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Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act, and helps determine how we handle stress, relate to others, and make choices.

Mental health is important at every stage of life, from childhood and adolescence through adulthood. Over the course of your life, if you experience mental health problems, your thinking, mood, and behavior could be affected.

Mental Health Conditions

Mental illnesses are disorders, ranging from mild to severe, that affect a person's thinking, mood, and/or behavior. According to the National Institute of Mental Health, nearly one-in-five adults live with a mental illness.

Many factors contribute to mental health conditions, including:

Biological factors, such as genes or brain chemistry

Life experiences, such as trauma or abuse

Family history of mental health problems

Some mental health topics include:

A Serious Mental Illness (SMI) is a mental illness that interferes with a person's life and ability to function. Despite common misperceptions, having an SMI is not a choice, a weakness, or a character flaw. It is not something that just "passes" or can be "snapped out of" with willpower.

View SAMHSA's Public Message about Serious Mental Illnesses.

Early Warning Signs & Symptoms

Not sure if you or someone you know is living with mental health problems? Experiencing one or more of the following feelings or behaviors can be an early warning sign of a problem:

Eating or sleeping too much or too little

Pulling away from people and usual activities

Having low or no energy

Feeling numb or like nothing matters

Having unexplained aches and pains

Feeling helpless or hopeless

Smoking, drinking, or using drugs more than usual

Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared

Yelling or fighting with family and friends

Experiencing severe mood swings that cause problems in relationships

Having persistent thoughts and memories you can't get out of your head

Hearing voices or believing things that are not true

Thinking of harming yourself or others

Inability to perform daily tasks like taking care of your kids or getting to work or school

Do you think someone you know may have a mental health problem? Talking about mental health can be difficult. Learn about common mental health myths and facts and read about ways to help you get the conversation started.

Tips for Living Well with a Mental Health Condition

Having a mental health condition can make it a struggle to work, keep up with school, stick to a regular schedule, have healthy relationships, socialize, maintain hygiene, and more.

However, with early and consistent treatment-often a combination of medication and psychotherapy-it is possible to manage these conditions, overcome challenges, and lead a meaningful, productive life.

Today, there are new tools, evidence-based treatments, and social support systems that help people feel better and pursue their goals. Some of these tips, tools and strategies include:

Stick to a treatment plan. Even if you feel better, don't stop going to therapy or taking medication without a doctor's guidance. Work with a doctor to safely adjust doses or medication if needed to continue a treatment plan.

Keep your primary care physician updated. Primary care physicians are an important part of long-term management, even if you also see a psychiatrist.

Learn about the condition. Being educated can help you stick to your treatment plan. Education can also help your loved ones be more supportive and compassionate.

Practice good self-care. Control stress with activities such as meditation or tai-chi; eat healthy and exercise; and get enough sleep.

Reach out to family and friends. Maintaining relationships with others is important. In times of crisis or rough spells, reach out to them for support and help.

Develop coping skills. Establishing healthy coping skills can help people deal with stress easier.

Get enough sleep. Good sleep improves your brain performance, mood and overall health. Consistently poor sleep is associated with anxiety, depression, and other mental health conditions.

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Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act, and helps determine how we handle stress, relate to others, and make choices.

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Centers for Disease Control and Prevention

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Mental health is an important part of children's overall health and well-being. Mental health includes children's mental, emotional, and behavioral well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day. Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

There are different ways to assess mental health and mental disorders in children. CDC uses surveys, like the National Survey of Children's Health, to describe the presence of positive indicators of children's mental health and to understand the number of children with diagnosed mental disorders and whether they received treatment. In this type of survey, parents report on indicators of positive mental health for their child and report any diagnoses their child has received from a healthcare provider. The information on this page provides data about indicators of positive mental health in children and mental health disorders that are most common in children.

Facts about mental health in U.S. children

National data on positive mental health indicators that describe mental, emotional, and behavioral well-being for children are limited. Based on the data we do have:

Facts about mental disorders in U.S. children

ADHD, anxiety problems, behavior problems, and depression are the most commonly diagnosed mental disorders in children. Estimates for ever having a diagnosis among children aged 3-17 years, in 2016-19, are given below.

