When anti-stigma mental health campaigns go too far… Is it possible to cause harm whilst trying to achieve good?

By Caroline Harroe (Harmless CEO)

When anti-stigma mental health campaigns go too far… Is it possible to cause harm whilst trying to achieve good?

In brief, the short answer, is yes.

While anti-stigma campaigning for mental health has gained momentum in recent years, it is important to acknowledge that there is a potential for over-pathologising human experience. This can occur when mental health issues are seen as the norm rather than the exception and when everyday experiences and emotions are pathologised.

Mental health anti-stigma campaigns aim to reduce the stigma and discrimination associated with mental health issues, and to promote awareness and understanding of mental health. However, there is a risk that these campaigns can inadvertently contribute to a culture of over-pathologisation by framing normal human experiences and emotions as mental health issues.

For example, sadness, anxiety and stress are common human experiences that can be exacerbated by life events such as bereavement, divorce or financial difficulties. While these experiences may be challenging, they are not necessarily indicative of a mental health disorder. However, if they are framed as such, it may contribute to a culture of over-pathologisation.

It is important to strike a balance between promoting awareness and understanding of mental health issues and recognising that mental health is a continuum that includes both positive and negative experiences. Mental health campaigns should aim to reduce stigma and discrimination, while also promoting resilience, coping skills and positive mental health. This can help to prevent over-pathologisation and promote a more balanced and nuanced understanding of mental health.


The impact on young people

Young people may be more susceptible to over-pathologising their experiences, as they are still developing their sense of identity and may be more vulnerable to societal pressures and expectations. This can lead to a tendency to label themselves with mental health conditions, such as depression or bipolar disorder, without necessarily meeting the diagnostic criteria.

There are a number of factors that may contribute to this. The increased awareness and visibility of mental health issues may lead young people to perceive their experiences as more abnormal or pathological than they actually are. The pressure to succeed academically and socially, as well as the impact of social media, may also contribute to feelings of anxiety and stress, which can be incorrectly labeled as mental health disorders as opposed to emotional struggles normal to each of us.

It is important for young people to have access to accurate and balanced information about mental health, so that they can distinguish between normal human experiences and actual mental health disorders. This can help to prevent over-pathologisation and ensure that young people receive appropriate support and treatment when necessary.

Mental health education and awareness campaigns can play an important role in promoting this understanding, as can access to mental health professionals who can provide an accurate diagnosis and treatment. It is also important to promote resilience and coping skills, so that young people are better equipped to manage the challenges of everyday life without feeling the need to label themselves with mental health conditions.


Striking the balance

Current research suggests that there needs to be a balance between raising awareness and reducing stigma around mental health, while also avoiding over-pathologisation of normal human experiences. Here are some of the key recommendations from recent research:

1. Promote resilience and coping skills: This can help to prevent over-pathologisation, by providing young people with the tools to manage everyday challenges without feeling the need to label themselves with mental health conditions.

2. Encourage a balanced understanding of mental health: Mental health campaigns should aim to promote a more nuanced understanding of mental health, which recognises that mental health is a continuum that includes both positive and negative experiences.

3. Improve access to mental health professionals: To ensure that young people receive an accurate diagnosis and treatment when necessary, there needs to be better access to mental health professionals.

4. Address the social determinants of mental health: Mental health is strongly influenced by social, economic and environmental factors, so addressing these determinants can help to promote positive mental health.

5. Involve young people in mental health advocacy: Young people should be involved in mental health campaigns to ensure that their perspectives and experiences are reflected in the messaging.

In summary, it is important to continue talking openly about mental health, but with a focus on promoting a balanced and nuanced understanding of mental health. By promoting resilience, improving access to mental health professionals, addressing social determinants and involving young people in mental health advocacy, we can work towards a more positive and supportive mental health culture.


Bibliography

Here are a few academic references that discuss how anti-stigma campaigns can lead to over-pathologising of normal human experiences:

1. Pescosolido, B. A., Medina, T. R., Martin, J. K., & Long, J. S. (2013). The “backbone” of stigma: identifying the global core of public prejudice associated with mental illness. American Journal of Public Health, 103(5), 853-860. doi: 10.2105/AJPH.2012.301147. This study argues that anti-stigma campaigns can lead to over-pathologising of normal human experiences, by portraying mental illness as a universal and permanent condition that requires medical treatment.

2. Rose, D. (2006). The mainstreaming of recovery. Journal of Mental Health, 15(3), 221-231. doi: 10.1080/09638230600680766. This article discusses how the recovery model, which emphasises the possibility of recovery from mental illness, can be co-opted by anti-stigma campaigns to promote a ‘positive’ image of mental illness that does not reflect the experience of many people.

3. Read, J., & Haslam, N. (2004). Attitudes towards mental illness: a review of the literature. Acta Psychiatrica Scandinavica, 110(6), 401-413. doi: 10.1111/j.1600-0447.2004.00323.x. This review of the literature discusses how anti-stigma campaigns can lead to over-pathologising of normal human experiences, by promoting a narrow and medicalised view of mental illness that ignores the social and cultural factors that contribute to mental distress.

While these studies do not explicitly argue that anti-stigma campaigns always lead to over-pathologising of normal human experiences, they do suggest that there is a risk of this happening if campaigns are not carefully designed and implemented.