De-stigmatizing mental health in diverse communities

Mental health is a critical component of overall well-being, yet it remains shrouded in stigma throughout communities, particularly where cultural norms, socioeconomic factors, and historical injustices often compound silence and misunderstanding. This stigmatization can lead to a reluctance to seek help, a lack of support from family and peers, and a pervasive sense of isolation for those struggling with mental health issues. With a growing recognition of the importance of mental wellness, it is time to break down the barriers that prevent individuals from accessing the care they require.

This blog will delve into the complex layers of mental health stigma and explore targeted strategies to challenge misconceptions, bridge knowledge gaps, and foster a culture of support and empathy. De-stigmatization is not just the responsibility of counseling professionals—it’s a societal imperative that calls for collective action across all levels.

How can you create safe spaces for open dialogue, promote inclusive health care policies, and empower community leaders to become advocates for mental health awareness? For professionals, educators, and individuals committed to social progress, this blog aims to provide valuable insights into how they can all contribute to building a more compassionate and understanding society where mental health is prioritized and respected.

Understanding cultural perspectives on mental health

Stigmas, a set of negative and unfair beliefs that a society or group of people have about something,¹ don't appear from nowhere. Stigmas are formed over time as a culmination of negative attitudes and perspectives on varying cultural levels from families to educational institutions to health care providers and beyond.

Stigmas about seeking mental health care or having mental illness aren't driven just by ignorance or lack of education. In many cases of mental illness stigma, especially among minority communities, real lived experiences and a lack of cultural competency on the provider's part can play a major role.

Mental health stigma is generally categorized into three types:²

• Institutional stigma: involving policies of government, public, and private organizations that intentionally or unintentionally limit opportunities or quality of care for people with mental illness.
• Public stigma: the negative or discriminatory attitudes that others have about mental illness
• Self-stigma: the negative attitudes, including internalized shame, that people with mental illness have about their own condition

Institutional stigma

Studies by the Anxiety & Depression Association of North America show that Black people are 20% more likely to experience significant mental health problems than the rest of the population yet only about a quarter of them seek mental health care, compared to about 40% of white Americans.³

Speaking to Counseling Today, Jardin Dogan-Dixon, a licensed counseling psychologist with the federal government said, "As far as therapists and psychologists go, we don’t necessarily get trained a lot to work with Black individuals. The norms in our training programs are definitely whitewashed and that doesn’t leave a lot of room to focus on the cultural nuances that may show up in therapy. I work with Black clients and their [depression] symptoms may look different but that doesn’t mean they’re not experiencing depression. It just shows up differently based on social norms, history and language barriers."³

The Community Health Equity Alliance, an initiative that joins community-based organizations and thought leaders as collaborators under the shared mission to improve serious mental illness care for Black and African Ancestry adults, finds that only one in three Black adults with mental illness receive treatment. The group also reports that people in the Black and African Ancestry community are less likely to receive care consistent with treatment guidelines and less frequently included in medical research.⁴

When taking this information into account, it's understandable how Black communities may be cautious of mental health providers who haven't been properly trained and hesitate to seek treatment from institutions that have historically ignored and harmed them.

Public stigma and stereotypes

Mental health stigma can arise in many different groups of people. The idea of "toxic masculinity," the way men are culturally trained and socially pressured to behave with toughness, anti-femininity, and power,⁵ can be a huge barrier to seeking professional help. According to Mental Health America, men are less likely to seek mental health care, even though they face similar rates of mental illnesses as women when it comes to a psychiatric disorder like bipolar disorder. They're even more likely than women to encounter mental health conditions such as schizophrenia, and four times as many men as women die by suicide every year.⁶

The National Alliance on Mental Illness (NAMI) advises that people in the diverse Hispanic/Latinx community can view talking about mental illness as taboo. NAMI gives the example of the common phrase “la ropa sucia se lava en casa” (similar to “don’t air your dirty laundry in public”) as part of what contributes to the stigma, and also notes that some people do not seek treatment for mental illness out of fear of being labeled as “locos” (crazy) or bringing shame and unwanted attention to their families.⁷

In some immigrant families mood disorders may be trivialized in comparison to other hardships or seen as a lack of gratefulness. NAMI gives the example of elders making statements, such as “How can you be sad when I worked so hard to bring us here?” or “No one is anxious back in our home country because they have other things to worry about."⁸

Self stigma

Self stigma is often the internal result of people who feel shame due to their mental illness or by internalizing messages about mental illness that they encounter in the public. For example, people raised or deeply embedded in certain religious groups might feel shame about seeking help outside of the church, or if their mental illness involves discussion of sexuality that's not accepted by the church. Other people might see their mental health condition as a defect or believe that they're not worthy of help.

