re more likely to get treatment. And research shows treatment works. Over 80 percent of workers who receive mental health care say they’re more effective and satisfied at work. According to the National Alliance on Mental Illness, the treatment efficacy for mental illness exceeds the rates for heart disease.

Treatment is also cost-effective. Not only can it transform the lives of employees and their loved ones, but it can also play a powerful role in helping businesses manage costs. Through several rigorous studies, Lyra Health has found that investing in employee mental health results in significant cost savings including:

Who is most affected by mental health stigma?

Mental illness stigma is pervasive. In one study, researchers concluded, “There is no country, society, or culture where people with mental illness have the same societal value as people without mental illness.”

While the stigma surrounding mental health affects everyone, some populations face unique stigmas as well as other barriers to mental health care.

Mental health stigma in minority communities

Black, Indigenous, and people of color (BIPOC) employees face unique mental health stigmas that make it difficult to access care. For example, BIPOC communities have historically been forced to engage in survival mode to endure systemic oppression. They have also had greater barriers to accessing mental health services, including lack of affordability.

Mental health stigma is also prevalent in the Latinx community. Many people in this community don’t seek care because of the labels, shame, and unwanted attention it can bring to them and their families. 

Given that 86 percent of psychologists are white, when BIPOC individuals do seek professional mental health support, they may encounter challenges finding someone who shares their cultural background. This can lead to concerns that due to lack of representation, the therapist will lack the cultural competency skills and training to address their specific issues.

Each person’s experience of mental illness stigma is influenced by cultural norms and messaging. Cultural influences impact how people cope with and understand mental health symptoms, and whether they seek treatment. Without support from their employers, many employees may not get the treatment they need to be the healthiest versions of themselves.

Cultural factors can influence how much support employees get from friends, family, and their community if they discuss their mental health. Cultures also differ in their perspectives on the causes, risk factors, nature, and meaning of mental illness. For instance, research by the U.S. Surgeon General’s Office shows that Asian patients are more likely to discuss physical symptoms such as dizziness, only describing emotional symptoms later or when specifically asked. It is also more acceptable in some cultures to try to cope with mental distress alone, rather than seeking mental health care.

It’s important to be sensitive to these differences—an approach that is effective in one region may be considered taboo in another. For example, research shows that people in Eastern countries are more likely to view mental illness as shameful or a moral failing than in Western countries. Asian mental health stigma can be particularly strong; for example, as many as 80 percent of psychiatric patients in China experience discrimination while receiving mental health services.

Mental health stigma in Korea is also a notable example. In South Korea, mental illness is widely considered taboo and rarely discussed. The country also has alarmingly high suicide rates. Nearly one in four Koreans have a mental health condition, yet only one in 10 receive treatment. These statistics point to the critical need to directly address mental health stigma in order to promote the mental health and wellness of people around the world.

Mental health stigma in males

Cultural norms and messages that perpetuate stigma about mental health can also come through gender identity. For example, depression and suicide are leading causes of death among men, yet mental health disorders often go unnoticed and untreated in this population due to the unique stigma around men’s mental health.

Stigma of serious mental illness

About 35 percent of U.S. adults living with serious mental health conditions such as severe depression and schizophrenia go without treatment, often due to mental illness stigma.

Mental health stigma examples

People with certain mental illnesses face significant stigma. For example:

• Borderline personality disorder stigma – Borderline personality disorder is often misunderstood and stigmatized, which can lead to misdiagnosis.
• Substance use stigma – Despite medical expert consensus that substance use disorders are complex health conditions that affect brain function and behavior, many people incorrectly see addiction as a result of weakness or flawed character. Research has found that about three-quarters of the public has negative attitudes toward people with substance use disorders.
• Schizophrenia stigma – Stigma against people with schizophrenia is widespread and contributes to discrimination, social exclusion, and relationship challenges. About 69 percent of people with schizophrenia are not receiving appropriate care.
• Depression stigma – Despite being one of the most common mental health disorders, research shows that about one-third of people incorrectly believe a weak personality causes depression and many still question whether it’s a real medical condition.

How to reduce mental health stigma in the workplace

Employers, people leaders, and managers play an important role in breaking the stigma of mental health and nurturing a positive work environment. Companies are increasingly offering mental health support for employees, but these benefits are likely to be underutilized if no one comes forward. Here are a few strategies to reduce stigma in mental health:

1. Start the conversation­—and keep it going

Many employees want to have a serious conversation about mental health. These can be difficult conversations to have under the best circumstances, but can feel impossible if a company doesn’t actively work on destigmatizing mental health and offer resources to support workers’ mental health and well-being.

