Reducing stigma in adolescent mental health

DR ASHA PEMBERTON

teenhealth.tt@gmail.com

As we conclude mental health awareness month, we must place focus on perhaps the single most significant factor which impedes timely and effective mental health services for young people: stigma. Up to one in two adolescents and young adults experience mental health difficulties at any given time, yet only one third of those suffering access treatment. Untreated mental illness predisposes people to longstanding individual difficulties, challenges with interpersonal relationships, poor quality of life, and presents a great public health burden.

By definition, stigma is conceptualised as a feeling of disgrace, shame, and self-blame that results in social exclusion, isolation, and embarrassment. In an attempt to avoid labels, young people and their parents opt not to seek support, accept guidance or follow up with recommendations. This is all too often a reality on our islands.

All methods and programmes to support mental health prevention and intervention must include strategies to continue to reduce the stigma associated with mental health concerns, so that affected youth do not hesitate to declare their concerns, parents feel empowered to access services, and the wider community reduces behaviours of ridicule or punishment.

Self-imposed stigma

In as much as young people affected by states of mental illness are often subject to comments, abandonment or inappropriate language by others, many youth themselves live in states of guilt or shame when they recognise their own emerging mental health concerns. Stigma can indeed be self-imposed. The strategy best effective against this, is knowledge and information. Through childhood and continuing into adolescence, young people require factual teachings on emotions, feelings, thinking and behaviours – the ways in which they all come together neurologically. An understanding of the genetic, environmental and other factors that can lead to mental illness helps to diffuse the idea that any particular disorder was created because an individual was “weak” or in some way “defective”.

Mental health education

Parental, school-based and community engagement educational strategies on mental health are essential. The responses of parents, educators and the society to teen mental health play a crucial role in uptake of existing services and understanding the needs of those affected. We continue to make some strides in this regard locally, but many urban myths and fallacies continue to permeate local mind-sets. On individual levels, use all opportunities to educate yourselves about mental illness, including substance use disorders.

Introspection

Be aware of your attitudes and behaviour. Examine your own judgemental thinking, reinforced by upbringing and society. As adults, we are all shaped and guided by our prior experiences and exposure. Without taking the time to reflect upon our patterns of thinking and belief systems, we all simply continue previous behaviours. We do better when we accept our thinking and know better. Take time to honestly analyse your thoughts and beliefs surrounding mental illness and use evidence-based and trusted resources to challenge thinking and move toward positive change.

Mindfulness

Choose your words carefully. The way we speak can affect the attitudes and experiences of others. If a young person in your life is affected by mental illness or even if they are at risk, the words spoken to them can play significant roles in their self-esteem, internal self-dialogue and self-concept. While harsh worlds alone do not often create a mental illness, they certainly have the power to worsen the emotional balance of a vulnerable or fragile young person. Mindfulness equips us with the ability to pause in times of stress, frustration or irritability, accept our emotions and then make a rational and positive response, rather than an impulse reaction. Mindful parenting has proven to be effective in the overall management of young people affected by mental health concerns and also has the ability to prevent the onset of such issues in vulnerable youth.

Inclusive support

Support people and treat everyone with dignity and respect. Mental illness can affect anyone, regardless of race, ethnicity, gender, sexuality, social status, economic stability or age. Supportive services for those affected should ideally be tailored in some way to specific stages of the life course, but overall, everyone affected will require consistent care and empathy. Carers too can experience burnout and their own states of distress while caring for affected family members and should not be forgotten. As a wider island community, if we each in our spaces seeks to educate, parent, support and mindfully care for each other, we holistically will improve our mental wellness and reduce stigma and other barriers to treatment.