Stigmatization Of Mental Health

Despite advancements in recent years, gaps in treatment for those with mental disorders persist, largely due to social suffering and stigmatization. In taking a biosocial perspective and analyzing potential solutions, a more thorough understanding of these interwoven problems might be obtained and applied to other global health disparities such as tuberculosis.
One unsettling problem is the global insufficiency in resources, especially considering the great impact mental health has on “adverse economic, social, and health outcomes” (p. 70, Becker & Kleinman, 2013). However, these factors also contribute to the disorders; social suffering and structural violence occur in that economic, cultural, and environmental factors are major contributors to ill mental health, serve as barriers to receiving treatment, and constrain individuals’ agency.

A second problem is the stigmatization of mental health, which can be understood through Berger and Luckmann’s social construction of reality theory; social biases and cultural norms shape the very definition of stigma and the perceived identity of someone with a mental illness.

In fear of social exclusion, embarrassment, or dishonor, many patients do not seek care, leading to an underestimation of the global burden of mental health. Not only are patients affected, however; stigma is embedded in “structures, policy, and legislation,” causing a lower number of healthcare workers to enter the field (p. 171, Vigo, Thornicroft, & Atun,

2016).
One solution includes advocacy for both patients and professionals on an institutional level. Policies, programs, and funding, or the “strengthening of institutional capacity,” are essential in changing the ideas about mental health and addressing social determinant inequalities such as poverty (p. 1658, Kakuma et al., 2011). Support can be successfully gained by effective leaders who spread accurate knowledge about disorders and can both acquire and correctly allocate resources while considering local moral worlds to avoid bureaucratic indifference.
A second solution is redistributing tasks to health workers who require shorter training and fewer qualifications, known as task shifting (WHO, 2008). In addition to the increased contribution of non-specialists, community workers can also acquire skills to take on certain healthcare duties to optimize the resources of time and staff. This more bottom-up approach will allow the cultural practices of the communities to be considered and address structural violence barriers. In addition, education through increased local workers can decrease stigma, ideally reconstructing perceptions about mental health. More immediately, symptoms can be actively recognized instead of waiting for patients to seek care.
Realistically, task shifting effectively works in many scenarios and will continue to be an important solution. One current problem is nonadherence to tuberculosis treatment, whether due to patient beliefs or structural factors outside of their control (Keshavjee et al., 2008). Task shifting applied to this particular issue could increase adherence through education, personal interaction and monitoring, and removal of the structural barriers that prevent adherence. In part, the DOTS-Plus program has exemplified the success of increased coverage via task shifting.
Through using a biosocial analysis to address medical and non-medical disparities, solutions will gravitate towards a local moral perspective, producing better outcomes