More than half of the people with mental illness do not receive help or hesitate to ask for help due to stigma, prejudice and discrimination against them. Such stigma or prejudices can be subtle or obvious. No matter the magnitude, it can harm and jeopardize their health even further.
The Ministry of Health and Population of Nepal estimates that about 15–20% of adolescents (2–3 million) may suffer from some form of mental disorder. The current prevalence of mental disorders among adults and children were 13.2% and 11.2% respectively. According to research by the National Health Research Council, the multi-sectoral action plan for the prevention and control of non-communicable diseases (2014-2020) estimated that 18% of the NCD burden is due to mental illness.
However, the present estimates of mental health problems are derived from small-scale studies in urban areas making it impossible to generalize the results in a national context. With the increasing cases of mental health illness among Nepalese; especially youth, treatment for it must be transparent and easy to access. However, the Nepalese society further adds to the burden by stigmatizing ill people and normalizing sadness, anxiety as a mere stage of human life.
“We are a generation of sad people who appear happy on social media”, said Mimamsha Dhungel, a student, who actively participates in discussions related to mental health. She further added, “Sadness is normalized in our society, and depression issues are often ignored. These constant ignorance mixed with a series of painful events cause mental illness to worsen. When such events accumulate, our health can worsen. People need to be more understanding that stress, relationship changes and a general dissatisfaction with the society cause serious mental health issues”.
A review of studies on stigma shows that while the public may accept the medical or genetic nature of a mental health disorder and the need for treatment, many people still have a negative view of those with mental illness. This often leads to self-stigma, which refers to the negative attitudes, including internalized shame. Such self- depreciation and self- victimization worsens the condition, reduces hope, lowers self-esteem, increases psychiatric symptoms, and poses difficulties with social relationships.
“A person with mental illness is stigmatized even when they take a step towards getting better. If someone visits a psychiatrist, he or she is considered mad. This causes victims to lean on various coping mechanisms which further pulls them further into the hell hole”, claimed Dhungel. She explained how such prejudices in society cause mentally ill people to adopt various mechanisms in order to escape from mental trauma. She further added, “The mentally ill may get involved in substance & alcohol abuse. Thus, we must provide them with a platform which accepts their illness as a problem and not ignore it. They do need validation that they are not suffering alone in this”.
Stigma and discrimination can contribute to worsening symptoms and reduced likelihood of getting treatment, which is very dangerous for those with severe mental illness. A recent extensive review of research by the American Psychiatric Association found that self-stigma leads to negative effects on recovery among people diagnosed with severe mental illnesses.
Salonika Neupane, a psychology teacher at St. Xavier’s College said that, “Various serious mental illnesses like schizophrenia cause hallucinations and violent behaviors, which is not just dangerous for the mentally ill but also for those around them. The public can not differentiate between types of depression and this lack of knowledge causes them to normalize and ignore serious problems”. She further added , “People who are seriously ill can't function normally in society. Thus, we should not be judgmental and discriminate against them. When they are stigmatized, they hesitate to consider treatment. We must be more accepting and communicate sensitively with them”.
Research shows that knowing or having contact with someone with mental illness is one of the best ways to reduce stigma. Individuals speaking out and sharing their stories can have a positive impact. Knowing someone with mental illness, makes it less scary and more real and relatable. People who have faced and overcome mental illness should be applauded
It is important to be sensitive towards them and steps to fight stigma and prejudices against mental illness should be taken. The National Alliance on Mental Illness (NAMI) offers some suggestions to help reduce the stigma of mental illness. Some of them are:
-Talk openly about mental health, such as sharing on social media,
-Educate yourself and others – respond to misperceptions or negative comments by sharing facts and experiences,
-Be conscious of language – remind people that words matter, show compassion for those with mental illness,
-Normalize mental health treatment just like other health care treatments.
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