Why Mental Disorders Are Still Stigmatized — and Why This Is Dangerous for Society

Stigma in the context of mental health is a social mark, a negative label based on stereotypes, fear, and ignorance. It is not just hurtful words directed at people living with a diagnosis. It is a powerful social barrier that prevents people experiencing mental health difficulties and their loved ones from seeking help, reduces adherence to treatment, and complicates recovery, leading to discrimination and social isolation. Despite progress in medicine and growing openness in modern society, prejudices have proven to be remarkably persistent. Why do many people still perceive mental disorders as a personal weakness rather than as medical conditions requiring care and support? And what does this threaten not only for individuals, but for global society as a whole?

Historical roots: from the mark of shame to modern myths

The concept of “stigma” dates back to Ancient Greece. It referred to a mark on the body of a slave or a criminal — a sign of shame and social rejection. The idea of a “brand” became firmly embedded in attitudes toward mental disorders for centuries to come. In the Middle Ages, such manifestations were often interpreted as demonic possession, leading to horrifying consequences, including burning at the stake. During the Enlightenment and in the 19th century, “madness” came to be viewed as a hereditary defect or a moral anomaly, which justified lifelong isolation in grim asylum-prisons. The apogee was reached with the Nazi eugenics programs of the 20th century, where people with mental disorders were exterminated as “inferior.”

Although these dark chapters of history are behind us, deeply rooted social prejudices formed over centuries are still alive. The idea that mental disorders are linked to “otherness,” danger, or moral deficiency is deeply ingrained in the collective consciousness. These historical layers continue to fuel modern myths, turning stigma into a long-lasting cultural phenomenon that society is still struggling to overcome.

Mechanisms of stigma persistence: fear, stereotypes, and the divide between “us” and “them”

Stigma is not merely a lack of knowledge, but an active social process. As formulated by sociologists B. Link and J. Phelan, it consists of several interconnected steps:

• Labeling — society singles out and defines a person by their mental disorder (“schizophrenic,” “depressive”), immediately marking them as different from others;
• Stereotyping — deeply rooted cultural stereotypes are “automatically” attached to the label: dangerousness, unpredictability, weak will, or incompetence;
• Separation — a categorical division emerges between “us” (healthy, normal) and “them” (ill, alien); a person with a diagnosis is perceived as fundamentally different;
• Discrimination — the chain culminates in real social actions (loss of status, exclusion, restriction of rights).

The driving force behind this mechanism is fear, rooted in misunderstanding. Symptoms of mental disorders (intrusive thoughts, altered perception, apathy) are often incomprehensible and frightening to those who have never encountered them. A lack of understanding of the biological nature of illness gives rise to the myth of its “moral” origin, while fear of apparent unpredictability transforms into prejudice about inherent dangerousness. This prompts society to instinctively distance itself, creating a vicious cycle: distancing increases misunderstanding, which in turn justifies further stigmatization and discrimination.

The WHO notes that stigma persists due to low levels of mental health literacy and discrimination at the institutional level. For example, in Europe, mental disorders affect more than 10% of the population, yet fewer than one third receive help because of stigma compounded by barriers created by society.

External and internal stigma: two sides of the same coin

Stigma manifests in two interrelated forms, creating a closed loop of rejection and suffering.

• Public (social) stigma

a set of biased attitudes, negative stereotypes, and discriminatory actions on the part of society, expressed in:

• prejudiced attitudes, where a person with a mental disorder is automatically attributed negative qualities (weakness, incompetence, dangerousness);
• negative labels, when derogatory clichés (“psycho,” “schizo”) are used in everyday life and in media shaping public opinion;
• discrimination, expressed in real barriers to employment, housing, access to non-psychiatric medical services, or in social relationships (people begin to avoid the individual, leading to isolation).

• Internal (internalized, self-stigma)

a far more insidious consequence of public stigma. This is the process by which a person, hearing and encountering prejudice, begins to believe it applies to them personally. They internalize societal stereotypes, turning them into self-blame (“I am dangerous to others,” “My diagnosis makes me worthless”). This generates shame, guilt, and a sharp decline in self-esteem.

The consequences of internalization are devastating. As emphasized by the WHO, self-stigma directly leads to avoidance of seeking help, exacerbating apathy and feelings of hopelessness. A person who believes in their own “defectiveness” considers treatment meaningless or fears that visiting a specialist will only confirm their “label.” This results in refusal or interruption of treatment, worsening prognosis and disease course, conscious isolation due to fear of being exposed or rejected, reduced quality of life, and loss of faith in the possibility of recovery and a dignified future.

External stigma gives rise to internal stigma, which in turn deprives a person of strength and motivation to fight, reinforcing and amplifying social prejudices. Breaking this vicious cycle is the central task of destigmatization.

The digital age: a double-edged sword

Mass media and social networks play an ambivalent role. On the one hand, cinema and news outlets often replicate the image of the “dangerous psychopath,” reinforcing fear. The informal language of social media, replete with words like “bulimic girl” or “schizo,” also strengthens stigma. On the other hand, the internet provides opportunities to create support spaces, share experiences, and conduct important educational work, becoming a key tool for destigmatization. And the media, which sometimes spread myths about disorders, can also contribute to improving mental health by encouraging society, through available means, to combat the stigmatization of mental illness.

