The hidden toll of silence

The 1st of February is Time to Talk Day, a day dedicated to starting conversations around mental health. In light of this, we’re going to talk about the profound consequences of silence around mental health issues, the critical nature of breaking this silence and how to navigate the barriers to getting help.

Time to Talk Day is just one of many mental awareness events spaced across the year. Others include National Stress Awareness Day, Men’s Mental Health Awareness Month and University Mental Health Day. With 1 in 4 people experiencing a diagnosable mental health problem in any given year awareness around this issue is increasing.

These events play a crucial role in reducing stigma and sparking conversation. A study examining a UK social media campaign called ‘Time to Change’ found a statistically significant increase in tolerance and support for people with mental health problems from people exposed to the campaign.

For people experiencing mental health problems, stigma and societal expectations are barriers to starting these conversations and getting the help they need. Time to Talk Day encourages people to talk about their problems, which can be the first step to getting help.

However, awareness days must be backed up with material resources that allow people experiencing mental health problems to get the help they need once that silence has been broken. Increased awareness can have a powerful role in shifting societal expectations and creating new narratives, but workable interventions that allow people to access support are also critical.

Societal Expectations

Societal expectations have a profound impact on people experiencing mental health conditions and represent a significant barrier to seeking support.

Expectations shape society’s view of the highs and lows of bipolar as a lack of self-control or unpredictability rather than as symptoms of a medical condition. Expectations shape society’s view of the highs and lows of bipolar as a lack of self-control or unpredictability rather than as symptoms of a medical condition.

Societal expectations can negatively shape perceptions around different conditions in different ways. For instance, expectations around motherhood create stigma for mothers experiencing postnatal depression – instead of being viewed as a person struggling with a condition, they can be viewed as ‘bad mothers’.

Expectations shape society’s view of the highs and lows of bipolar as a lack of self-control or unpredictability rather than as symptoms of a medical condition.

In both of these examples, expectations contribute to ‘self-stigma’. The sufferer internalises expectations, leading to withdrawal and social exclusion and creating a barrier to seeking help.

Expectations and stigma are inextricably linked. Public perceptions and misunderstanding can lead to people suffering from mental health conditions having their symptoms viewed in the worst possible light, leading them to internalise these harmful ideas around their conditions and feeling unworthy of help. This is why talking openly to change these perceptions and expectations is crucial.

Stigma as a Barrier to Support

Stigma is fueled by prejudice and discrimination and can influence psychiatric care, leading to delayed treatment, increased morbidity and a poorer quality of life.

Mental health stigma is formidable. It’s not just about the fear of being labelled or misunderstood; it’s about the internalised shame that can deter individuals from seeking professional help. Conditions like PTSD, stress, anxiety, depression and social anxiety are often trivialised or misunderstood, making it harder for those affected to talk about their struggles and seek appropriate treatment.

Personality disorders such as Borderline Personality Disorder and Narcissistic Personality Disorder are stigmatised – sometimes even by mental health practitioners. This is a massive barrier to support, giving rise to a profound sense of shame in the person experiencing these conditions.

A step to destigmatising mental health issues is increased public understanding. The media can play a critical role in educating and raising awareness – but historically, it has not always done a good job.

Media’s Double-Edged Sword

The media can be vital for raising mental health awareness and encouraging people to break their silence. But despite the potential of mass media to educate and foster empathy, it also can perpetuate harmful stereotypes, sensationalise, and inadvertently romanticise these conditions.

Media misrepresentation has led to profound misunderstandings of many conditions by the general public.

For example, schizophrenia has been historically portrayed as a ‘split personality disorder’. Originating in a mistranslation of early theorist Eugen Bleuler, who proposed that schizophrenia resulted from split psychological processes, this was taken by many to mean people with schizophrenia experienced entire split and separate personalities.

OCD is another example of a condition which has long been inaccurately portrayed in the media. Popularly characterised as excessive cleanliness or orderliness, OCD is characterised by distressing obsessions and compulsions that are not limited to cleanliness. Despite a worldwide prevalence rate of 2%, OCD remains misunderstood.

As well as misinformation, the media has portrayed mental health problems as uniquely dangerous, contributing to stigma and isolation. By being open about their struggles, people suffering from mental health problems have a chance to correct these narratives and tell their own stories.

Impact on Relationships and the Workplace

Stigma and shame have a knock-on effect on relationships, while the conditions themselves, when improperly understood, can strain interpersonal relationships. Silence and stigma surrounding these conditions can exacerbate the strain as individuals and their loved ones struggle to navigate these complex dynamics without open dialogue and understanding.

Intimate and interpersonal relationships can be profoundly affected by mental health issues – but professional lives are also severely impacted.

Mental health conditions can be a barrier to gaining employment in the first place. To be ’employable’ is to live up to an idealised ‘sellable self’, which cannot have faults, limitations or weaknesses.’’

Once in the workplace, the pressure to be consistently productive, conformance to workplace norms, and lack of concrete support around mental health make matters even more difficult for employees experiencing mental health problems. For this reason, workplace mental health programs are critical – but they must be evidence-based.
Research on workplace mental health initiatives indicates that such programs can be effective, but not all workplace mental health programmes are created equally.

Key components of successful programmes include management support, employee involvement, confidentiality, and integration with broader health and safety policies. The effectiveness of these initiatives is often enhanced when they are tailored to the workforce’s specific needs. For this tailoring to be possible, an environment of openness, where people feel able to speak openly about their struggles, must be fostered.

Dual diagnosis

Public misunderstanding, fuelled by inaccurate media depictions, is compounded for people facing dual diagnosis, a situation that requires an increased level of nuance and sensitivity.

Dual diagnosis is the co-occurrence of a substance misuse disorder and a psychiatric disorder. These conditions can be highly comorbid – it is common for people with a psychiatric disorder to self-medicate using substances, which can exacerbate both conditions. In addition, substance addiction and mental health conditions are both highly stigmatised, meaning breaking the silence can be even harder for people struggling with both.

Fortunately, help is available.

The Path to Support

Tailored and compassionate mental health treatment is instrumental for those struggling with mental health conditions. Our London clinic offers a stigma-free environment essential for effective mental health and recovery treatment. By providing a holistic approach, the path to recovery is clearer.

Follow UKAT rehabs on Instagram to follow our Time to Talk 2024 campaign.