ADHD 9.8% (approximately 6.0 million)

Anxiety 9.4% (approximately 5.8 million)

Behavior problems 8.9% (approximately 5.5 million)

Depression 4.4% (approximately 2.7 million)

Some of these conditions commonly occur together. For example, among children aged 3-17 years in 2016:

Having another mental disorder was most common in children with depression: about 3 in 4 children with depression also had anxiety (73.8%) and almost 1 in 2 had behavior problems (47.2%).

For children with anxiety, more than 1 in 3 also had behavior problems (37.9%) and about 1 in 3 also had depression (32.3%).

For children with behavior problems, more than 1 in 3 also had anxiety (36.6%) and about 1 in 5 also had depression (20.3%).

For adolescents, depression, substance use and suicide are important concerns. Among adolescents aged 12-17 years in 2018-2019 reporting on the past year:

Learn more about high-risk substance use among youth. Learn more about suicide.

Mental, behavioral, and developmental disorders begin in early childhood
1 in 6 U.S. children aged 2-8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder.

Prevalence of mental disorders change with age

Diagnoses of ADHD, anxiety, and depression become are more common with increased age.

Behavior problems are more common among children aged 6-11 years than younger or older children.

Adverse childhood events (ACEs) are associated with children's physical and mental health. In 2016-2019, among children aged 6-17 years:

Children who were discriminated against based on race or ethnicity had higher percentages of one or more physical health conditions (37.8% versus 27.1%), and one or more mental health conditions (28.9% versus 17.8%).

Racial/ethnic discrimination was almost seven times as common among children with three other ACEs compared to those with no other ACEs.

Note: The estimates reported on this page are based on parent report, using nationally representative surveys. This method has several limitations. It is not known to what extent children receive these diagnoses accurately. Estimates based on parent-reported diagnoses may match those based on medical records, but some children may also have mental disorders that have not been diagnosed, or receive diagnoses that may not be the best fit for their symptoms. Limited information on measuring children's mental health nationally is available.

Read more about children's mental health from a community study.

Access to mental health treatment

Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders. Access to providers who can offer services, including screening, referrals, and treatment, varies by location. CDC is working to learn more about access to behavioral health services and supports for children and their families.
View information by state describing the rates of different types of providers who can offer behavioral health services providers by county. Read a recent report describing shortages of services, barriers to treatment, and how integration of behavioral health care with pediatric primary care could address the issues. Read a policy brief on potential ways to increase access to mental health services for children in rural areas
Data sources for mental health and related conditions

There are many different datasets which include information on children's mental health and related conditions for children living in the United States.

Healthy People 2030
Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade, including children's mental health and well-being.

National Survey of Family Growth (NSFG)
NSFG gathers information on family life, marriage and divorce, pregnancy, infertility, use of contraception, and general and reproductive health.

National Health and Nutrition Examination Survey (NHANES)
NHANES assesses health and nutritional status through interviews and physical examinations, and includes conditions, symptoms, and concerns associated with mental health and substance abuse, as well as the use and need for mental health services.

National Health Interview Survey (NHIS)
NHIS collects data on children's mental health, mental disorders, such as ADHD, autism spectrum disorder, depression and anxiety problems, and use and need for mental health services.

National Survey of Children's Health (NSCH)
NSCH examines the health of children, with emphasis on well-being, including medical homes, family interactions, the health of parents, school and after-school experiences, and safe neighborhoods. This survey was redesigned in 2016.

For previous versions of this survey, see also:
National Survey of Children's Health (NSCH 2003, 2007, 2011-12)
National Survey of Children with Special Healthcare Needs (NS-CSHCN 2001, 2005-6, 2009-10)

National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA)
NS-DATA collects information about children, 2-15 years old in 2011-2012, who had ever been diagnosed with ADHD and/or Tourette syndrome (TS), with the goal of better understanding diagnostic practices, level of impairment, and treatments for this group of children.

National Survey on Drug Use and Health (NSDUH)
NSDUH, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides national- and state-level data on the use of tobacco, alcohol, and illicit drugs (including non-medical use of prescription drugs), as well as data on mental health in the United States.

