By Dr. Vaunam Venkadasalam, Ph.D
Erving Goffman (1963) defined stigma as a “deeply discrediting” attribute. A discredited attribute could be easily detectable, such as skin colour or body size, or it could be hidden but discreditable if disclosed, such as a criminal record or struggles with mental health (Claire, 2018). Regardless of whether the attribute is detectible or hidden, a stigmatized person is seen as tainted and discounted rather than a whole and usual person.
The stigma around mental health problems can impact individuals and their families. For instance, while mental health problems are common because 1 in 5 individuals experience mental health concerns, as many as 60% of people with a mental health problem won’t seek help – primarily due to stigma (Mental Health Commission of Canada, 2023). Stigma is a barrier that can be directly experienced by and perceived by children and their parents; in other words, stigma can be enacted and felt (Eaton et al., 2016). The following sections consider several ways parents have reported the ways in which stigma can negatively impact their lives (Eaton et al., 2016).
Awareness of external stigma
Stigma frequently originates from external sources such as family, friends, co-workers, or strangers. However, stigma can also be transmitted from services and systems. For example, this can be a lack of access to healthcare services or a lack of a collaborative system between healthcare providers. Often, there is an awareness of the external stigma that parents experience, which can be characterized into three categories:
- Blame and bad-parent stigma are supported by the notion that childhood mental health problems do not exist—instead, the child’s problems result from failing to be a good parent. A prominent example is having others say, “You haven’t disciplined your child right” or “You haven’t raised them properly”. These exchanges can lead parents to feel stigmatized by their peers.
- Courtesy stigma results from judgment or criticism regarding the quality of parenting. This type of stigma is often magnified in social settings where the child’s misbehaviour and/or symptoms are evident in an interaction. For instance, when a child swears or yells at a parent in a public setting such as a store. The parent can experience stigma from observers of the situation.
- Vicarious stigma is when the parent and child experience similar feelings in a situation where the child experiences stigma. For example, this might be felt when other parents say, “My child doesn’t play with that child”. These words can illicit negative emotions for both the child and the parent.
How the external stigma impacts self-stigma.
Self-stigma, or internalized stigma, refers to the process by which a person adopts the stigmatizing views widely held by external sources. This internalization can happen whether it’s directly enacted or felt by the parent. As parents start to believe the external stigma they are experiencing is accurate, this can lead them to have greater self-doubt. In this phase, a parent may start to believe they are a bad parent and may even begin to believe they caused the disorders based on past choices – leading to self-blame.
Outcomes of Stigma
The burden of external and internal stigma can lead to adverse outcomes for parents. First, stigma may lead parents to avoid social interactions with neighbours, family and friends, which can reduce their social circle and support systems. Stigma can also result in many parents experiencing greater self-doubt. Self-doubt can manifest in several ways. It can include failing to live up to “the good parent ideal” or not meeting this standard. It can also lead parents to question their role in the causation, exacerbation or continuation of their child’s problems. Finally, stigma can lead to poor life outcomes for the parents, such as stress, negative affect (e.g., depression), poor quality of life, and chronic health conditions.
Strategies for Coping with Stress and Stigma
Stigma is a significant barrier to seeking help for individuals who are experiencing mental health problems. Below is a list of coping strategies that can help parents deal with stress and adverse outcomes that result from external and internal stigma:
- Let go of stigma, judgments, and unjustified shame (Eaton et al., 2016)
- Engage in active and emotion-based coping (Dunn et al., 2001; Kim-Godwin, 2020)
- Seek social support (Dunn et al., 2001; Dunst, 2022)
- Engage in self-care and positive family environments (Torres-Soto et al., 2022)
- Practice mindfulness (Burgdorf et al., 2019)
- Engage in meaningful non-parenting activities (Ha et al., 2008)
- Seek professional treatment (Brown, 2018)
References
Brown, Jenny. “Parents’ experiences of their adolescent’s mental health treatment: Helplessness or agency-based hope.” Clinical Child Psychology and Psychiatry 23, no. 4 (2018): 644-662.
Burgdorf, V., Szabó, M., & Abbott, M. J. (2019). The effect of mindfulness interventions for parents on parenting stress and youth psychological outcomes: A systematic review and meta-analysis. Frontiers in Psychology, 10, 1336.
Clair, M. (2018). Stigma. In J. M. Ryan (Ed), Core concepts in sociology (pp. 318-321).
Dunn, M. E., Burbine, T., Bowers, C. A., & Tantleff-Dunn, S. (2001). Moderators of stress in parents of children with autism. Community Mental Health Journal, 37(1), 39-52.
Dunst, C. J. (2022). Associations between perceived family social support and the psychological health of caregivers of children and adolescents: A systematic review and meta-analysis. European Journal of Psychological Research, 9(2), 32-57.
Eaton, K., Ohan, J. L., Stritzke, W. G., & Corrigan, P. W. (2016). Failing to meet the good parent ideal: Self-stigma in parents of children with mental health disorders. Journal of Child and Family Studies, 25, 3109-3123.
Goffman, Erving. 1963. Stigma: Notes on the Management of Spoiled Identity. New York: Simon & Schuster.
Ha, J.-H., Hong, J., Seltzer, M. M., & Greenberg, J. S. (2008). Age and gender differences in the well-being of midlife and aging parents with children with mental health or developmental problems: Report of a national study. Journal of Health and Social Behavior, 49(3), 301–316.
Kim-Godwin, Y. S., Kim, S. S., & Gil, M. (2020). Journaling for self-care and coping in mothers of troubled children in the community. Archives of Psychiatric Nursing, 34(2), 50-57.
Mental Health Commission of Canada (2023). Anti-Stigma: Mental health problems and illnesses are common in Canada. https://mentalhealthcommission.ca/what-we-do/anti-stigma/#:~:text=About%2040%25%20of%20parents%20say,for%20fear%20of%20being%20labelled.
Torres-Soto, N. Y., Corral-Verdugo, V., & Corral-Frías, N. S. (2022). The relationship between self-care, positive family environment, and human wellbeing. Wellbeing, Space and Society, 3, 100076.