Let your employees know their health and well-being is important to you through both words and actions. A few ideas for how to reduce mental health stigma in the workplace include:

• Checking in with your teams regularly and proactively sharing useful mental health resources
• Talking about mental health on all-company calls
• Sharing internal videos of company leaders discussing their mental health, which signals that vulnerability is a strength and helps combat perceptions people may have of mental illness as “unknown” or “scary”
• Modeling healthy behaviors by using PTO or telling employees you took time for a mid-day walk, therapy appointment, or other forms of self-care
• Accommodating PTO to focus on improving mental, not just physical health
• Taking quarterly employee surveys to understand the impact of mental illness stigma, and following through with meaningful action in response to the survey findings

2. Choose your words wisely

Be conscious of the language you and others use. Your words can impact other people’s beliefs and attitudes in a way that destigmatizes mental illness, or it can further contribute to stigma and mental health discrimination.

3. Provide mental health literacy training

Company-wide training can help teams notice and respond appropriately to signs of psychological distress in themselves and those around them, develop strategies to reduce stigma in mental health, and get connected to resources that can support their mental health and well-being. Training should explain that struggling with mental health is common and that effective treatment for mental health conditions exists. Communicating this type of information can help with destigmatizing mental illness.

Also consider providing specialized training for managers to help them understand how to identify employees who may be experiencing psychological distress and respond appropriately by having empathetic conversations about mental health with the goal of connecting employees to resources. Many employees assume their managers get training on identifying mental health issues; however, surveys suggest that just 25 percent of managers have actually received this type of education. Equipped with tools and knowledge about mental health, managers can assess workplace conditions that may be negatively impacting mental wellness and effectively respond to employees’ mental health concerns.

4. Eliminate mental health discrimination

Take steps to ensure your workplace is an inclusive, supportive environment so that everyone feels comfortable asking for help. For example:

• Develop and enforce anti-discrimination policies.
• Ensure policies and procedures are consistently applied to all employees in an unbiased way.
• Educate managers about common barriers to treatment based on cultural background or social identity, such as access, affordability, and stigma, so they can respond to employee distress in a way that promotes seeking care and builds psychological safety for their teams.
• Avoid labeling, stereotyping, creating divisions, or discriminating against someone because of a label or diagnosis they may have. Even well-intentioned behaviors, like assuming that a task at work is “too much” for someone who’s struggling with their mental health without consulting them, can fall into this category.
• Challenge myths and stereotypes if you hear them.

5. Launch mental health awareness campaigns

While employers can’t directly treat issues like depression and anxiety, they do have the power to break down barriers to treatment. Here are a few ways to build awareness:

• Create ongoing anti-stigma mental health campaigns, trainings, or workshops that educate employees about mental illness and encourage them to seek help. Workplace anti-stigma campaigns can build knowledge, change behavior, and reduce mental health stigma at work. Research also shows these programs have a positive return on investment for employers. A survey found that 80 percent of workers said they’d benefit from an anti-stigma mental health campaign, but only 23 percent of employers reported having this type of program.
• Develop a team of “mental health ambassadors” who build awareness of mental health and are non-judgmental sources of support. Learning from those living with mental health conditions is one of the best ways to reduce mental health stigma in the workplace.
• Launch employee resource groups to provide a forum for people interested in connecting around mental health topics and advocacy efforts.

6. Invest in programs that support mental health

Surveys show employees want parity between the mental health benefits and physical health plans their employers offer. Having a mental health benefit, like an employee assistance program or digital tools and apps, sends a message that employee concerns will be met with compassion and support. This alone can help with destigmatizing mental health. But these offerings often fall short in terms of quality, utilization, and effectiveness.

Offering a truly comprehensive benefit that makes it easy for employees to quickly access evidence-based care makes it clear that your company isn’t just making a symbolic gesture of support, but that you’ve invested in a benefit that makes a tangible difference in employees’ health and well-being. Here are a few key features to look for when selecting a mental health benefit:

• Offerings that address the full spectrum of issues, from preventive self-care to support for complex mental health needs like substance use and suicidality
• Technology to make care widely accessible in a variety of ways, such as video, telephone, live chat, and in-person
• Culturally responsive care from a diverse provider base that understands and adapts to different cultures’ varying mental health needs
• Evidence-based therapies and approaches

Consider assigning an executive-level leader to oversee your behavioral health offerings. This person can help end mental health stigma in the workplace by encouraging employees to take advantage of your programs and measuring their effectiveness. People are more likely to get care if they feel the organization and their supervisor support the use of those benefits.

Putting an end to mental health stigma

The stigma of mental illness in the workplace takes a heavy toll on workers and their employers. By learning how to reduce mental health stigma and providing a comprehensive mental health benefit, you can create an environment where your employees feel comfortable sharing when they’re struggling and empowered to seek the support they need to get back on track, feel mentally healthy, and thrive.