National Vital Statistics System (NVSS)
NVSS contains vital statistics from the official records of live births, deaths, causes of death, marriages, divorces, and annulment recorded by states and independent registration areas

National Youth Tobacco Survey (NYTS)
NYTS is a nationally representative school-based survey on tobacco use by public school students enrolled in grades 6-12.

School Associated Violent Death Study (SAVD)
SAVD plays an important role in monitoring trends related to school-associated violent deaths (including suicide), identifying the factors that increase the risk, and assessing the effects of prevention efforts.

School Health Policies and Programs Study (SHPPS)
SHPPS is a national survey assessing school health policies and practices at the state, district, school, and classroom levels. Collected data includes mental health and social service policies.

Web-based Injury Statistics Query and Reporting System (WISQARS)
WISQARS is an interactive database system that provides customized reports of injury-related data.

Youth Risk Behavior Surveillance System (YRBSS)
The YRBSS monitors health-risk behaviors, including tobacco use, substance abuse, unintentional injuries and violence, sexual behaviors that contribute to unintended pregnancy, and sexually transmitted diseases.

References

1. Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM, Gfroerer JC, Hedden SL, Crosby AE, Visser SN, Schieve LA, Parks SE, Hall JE, Brody D, Simile CM, Thompson WW, Baio J, Avenevoli S, Kogan MD, Huang LN. Mental health surveillance among children - United States, 2005-2011. MMWR 2013;62(Suppl; May 16, 2013):1-35. [Read summary]

2. Bitsko RH, Claussen AH, Lichtstein J, Black LJ, Everett Jones S, Danielson MD, Hoenig JM, Davis Jack SP, Brody DJ, Gyawali S, Maenner MM, Warner M, Holland KM, Perou R, Crosby AE, Blumberg SJ, Avenevoli S, Kaminski JW, Ghandour RM. Surveillance of Children's Mental Health - United States, 2013 - 2019 MMWR, , 2022 / 71(Suppl-2);1-42. [Read article]

3. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print October 12, 2018 [Read summary]

4. Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, Walkup J. Epidemiology and impact of healthcare provider diagnosed anxiety and depression among US children. Journal of Developmental and Behavioral Pediatrics. Published online before print April 24, 2018 [Read summary]

5. Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2-8 years - United States, 2016. MMWR, 2018;67(5):1377-1383. [Read article]

6. Hutchins HJ, Barry CM, Valentine V, Bacon S, Njai R, Claussen AH, Ghandour RM, Lebrun-Harris LA, Perkins K, Robinson LR (submitted). Perceived racial/ethnic discrimination, physical and mental health conditions in childhood, and the relative role of other adverse experiences. Adversity and Resilience Science published online May 23, 2022. [Read summary]

7. US Department of Health and Human Services Health Resources and Services Administration & Maternal and Child Health Bureau. Mental health: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999. [Read report]

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Data and Statistics on Children's Mental Health | CDC

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Read data highlights about children's mental health.

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Children's Mental Health Week is organised by the Place2Be charity and is taking place from Feb 5th-11th. This year's theme is 'My Voice Matters' to empower young people to use their voices, share what matters to them, and encourage those around them to hear their voices.

1 in 6 children have a diagnosable mental health issue, so it's really important to help each other out when we can, and to find ways to take care of our minds. One very simple but powerful way to connect with others is through kindness.

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Children's Mental Health Week 2024 - School of Kindness

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Download free teaching resources for Children's Mental Health Week 2024 and join our virtual assembly.

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Resources for Mental Health Awareness Month - Child Mind Institute

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Ways to support kids' mental health, cope with challenges together, and get them help when they need it.

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Loneliness and Depression in Young Adults

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Feeling lonely increases the risk of mental health conditions—creating an epidemic of loneliness and depression in young adults.

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What is the current state of loneliness in children and young people?

Restrictions put in place by Governments to contain the spread of COVID-19 have caused extended periods of physical isolation for children and young people away from their friends, teachers, extended families and community networks.
Loneliness can be defined as the state of distress or discomfort that results when we perceive a gap between our desires for social connection and actual experiences of it.
Early in the pandemic, when young people were asked in March 2020 what their top concerns were about coping over the next few months, their top concern was isolation and loneliness ¹.

