The Impact of Societal Perception on Mental Illness

Mental illness refers to a health condition that involves changes in emotions, thoughts, or behaviors that can potentially lead to distress and impact one’s quality of life (American Pyschistric Association, n.d.). Statistics from a 2023 State of Mental Health in America survey reveal that in 2019 and 2020, 1 in 5 U.S. adults, which is about 50 million people, experienced mental illness (Mental Health America [MHA], 2023).

Among these individuals, about 55% of them have not received any treatment (MHA, 2023). 55% of 50 million is 27.5 million — meaning that 27.5 million people in the US have not received treatment for their mental disorders and are suffering in silence. Therefore, it is significant to evaluate which factors prevent individuals from seeking treatment in order to promote a healthy society.

Often, societal perception, heavily influenced by media portrayals and societal attitudes, amplifies individuals’ reluctance to seek treatment or help for mental illness. It is the process in which people understand each other, form a global picture of others’ personalities, and determine the reasons and causes behind others’ behaviors that significantly influences how individuals perceive their own treatment (Sandu et al., 2020). This, in turn, impacts how individuals perceive their treatment, thereby impacting their willingness to engage with mental health services. These perceptions can be shaped by a variety of factors, including misallocation of resources and legislation (Ahad, 2023). Understanding these dynamics is significant for identifying where interventions are most needed, thus improving treatment accessibility and enhancing the health status of individuals with mental illness. Therefore, the societal perception of mental illness is a key factor contributing to an individual’s hesitation to seek help or treatment.

Stigma and Discrimination

A study by the National Council for Behavioral Health found 52% of individuals with mental illness avoided seeking treatment due to stigma (National Council for Behavioral Health, 2018). Stigma refers to the negative perception directed towards individuals or groups because of their specific characteristics and conditions, such as mental illness. People with serious mental illnesses face challenges from both their symptoms and societal prejudices, often leading to limited opportunities for quality life.

The impact of stigma is twofold — public stigma, which is the general population’s reaction to people with mental illness, and self-stigma, where people with mental illness internalize the prejudice against themselves. Both types of stigma involve stereotypes, prejudice, and discrimination. Stereotypes are shared social beliefs acquired by most members of a group, while prejudice involves endorsing these negative stereotypes and generating negative emotional reactions. Discrimination, the behavioral reaction to prejudice, can lead to harmful actions (Corrigan, 2002).

Public stigma can lead to discrimination, such as refusing to help, avoiding, or enforcing coercive treatments. In an international survey, it was found that 93% of respondents from 200 countries didn’t believe that recovery from mental illness was possible (Seeman et al., 2016). This shows just how widespread and ingrained public stigma towards mental health really is.

This public stigma can potentially lead to self-stigma, which refers to when individuals with mental illness internalize negative beliefs about their condition. This process can be explained using a stage model. The first stage, awareness, happens when the individual recognizes the public stigma associated with their condition. The next stage, agreement, is when the individual starts to believe that these negative stereotypes truly represent their group. Then, application happens when the person subconsciously applies these stereotypes to themselves, leading to avoidance of seeking treatment due to fear of further discrimination, judgment, and harm in the form of significant decreases in self-esteem (Corrigan, 2002). This harm situations include self-stereotypes, and experiencing prejudice , leading to self-discrimination, such as self-imposed isolation (Corrigan, 2002). Therefore, it is really important to address both public and self-stigma, as it not only affects individuals’ willingness to seek help but also their self-esteem and sense of self-worth. By changing societal attitudes and beliefs about mental illness could significantly reduce the harmful impacts of stigma and improve mental health treatment accessibility and acceptance.

Cultural and International Perspectives on Stigma

Cultural and societal beliefs significantly influence attitudes toward mental health, as highlighted by Ahad (Ahad, 2023). For example, some countries in East Asia are heavily influenced by traditional Confucian values, which view mental disorders as internal issues to be endured, not treated (Zhang et al., 2020). Park et al. revealed that these ideals still influence current society in Korea, resulting in misinterpretations and increased stigma surrounding mental illness. Bandata et al.’s study showed that the idea of prioritizing family honor led individuals to avoid mental health treatment to preserve family reputation (Bandata et al.,2022) . Also, medical professionals in South Korea have also noted that the Confucian emphasis on individual will and self-discipline can create societal biases against mental health (Chu, 2018). These cultural norms directly impact how mental health is perceived and addressed, often acting as barriers to seeking necessary help and support.

