By Victor Schwartz M.D., Chief Medical Officer, JED and Dan Reidenberg Psy.D., Executive Director, Suicide Awareness Voices of Education
The issue of stigma around mental health has received a tremendous amount of media attention and increased public awareness (Let’s Call Mental Health Stigma What It Really Is: Discrimination; The Stigma of Mental Illness Is Making Us Sicker) and there are even organizations dedicated to fighting mental health stigma including JED, SAVE, NAMI and more, yet not everyone always agrees what we mean by stigma in relation to mental health. Sometimes we use this term in relation to prejudice against or fear of people with mental illness. Sometimes we use it to describe the fact that people with mental illness are often treated worse than people with physical illness. Sometimes we mean that people are afraid of having mental illness and look down on those with mental illness. But no matter what meaning we are thinking of when we consider stigma in relation to mental illness, just about everyone (and it’s fair to say that everyone in the professional mental health community) agrees that mental health stigma is not a good thing.
We would like to suggest though that there is one area of concern in the mental health world where the question of stigma gets a whole lot more complicated. Stigma is much trickier to discuss in relation to suicide. What are we talking about?
On the one hand, we agree that it is really important that there is greater awareness about the realities of suicide and less myths, that people be educated about risks and protective factors around suicide and that we be able to talk openly about these concerns. This is vitally important and both our organizations put great effort into doing just this. It is also desperately important that those who experience a suicide death among family or friends are not made to feel ashamed but in fact receive support and care from family, friends and community.
But, we also know that in societies and some religious communities that have negative views of suicide ― that look askance at suicide ― rates of suicide are generally lower. This is an important and robust effect that tells us, in essence, you are less likely to die by suicide if your community ideologically opposes suicide (although suicides do occur in these communities too).
Finding a balance between good and not-good stigma
Bad (not-good) stigma keeps people from talking, sharing, reaching out for help. Bad stigma creates beliefs that are rooted in unfair and misinformed information often passed on generation after generation. Bad stigma sends a message that there is a reason to keep things a secret. Good stigma, on the other hand, creates a belief that suicide is not “normal,” it is not common, and it is not something to try. Good stigma needs to be promoted so that young people, in particular, learn a new message and way to understand suicide as a path not to follow. Good stigma sends the message that something about suicide is not right and if that is happening for someone that is not good and we need to get them to help.
We are posing the question then: how do we continue to speak and educate about suicide and fully and lovingly support those struggling with suicidal urges and those who have lost someone to suicide, while at the same time continuing to convey that suicide is not an acceptable solution to dealing with life’s problems?
Serious and deep issues sometimes are complicated and not amenable to simple approaches or answers. We would like to deepen the conversation around stigma and suicide. These are both important, urgent and complex issues. Let us know your thoughts about this question.
If you or someone you know is struggling, please reach out for help: Text “START” to 741-741 or call 1-800-273-TALK (8255)