As the first lockdown was progressing in April/May 2020, 35% of young people said they feel lonely often or most of the time despite spending three hours on social media 2.

In late November 2020, according to a survey of UK adults which took place nine months into COVID-19 restrictions, almost half of 18- to 24-year olds reported being lonely during lockdown.

In a YouGov poll responded to around the same time, 69% of adolescents aged 13-19 said they felt alone "often" or "sometimes" in the last fortnight and 59% feel they have no one to talk to "often" or "sometimes"³.

These findings suggest that current restrictions are having a heavy toll on children and young people. As the amount of time living under restrictions increases, children and young people are reporting feeling lonely in higher numbers.

Why are children and young people experiencing loneliness?

One of the primary reasons that children and young people may be feeling lonely is the inability to socialise and mix with friends in and outside of educational settings at this time.

76% of young people have said not being able to see friends had a negative impact³.

26% of respondents said their relationships with friends have got worse ³.

Friends are of particular importance to the development of a young person's identity during these early life stages and they provide vital forms of support 4. Removing opportunities from children and young people to socialise with their peers appears to be contributing to feelings of loneliness and may have long term effects on their mental health.

Is the pandemic solely to blame for this?

However, restrictions in response to the pandemic can't be blamed fully for comparatively high feelings of loneliness in children and young people. Even before the pandemic, young people had been reporting they are more lonely than older generations.

A survey conducted in 2019 of more than 2,000 UK adults found that:

Nearly nine in ten (88%) Britons aged from 18 to 24 said they experience loneliness to some degree with a quarter (24%) suffering often and 7% saying they are lonely all of the time.

In comparison, 70% of those aged over 55 also say they can be lonely to some extent, however, only 7% are lonely often and just 2% say they are lonely all the time⁵.

Similarly, results of a survey circulated in 2018 found that:

40% of respondents aged 16-24 reported feeling lonely often or very often, while only 29% of people aged 65-74 and 27% of people aged over 75 said the same⁶.

These findings fly in the face of the stereotypical image of a lonely, elderly person, with some experts suggesting that young people feel loneliness more intensely because they are at a life stage of discovering who they are, leaving established support networks to go to university or starting a new job away from home. This is not to say that many older people don't experience intense feelings of loneliness however the stereotype of the lonely, elderly person may cause us to overlook loneliness in other age groups.

Does social media have a role?

There may be other factors at play in young people's lives that are causing heightened levels of loneliness compared to older generations. The role of social media has been highlighted as a potential reason why loneliness is higher in children and young people although the evidence is not clear.

Social media use can decrease loneliness through seeking support and positive feedback but it can also have negative effects through receiving negative feedback and experiencing social media ostracism ⁷.

Social media use appears not to be a "smoking gun" in terms of trying to explain why young people feel more lonely than older generations. Overall, these levels of loneliness in children and young people should be of major concern to us as a society and efforts should be made to reduce loneliness in this age group.

The relationship between loneliness and mental health

There are well established links between loneliness and poor mental health. In a recent review of the scientific literature, loneliness was associated with future mental health problems up to 9 years later with the strongest association being with depression.

Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time at which loneliness was measured and between 0.25 and 9 years later. It appears that the duration of loneliness was more strongly correlated with symptoms of poor mental health than intensity of loneliness.

This is of particular relevance in the COVID-19 context, as politicians in different countries consider the length of time that schools should remain closed, and the implementation of social distancing within schools. These findings were consistent across studies of children, adolescents, and young adults ⁸.

Loneliness may affect the mental health of boys and girls differently. Loneliness seems to be more strongly associated with elevated depression symptoms in girls ⁹ and with elevated social anxiety in boys ¹⁰.

Need support?

If you are a young person experiencing loneliness then read our tips for you.

If you are an adult experiencing loneliness then read our tips for you.

Remember that Samaritans are available 24/7 for free on 116 123 (UK) and whatever you're going through, they're here to face it with you.

