Breaking the Cycle of Stigma in Mental Health:

Over the years I have worked as a mental health support worker, I've witnessed how stigma can profoundly affect the lives of those facing mental health challenges. Many individuals I supported were not defined by their diagnoses; they were ordinary people who once held meaningful jobs, nurtured relationships, and lived comfortably within their communities. However, the burden of stigma often overshadowed their identities, resulting in isolation, lost opportunities, and a diminished sense of self-worth.

The 'Like Minds, Like Mine' programme, launched in New Zealand in 1997, aimed to address this very issue by reducing stigma and discrimination against people with mental illness. According to research, over half of the participants in the program reported seeing improvements in discrimination over five years. However, a staggering 89% of respondents still experienced unfair treatment due to their mental health conditions. Many concealed their struggles or avoided job applications, fearing discrimination. The primary source of both positive and negative discrimination often came from those closest to them—their families.

One of my most impactful experiences was observing how stigma manifested in clinical settings. When accompanying participants to their doctor's appointments, I noticed that some healthcare professionals would often address me, the support worker, rather than the individuals themselves. It was as if the person sitting before them was invisible, incapable of understanding or communicating. This undermined the participant’s autonomy and reinforced a negative self-perception.

Research supports this observation. A study by Henderson et al. (2014) found that mental health-related stigma is pervasive even among healthcare professionals. While many mental health workers advocate for the rights of individuals, unconscious biases often lead to microaggressions and patronising behaviour, which can severely impact recovery and self-efficacy. The document titled "Mental Health-Related Stigma in Health Care and Mental Health-Care Settings" highlights how stigma within healthcare settings can affect the quality of care and how addressing these biases through education and advocacy can lead to better outcomes for mental health service users.

The transition from institutionalised mental health care to community-based living was a significant step forward. However, old mindsets often linger. I encountered residential settings where participants were treated as if growth and independence were out of reach. Staff would say, “There is no changing them,” or “They will never be independent”. These sentiments were not just limiting but were a form of institutionalised stigma that perpetuated dependency.

When I managed a residential home, I aimed to shift this mindset. The house accommodated individuals aged 30 to 65 with a variety of mental health conditions, such as schizophrenia, OCD, ADHD, paranoid schizophrenia, and depression. Many participants relied on staff for daily tasks, not because they couldn't do them, but because they had been conditioned to believe they couldn't. It was a cycle of learned helplessness reinforced by well-meaning but misguided support.

One story that stands out involves a participant with severe anxiety and paranoid schizophrenia. They relied heavily on PRN (as-needed) medication, requesting it almost every other day. I began working with them on small, manageable goals, like learning to do their own laundry. Initially, the fear of being locked in the laundry room (due to a lock on the door) was a significant barrier. By simply removing the lock and offering consistent encouragement, this person gradually became comfortable using the washing machine independently.

Over time, not only did their practical skills improve, but their anxiety decreased noticeably. The need for PRN medication dropped to zero over a year. This transformation wasn't just about learning to do laundry—it was about reclaiming agency, building confidence, and breaking free from the internalised stigma that they were incapable of growth.

Breaking the cycle of stigma requires a shift from caretaking to empowerment. It involves seeing people not just through the lens of their diagnosis but as individuals with the potential to learn, adapt, and thrive. Studies have shown that involving individuals with lived experiences in public health campaigns, as seen in the 'Like Minds, Like Mine ' program, can significantly reduce stigma and change public attitudes.

It is crucial to create environments where individuals feel safe, valued, and capable. This involves not only educating healthcare professionals on the importance of treating individuals with respect but also building community programs that promote independence and celebrate progress, no matter how small.

The journey to reducing mental health stigma is ongoing. We can make meaningful strides by sharing stories, challenging old mindsets, and promoting inclusive and growth environments. The success of initiatives like 'Like Minds, Like Mine' demonstrates that change is possible when those with lived experience are given a platform and support systems focus on building independence rather than maintaining dependency.

Let us all strive to be allies, not just in word but in action—working together to create a world where mental health challenges do not define an individual’s worth or potential.

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