A global danger: how stigma harms societal health

The effects of stigma extend far beyond personal tragedy, creating a heavy burden on society as a whole and provoking systemic consequences:

• Economic losses
  According to the latest reports from the WHO and the OECD, mental disorders are among the leading causes of disability worldwide. People conceal their condition, leading to frequent and prolonged sick leave, a sharp decline in productivity, and ultimately premature exit from the labor market. Experts estimate that depression and anxiety disorders cost the global economy approximately €1 trillion annually, and the lion’s share of these losses is linked precisely to cases left untreated because of stigma.
• Distortion of the healthcare system
  Fear of judgment forces people to seek help only at moments of acute crisis. This increases the burden on inpatient facilities at the expense of developing prevention, early diagnosis, and accessible outpatient care, which are many times more effective and less costly.
• Pressure on social and state resources
  Conditions left untreated due to stigma lead to increased reliance on social benefits, a growing number of people requiring lifelong care and support, and increased strain on social protection systems and relatives forced to become unpaid caregivers.
• Loss of human capital
  Stigma from employers and self-stigmatization render a vast layer of professional potential “invisible.” Millions of people drop out of the economy, their skills and talents remaining underutilized. Society loses twice over: it bears the cost of support and forfeits these individuals’ contributions to development.

Positive trends: a movement toward understanding

The global community recognizes the harm caused by stigma. The WHO actively promotes destigmatization through programs (mhGAP — a guide for non-specialists in primary care for depression, psychoses, and others) and supporting initiatives (MOSAIC — a toolkit based on evidence-based principles of engagement with people with lived experience, leadership by people with lived experience, partnership, and collaboration). Research confirms that direct social contact and inclusion in work or education are more effective than abstract education.

The global trend of destigmatization involves a shift from isolation toward rehabilitation and resocialization, where the key marker of success is the restoration of social roles and quality of life. However, the trend toward normalizing help-seeking has developed at different paces across regions:

• The United States and Western Europe — systematic efforts began with the patients’ rights movement in the 1960s, later consolidated in the transition to community-based care and the Recovery Model, which focuses on a person’s capabilities rather than solely on symptoms. By the 1990s–2000s, this led to psychiatric consultation being perceived as part of routine medical practice, with care systems emphasizing outpatient services, psychoeducation, and family support;
• Russia and Eastern Europe — in these countries, a closed institutional model dominated for a long time, so significant changes have emerged only in the past 10–15 years: growth of NGOs, the emergence of habilitation centers outside hospitals, and the development of private comprehensive care clinics combining therapy, rehabilitation, and systematic family work.

An illustration of this trend is the emergence in Russia of comprehensive clinics operating in accordance with modern international standards. For example, the Dr. Isaev Clinic (Moscow) has been operating since 2013 and specializes in treatment and rehabilitation, collaborating with specialized organizations in the United States, Europe, and Israel. Its approach, which includes not only the alleviation of symptoms but also psychotherapy, rehabilitation, and work with families, reflects a broader shift toward a destigmatizing, recovery-oriented model of care for people with mental disorders and dual diagnosis.

Practical advice on destigmatization

Practical steps for everyone include learning empathy, consciously rejecting stigmatizing labels, and supporting open dialogue. In communication, avoid slang and insinuations, remain calm, and do not respond to possible aggression. Be empathetic — this helps to see the situation through the eyes of a person with a disorder, builds trust, and reduces isolation. Use supportive words (“I’m with you,” “I believe in your recovery”). Educate yourself and share knowledge with those around you, debunking myths to reduce stigma in society. These actions gradually change the mental health landscape, making help more accessible and society healthier.

Why all of this matters to everyone

Stigma toward mental disorders is not someone else’s problem. It undermines public health, causes economic damage, destroys social ties, and ruins human lives. But combating it is not an abstract act of goodwill. The entire set of measures aimed at destigmatizing mental disorders is a pragmatic investment in a more resilient, healthy, and productive society. By changing our language, showing empathy, supporting open conversations and educational initiatives, each of us can make a meaningful contribution to creating an environment where seeking help is seen as a sign of strength rather than weakness, and respect for mental health becomes the norm.

Literary Sources

1. Bruce G. Link, Jo C. Phelan. Conceptualizing Stigma; 2001.
2. Comprehensive Mental Health Action Plan 2013–2030. Geneva: World Health Organization; 2022.
3. Promoting Mental Health and Preventing Mental Disorders: Best Practices in Public Health. OECD Publishing, Paris; 2025.
4. Mental Health Atlas 2024. Geneva: World Health Organization; 2025.
5. Mental Health Gap Action Programme (mhGAP) Guideline for Mental, Neurological and Substance Use Disorders: Executive Summary. Geneva: World Health Organization; 2025.
6. Enikolopov S. N. Stigmatization and the Problem of Mental Health // Medical (Clinical) Psychology: Traditions and Prospects.