Unlock loneliness campaign

Want to learn more about our campaign which aims to raise awareness of loneliness in young people, provide tips on ways to cope and inform the government on recommendations for tackling this? Then head to our campaign page:

References

1. Young Minds. Coronavirus report March 2020. https://youngminds.org.uk/media/3708/coronavirus-report_march2020.pdf.

2. Oxford ARC Study. Achieving resilience during COVID-19 weekly report 2. 2020. https://oxfordarcstudy.com/2020/05/20/weekly-report-2/.

3. Mental Health Foundation. Loneliness during Corona-virus. https://www.mentalhealth.org.uk/coronavirus/loneliness-during-coronavirus (2020).

4. Meeus W, D. M. Identity development, parental and peer support in adolescence: results of a national Dutch survey. Adolescence. 30, 931-944 (1995).

5. Ibbetson, C. Young Britons are the most lonely. https://yougov.co.uk/topics/relationships/articles-reports/2019/10/03/yo....

6. BBC. 16-24 year olds are the loneliest age group according to new BBC Radio 4 survey. https://www.bbc.co.uk/mediacentre/latestnews/2018/loneliest-age-group-ra....

7. Webster, D., Dunne, L. & Hunter, R. Association Between Social Networks and Subjective Well-Being in Adolescents: A Systematic Review. Youth Soc. (2020) doi:10.1177/0044118X20919589.

8. Loades, M. E. et al. Rapid Systematic Review : The Impact of Social Isolation Adolescents in the Context of COVID-19. J Am Acad Child Adolesc Psychiatry 59, 1218-1239 (2020).

9. Liu, H., Zhang, M., Yang, Q. & Yu, B. Gender differences in the influence of social isolation and loneliness on depressive symptoms in college students : a longitudinal study. Soc. Psychiatry Psychiatr. Epidemiol. (2020) doi:10.1007/s00127-019-01726-6.

10. Mak, Hio Wa, Gregory M. Fosco, M. E. F. The Role of Family for Youth Friendships: Examining a Social Anxiety Mechanism. J Youth Adolesc. 47, 306-320 (2019).

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Loneliness in young people: research briefing

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Improving our understanding of the current state of loneliness in children and young people.

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Solutions to Strengthen Colorado's Youth Mental Health Ecosystem

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According to the 2021 State of Mental Health in America Report for children and youth specifically, Colorado ranks 42nd in the country for pediatric mental health when analyzing several indicators including the prevalence of children's mental illness and access to care.

Many Colorado kids who need mental health services cannot access them. Care is patchy and inconsistent. Providers statewide are unaware of the other services available. This is confusing for families to navigate. Oftentimes they face road block after road block to getting care. Some never receive care.

The Colorado children's mental health crisis is not due to a lack of expertise, dedication or effort aimed at reform and improvement. There are valuable efforts in progress across Colorado in many state and community systems. Currently, a number of groups are working in a variety of directions, and the result has been gradual progress. However, if we come together with a unified vision, a clear strategy and specific goals, we can create change for the children and families of Colorado.

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Colorado Youth Mental Health Crisis | Partners for Children's Mental Health

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In Colorado, children's mental health is in a state of crisis. We strive to make mental health resources easily available to any child, at any time. Many Colorado kids who need mental health services cannot access them. Understand the current facts & how together we can create change for our youth.

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Bullying continues to be a prominent issue for kids and teens. In 2020, one in five high school students stated they were victims of bullying at school. And bullying doesn't only occur in schools. It can happen in person or online, and the ramifications can have a ripple effect.

The short- and long-term effects of bullying leave an impression on both parties involved. While schools offer support and resources and parents can help, the benefits of speaking to a professional are valuable.

Understanding how bullying impacts life and the state of someone's mental health can provide strategies and solutions.

What Is Bullying?

Most people have a general understanding of what behaviors constitute bullying. The most recent definition of the action describes it as a type of violence inflicted by an individual or group that threatens kids' or teens' well-being. Many factors can lead one person to bully another, but a power imbalance lies at this issue's root. This dichotomy can either be an actual occurrence - such as wealth, physical size or popularity at school - or a perceived problem.

A bully's actions can consist of:

Physical violence or harm

Intimidation and threats

Social humiliation or exclusion

Learning how bullying affects students mentally and possible signs to watch for are essential for resolving the problem at its root.

How Can Bullying Affect Mental Health?