Media Portrayal and Misconeptions

Negative media portrayals and misconceptions of mental illness have a significant impact on societal attitudes and beliefs about such conditions. Media, including films and television shows, often depict individuals with mental illnesses as violent, dangerous, and unpredictable. These portrayals are largely based on stereotypes and misconceptions, rather than accurate representations of mental health conditions.

A 2018 study by Quintero Johnson & Riles found that 72% of mentally ill characters on TV inflicted harm upon or even killed others, making them ten times more likely to engage in violent crime compared to other characters (Quientero Johnson & Riles, 2018). This is despite the fact that the actual risk of violence among this demographic is relatively low. One of the most common stereotypes is the “homicidal maniac” — a character with serious mental illness who is violent and dangerous. This stereotype, prevalent in many contemporary “slasher” or “psycho killer” films, conflates mental illness with violent behavior, despite weak evidence supporting such a link (Hyler et al., 1991). This perpetuates the misconception that individuals with mental illnesses are inherently violent, leading to increased discrimination and stigma. The film “Me, Myself & Irene” is an example of negative media portrayal and misconceptions of mental illness due to its inaccurate and stigmatizing depiction of schizophrenia and dissociative identity disorder (DID) (Owen, 2012). The film conflates these two distinct disorders and portrays the main character, Charlie, as having a violent and uncontrollable alter-ego, Hank, that emerges when he forgets to take his medication. This contributes to the harmful stereotype that individuals with mental illnesses are violent and uncontrollable, even though violence is not a symptom of these conditions. This kind of portrayal can lead to harmful misconceptions, stigma, and discrimination, and may deter individuals from seeking help for their mental health concerns. The film Split is another example of negative media portrayal and misconceptions of mental illness because it perpetuates harmful stereotypes and misunderstandings about dissociative identity disorder (DID). In the film, the main character, Kevin, who has DID, kidnaps three teenage girls, and an evil, sinister personality, “The Beast,” begins to emerge (Wang, 2017). This portrayal incorrectly suggests that individuals with DID are inherently violent and dangerous, which is a gross misrepresentation of the condition. In reality, DID often results from severe trauma, and those with the disorder are far more likely to be victims, rather than performing violence (Giashi, 2023).

Negative portrayals of mental health treatments and professionals are also widespread in the media, particularly in horror films. For instance, a study by Goodwin analyzed 55 horror feature films that were made between 2000 and 2012, uncovering several stereotypes. The study found that over half the films showed hospital staff harming patients. Almost two-thirds used some form of restraint, like straitjackets (Goodwin, 2012). Over one-third of the films showed a stereotype of evil doctors or nurses. Also, over one-third showed therapists crossing boundaries with their patients. (Goodwin, 2012). These erroneous representations contribute to misinformation and can further stigmatize individuals seeking life-saving help for mental health conditions. As a society, it is crucial to challenge these misguided representations and increase understanding and empathy towards mental health, as this can help those affected to seek necessary help without fear of stigma or discrimination.

Positive Impact of Social Perception

The influence of societal perception on mental health conditions can vary, with some conditions experiencing less stigma due to factors such as public awareness and representation in the media. These factors can rather empower individuals to seek the help they need. For instance, a study by Hazell et al. found that depression and generalized anxiety disorder (GAD) are less stigmatized than schizophrenia or antisocial personality disorder (Hazell, 2022). This could be because depression and anxiety are considered more common and relatable, thereby being frequently represented in media and discussions, normalizing them and reducing stigma. Therefore, raising awareness about diverse mental health disorders, beyond just common ones like depression and anxiety, is important for reducing stigma and encouraging individuals to seek help. By focusing attention on less prevalent conditions, public perception can transition from fear and misunderstanding to empathy and support.

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