Brave conversations need to happen — but we need to think bigger if we want to end stigma for good.

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Illustration by Brittany England

I remember the first time I expressed a desire to go to therapy. I was 17 years old, unknowingly struggling with obsessive-compulsive disorder (OCD).

The anxiety I was living with tormented me, but I was still terrified to ask for help.

When I finally found the courage to tell my parents I needed support, their response was less than stellar. “That’s family business,” they said, aghast.

The shame was written all over their faces. They rejected the idea that their son might need professional help — and I quickly internalized that shame, too.

It would take another year, tormented by my condition, before I would finally get the help I so badly needed.

Stories like mine are far from unique.

More than half of Americans with a mental health condition still remain untreated, impacted by a deep societal stigma that leaves us reluctant to reach out.

The impact on those already struggling is undeniable.

According to the American Psychiatric Association (APA), stigma results in reduced hope, lower self-esteem, increased symptoms, difficulties at work, and a lower likelihood of maintaining your treatment plan.

So where does this stigma come from? Attitudes around mental illness are still reinforced in our culture and media.

People with mental illnesses — especially those with less understood conditions, like bipolar disorder and schizophrenia — are still widely believed to be dangerous, untrustworthy, and incompetent, despite experience and evidence showing this is rarely the case.

In fact, people with schizophrenia are more likely to be the victim of violence, rather than the perpetrator.

Still, being labeled “crazy” by what feels like much of society can feel like a shameful burden that few are willing to take on.

Even the jokes we make — like calling ourselves “so OCD” when we wash our hands or “bipolar” when our moods shift — lead to others taking these disorders less seriously.

This stigma is intensified further for historically marginalized groups — like people of color, women, and LGBTQIA+ people — who have traditionally been depicted as “crazy” or “unstable” due to prejudice, increasing their mistrust of the mental health system.

This is a system that frequently misdiagnoses vulnerable communities because of these same prejudices.

The consequences of stigma are far-reaching, too. Research has shown that discrimination in the workplace, housing, healthcare, and more can be connected to mental health stigma.

There’s a far-reaching assumption that simply talking about mental health is enough to reduce stigma. However, recent research suggests that the effectiveness of these campaigns is actually very limited — more must be done.

To truly break down stigma, it has to be addressed at multiple levels:

  • Systemic change. Discrimination is still an everyday reality for those with disabilities, including psychiatric disabilities. There’s a high correlation between stigma and structural inequality. To truly address stigma, the rights and dignity of people with disabilities have to be meaningfully addressed in education, housing, the workplace, and healthcare, including increased access to treatment.
  • Research and funding. To better understand mental health and illness, more research is needed to increase our knowledge about these conditions and to improve the effectiveness of our interventions, as well as funding to make treatment more accessible.
  • Media interventions. Media, including television and film, can be a huge accelerant of stigma. Media must be challenged to handle topics of mental health and illness more responsibly to reduce stigma.
  • Mental health literacy. Simply being “aware” of mental health isn’t enough to address stigma. People must be empowered to take command over their own mental health, like knowing where to access help and how to advocate for themselves.
  • Increased awareness. For many people, there’s still mystery about what mental healthcare really is or looks like. By becoming more active and visible in their communities, healthcare practitioners can reduce a possible fear of the unknown. For communities with a history of mistrust in the healthcare system, seeing a healthcare professional who looks like them and is from the same community can be beneficial.

While talking about mental health is a great starting place, more will be needed to truly better the lives of those with mental health conditions.

While stigma won’t change overnight, it’s still true that change begins with us. This starts by addressing our own attitudes about mental health.

Below are some common myths that still exist today:

Mental illness is just an excuse for poor behavior

Mental illnesses aren’t chosen — and they certainly aren’t an excuse for someone’s behavior.

They’re complex conditions that result from biological, genetic, and environmental factors.

Only a certain kind of person ends up with a mental illness

Mental health conditions touch every single community.

Chances are, you already know someone who lives with a mental health condition. Mental illness doesn’t affect a certain kind of person — it can affect anyone.

You could snap out of it if you tried hard enough

If we could snap out of it, most of us would, gladly. These conditions are much more complicated than that, though.

Most people with a mental health condition will benefit immensely from some combination of therapy, medication, and community support. This is why it’s crucial that we support people seeking the help they need.

Mental illness is a private issue that shouldn’t be talked about

Everyone will have a different relationship to their health journey. Some will choose to keep their mental health issues private; others will find it empowering to share their story.

There’s no right or wrong way to talk about your mental health.

Mental illness can be completely cured

While many people will see improvements in their mental health, and some may make a full recovery, most mental health conditions can’t actually be cured. They’re chronic conditions to be managed with the right support.

If you’re struggling with your mental health, it’s important to know that help exists. You can find a non-exhaustive list of mental health resources here.

If thoughts of suicide arise

If you or someone you know is considering suicide, you’re not alone. Help is available right now:

If you’re not in the United States, you can find a helpline in your country at Befrienders Worldwide.

Since my teen years, I’ve had the privilege of accessing therapy and medication for my OCD. It’s made an enormous difference — as it has for many people living with mental health conditions.

While stigma won’t change overnight, that change begins with brave conversations.

More than just talking about mental health, we need to examine what changes have to happen to make mental health accessible to all.

As I approach my 30th birthday, I’m immensely grateful that so many people are opening their hearts and minds to these conversations.

Far from being “family business” or a personal issue, mental health is our collective business and responsibility. Each and every person deserves mental health. And we deserve to live in a world where people with mental health conditions feel safe, supported, and affirmed.