Bullying's repercussions can affect your mental, emotional and physical health. The short- and long-term effects can impact your social life and emotional well-being, and, in some cases, result in physical injuries or death.

The victim and the bully experience the significant impacts of bullying, including being more likely to experience mental or behavioral issues.

Bullying also affects bystanders, including:

1. People who proactively attempt to stop the bullying

2. People who are too intimidated or afraid to stand up and intervene

Bullying can impact the second group by increasing their risk for mental health problems and affecting their academic achievements. The first group is more likely to have positive outcomes from standing up to bullying, like increased confidence or self-esteem. The victim and all those around them feel bullying's significance.

What Does Bullying Do to Your Mental Health?

Bullying's effects vary, depending on the impacted person and whether they are the victim. While the effects of physical bullying on children are painful, any injuries sustained usually heal faster than the impact all types of bullying have on mental health. It can cause long- and short-term issues that hinder the victim's and the bully's lives. These two parties can both experience psychological consequences of bullying.

Short-Term Effects of Bullying on Health

How does bullying affect students mentally? Bullying's immediate or short-term effects are typically straightforward and noticeable. These can be mental, emotional or physical.

Here are a few examples of the short-term effects of bullying.

Mental health problems and symptoms: Victims may show signs of poor mental health, and the emotional effects of bullying may become increasingly severe. Most bullies' targets notice anxiety or depression symptoms after one or more incidents.

Psychosomatic issues: This effect describes health issues with no medical cause, like upset stomachs, headaches and muscle pain. A person may experience these symptoms at any time, but usually before the school day.

Sleep problems: Victims can experience a range of sleep issues, like trouble falling or staying asleep. These kids are also more likely to have nightmares compared to their peers.

Poor academic performance: A student's grades may begin to suffer because of bullying, which can occur due to trouble concentrating or skipping school to avoid their bully.

Socialization issues: A significant issue stemming from bullying is social isolation or exclusion from peers. Bullying victims may fall to a lower tier in the school's social structure and struggle to make or keep friends.

Other short-term effects of bullying on the victim include:

Eating habit changes

Skipping or avoiding school

Low confidence and self-esteem

Feeling shameful

High risk of illness

It's hard to empathize with a bully, but it's essential to understand the root of their behavior. Parents, guardians and school officials should learn the reasons for the bully's actions and how they can affect their life.

The short-term consequences of bullying behavior include:

High risk of absenteeism

Poor academic performance

Difficulty maintaining relationships

More susceptibility to substance abuse

Long-Term Effects of Bullying on Health

If bullying persists, it can lead to long-term effects and severe problems that are more difficult to handle. The challenges can be debilitating for both the victim and the bully if nobody resolves the issue or intervenes with help.

Here are some of the long-term consequences of bullying on the victim.

Stress-induced sickness: The physical impact of bullying can carry on throughout a person's life. Someone who experiences anxiety after bullying can experience various physical illnesses that impact their daily lives.

Family impact: The entire family can experience bullying's long-term effects. Parents may feel guilty or helpless in navigating this process, and siblings may feel sad if their brother or sister is behaving differently or not spending time with them.

Depression and anxiety: Mental health symptoms can grow into a more chronic problem.

Risk of suicidal thoughts: The victim and the bully are at risk for suicidal ideation or suicide-related behaviors. The CDC describes the relationship between bullying and suicide and how it affects young people.

Maintaining friendships: Bully victims can have a difficult time maintaining and establishing friendships. Establishing trust with people may also be a challenge.

Other long-term effects include:

Poor health habits

Self-harm

Substance use

PTSD

The long-term effects of bullying for the bully include:

Quality Mental Health Counseling From Advanced Psychiatry Associates

Navigating bullying can be a tricky process. Whether a person is a target or a bullier, it's beneficial for both parties to seek psychological help to improve their mental health after bullying.

If you're looking for mental health counseling to help navigate bullying, reach out to Advanced Psychiatry Associates in Sacramento. We offer a range of mental health services at our full-service psychiatric facility. Our professional staff has the years of experience and knowledge to provide quality care to each patient to improve their lives. Schedule an appointment today and learn more about our services.