Strategies for breaking down barriers

When it comes to mental and behavioral health, stigmas are deeply engrained in society. However, new movements in the fields of psychiatric research and counseling have driven health care professionals to work to both better understand and reduce stigma around receiving mental health care.

Culturally competent mental health education

Culturally competent counseling is a cornerstone in de-stigmatizing mental health within diverse communities. This form of therapeutic practice recognizes and respects the unique cultural backgrounds of each client, integrating their beliefs, values, and customs into the treatment process. Culturally competent counselors are not only aware of cultural differences, but they are also skilled in communicating and connecting across these variances to provide effective and sensitive care. They must continually educate themselves about the cultures with which they work, challenge their own biases, and understand the cultural contexts that influence their clients’ perspectives on mental health. By doing so, they bridge the gap between their professional expertise and the client's cultural experiences, fostering an environment of trust and openness that is essential for successful therapeutic outcomes.

An article for the American Psychological Association (APA) argues that the mental health profession needs to embrace a new paradigm to better serve American Indian and Alaska Native people. Art Blume, PhD, a clinical psychology professor at Washington State University who is Cherokee and Choctaw, told the APA, "The traditional understanding of mental health issues and the models for treating them are still rooted in a Western perspective. In psychology, we focus on treating the individual and promoting autonomy as a marker for health and well-being, but this is not necessarily the worldview of Indigenous people," and added that traditionally, many tribes have viewed the world as an interdependent system in which the cosmos, the natural environment, and the community are connected to wellness.⁹

Culturally competent counseling is a key strategy in reducing stigma, encouraging individuals from all walks of life to seek the help they need without fear of cultural insensitivity or misunderstanding.

Normalizing mental health conversations

Whether it's between friends, family members, or among community members, one of the best ways to dismantle mental health stigma is to continually have conversations about it. The American Hospital Association (AHA) suggests following guidelines set by Yale New Haven Health B.R.A.V.E. program. The acronym stands for Bold/Relevant/Authentic/Valuable/Educational and was developed with the goal of creating a safe space for conversations around racism, racial equality and racial healing, but the AHA suggests applying the concepts to reduce the stigma of mental health in the cultural and ethnic minority populations. The steps are:¹⁰

• Reinforce the purpose: Create a safe space to share concerns and feelings around comments that you hear
• Set agreements to encourage open and respectful dialogue: Listen, acknowledge discomfort, be compassionate and avoid negative language. Assume good intent and value the other person’s feelings
• Open the conversation with your personal story and engage others: Share how the experience impacted you and invite others to do the same
• Bring the conversation to a close and thank them for the courage to share and listen: Encourage people to think about what they can do to impact change and act

The role of clinical mental health counselors

Mental health counselors play a pivotal role in reducing the stigma surrounding mental wellness, serving not only as healers but also as educators, advocates, and community leaders. In their therapeutic roles, they provide a safe, non-judgmental space for clients to explore and understand their mental health challenges, which in itself can be a powerful antidote to stigma. Outside the therapy room, counselors are uniquely positioned to impart knowledge and challenge the myths and stereotypes perpetuating mental health stigma through workshops, public speaking, and collaboration with community organizations. By actively engaging with diverse populations, they can tailor their outreach and educational efforts to resonate with specific cultural contexts. Moreover, when mental health counselors embody empathy and practice inclusivity in their work, they model behavior that encourages openness and acceptance within society. By shedding light on the reality of mental health issues and championing the benefits of seeking assistance, these professionals play an instrumental role in fostering a broader understanding and empathy, contributing to a societal shift toward de-stigmatizing mental health.

Charting a Path to Change: Your next step in clinical mental health counseling

Our exploration of strategies for de-stigmatizing mental health in diverse communities emphasizes the need for skilled mental health professionals ready to lead the charge toward greater understanding and inclusivity of mental health treatment. Oklahoma City University offers an opportunity to be at the forefront of this transformative field through its online M.Ed. in Clinical Mental Health Counseling. This comprehensive program is designed to equip you with the knowledge, tools, and cultural competencies necessary to become a catalyst for change within your community. As you contemplate the next steps in your professional journey, consider how an advanced degree from OCU can prepare you to break down barriers and support the well-being of individuals across all walks of life. Embrace the opportunity to make a lasting difference and start your journey toward becoming a mental health counselor with the skills to challenge stigma and champion mental health advocacy. Schedule a call with an admissions outreach advisor to learn more about how you can embark on a career that not only transforms lives but also reshapes society's approach to mental health.