Opinion: Existing mental health stigma still a barrier to health equality

The WHO elaborate that this includes having the right to be able to access timely, acceptable, and affordable quality healthcare. Where are we at with efforts to realise this grand aim in relation to mental health though? 

In the UK, at first glance, affordability of mental health care seems not to be an issue. It’s true that the NHS still does most of the heavy lifting when it comes to providing care for people who are struggling with mental health issues. Increasingly, however, NHS services are overwhelmed by the sheer number of people who need support. This often results in people not receiving the care that they (or their loved ones) think they need in a timely fashion.

As a CBT therapist, many people have approached me in recent years looking to pay for CBT because they’ve been told by their GP that they would face a lengthy wait for this through the NHS. This creates a health inequality, where people who are financially less able are priced out of being able to fulfil this universal human right. 

In fact, there is an inextricable link between deprivation and mental health. People living in Scotland’s most deprived areas are twice as likely to experience common mental health problems than those who live in the least deprived areas. This is likely due to people from areas of greater deprivation being more likely to experience higher levels of stress, more often and for longer than people from more affluent areas. These stressful experiences often occur in combination and can include poverty, poor housing, unemployment, adverse childhood experiences, family conflict and chronic health problems. 

These wider issues of inequality in relation to mental health need to be addressed at governmental levels, however there are things that we can influence at societal and individual levels to help people with mental health problems get closer to achieving this basic human right.

There is a problem with how we talk about mental health… when we say ‘mental health’ we often mean ‘mental disorder’ as in (said in a worrying tone) ‘lots more children nowadays have mental health’. We would never speak this way about physical health because it would sound ridiculous. In fact, the term ‘physical health’ often conjures positive connotations. So why is the opposite true for the term ‘mental health’? 

The answer, perhaps, is stigma. Like it or not, a taboo continues to exist around mental health despite every one of us experiencing mental health problems some of the time. A fear of being marked as different in an unfavourable way stops many of us from discussing mental health problems openly in the way that we might discuss our physical health problems. The situation can be even worse for people who experience mental disorders.

While some mental disorders garner sympathy or some level of understanding from the general public and healthcare providers, people experiencing some disorders are often vilified as ‘attention seekers’, ‘manipulators’ (e.g. people with personality disorder diagnoses) or as deserving of their problems because of lifestyle ‘choices’ (e.g. people with drug or alcohol problems). Thinking about people in this way serves to dehumanise them in our minds and makes it easier for us to treat them in sub-human ways, leading to a culture of injustice and discrimination for these people which makes it difficult for them to speak about their struggles or to reach out for help when it is needed.

One thing you can do to help is to try to set aside labels or judgements and instead, try to see people with mental health problems as humans each with their own individual story and struggles, deserving of the right to be able to achieve the highest possible standards of health.

By Scott Macpherson, Lecturer in Mental Health Nursing at the School of Nursing, Midwifery and Paramedic Practice, and registered nurse and CBT therapist.