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Effects of Bullying on Mental Health | Advanced Psychiatry Associates

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Bullying continues to be a prominent issue for kids and teens. In 2020, one in five high school students stated they were victims of bullying at school. And bullying doesn't only occur in schools. It can happen in person or online, and the ramifications can have a ripple effect.

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Many people with serious mental illness are challenged doubly. On one hand, they struggle with the symptoms and disabilities that result from the disease. On the other, they are challenged by the stereotypes and prejudice that result from misconceptions about mental illness. As a result of both, people with mental illness are robbed of the opportunities that define a quality life: good jobs, safe housing, satisfactory health care, and affiliation with a diverse group of people. Although research has gone far to understand the impact of the disease, it has only recently begun to explain stigma in mental illness. Much work yet needs to be done to fully understand the breadth and scope of prejudice against people with mental illness. Fortunately, social psychologists and sociologists have been studying phenomena related to stigma in other minority groups for several decades. In this paper, we integrate research specific to mental illness stigma with the more general body of research on stereotypes and prejudice to provide a brief overview of issues in the area.

The impact of stigma is twofold, as outlined in Table ​Table1. 1 . Public stigma is the reaction that the general population has to people with mental illness. Self-stigma is the prejudice which people with mental illness turn against themselves. Both public and self-stigma may be understood in terms of three components: stereotypes, prejudice, and discrimination. Social psychologists view stereotypes as especially efficient, social knowledge structures that are learned by most members of a social group ( 1- 3). Stereotypes are considered "social" because they represent collectively agreed upon notions of groups of persons. They are "efficient" because people can quickly generate impressions and expectations of individuals who belong to a stereotyped group ( 4).

PUBLIC STIGMA

Stigmas about mental illness seem to be widely endorsed by the general public in the Western world. Studies suggest that the majority of citizens in the United States ( 13, 15- 17) and many Western European nations ( 18- 21) have stigmatizing attitudes about mental illness. Furthermore, stigmatizing views about mental illness are not limited to uninformed members of the general public; even well-trained professionals from most mental health disciplines subscribe to stereotypes about mental illness ( 22- 25).

Several themes describe misconceptions about mental illness and corresponding stigmatizing attitudes. Media analyses of film and print have identified three: people with mental illness are homicidal maniacs who need to be feared; they have childlike perceptions of the world that should be marveled; or they are responsible for their illness because they have weak character ( 29- 32). Results of two independent factor analyses of the survey responses of more than 2000 English and American citizens parallel these findings ( 19, 33):

1. fear and exclusion: persons with severe mental illness should be feared and, therefore, be kept out of most communities;

2. authoritarianism: persons with severe mental illness are irresponsible, so life decisions should be made by others;

3. benevolence: persons with severe mental illness are childlike and need to be cared for.

Although stigmatizing attitudes are not limited to mental illness, the public seems to disapprove persons with psychiatric disabilities significantly more than persons with related conditions such as physical illness ( 34- 36). Severe mental illness has been likened to drug addiction, prostitution, and criminality ( 37, 38). Unlike physical disabilities, persons with mental illness are perceived by the public to be in control of their disabilities and responsible for causing them ( 34, 36). Furthermore, research respondents are less likely to pity persons with mental illness, instead reacting to psychiatric disability with anger and believing that help is not deserved ( 35, 36, 39).

The behavioral impact (or discrimination) that results from public stigma may take four forms: withholding help, avoidance, coercive treatment, and segregated institutions. Previous studies have shown that the public will withhold help to some minority groups because of corresponding stigma ( 36, 40). A more extreme form of this behavior is social avoidance, where the public strives to not interact with people with mental illness altogether. The 1996 General Social Survey (GSS), in which the Mac Arthur Mental Health Module was administered to a probability sample of 1444 adults in the United States, found that more than a half of respondents are unwilling to: spend an evening socializing, work next to, or have a family member marry a person with mental illness ( 41). Social avoidance is not just self-report; it is also a reality. Research has shown that stigma has a deleterious impact on obtaining good jobs ( 13, 42- 44) and leasing safe housing ( 45- 47).

Discrimination can also appear in public opinion about how to treat people with mental illness. For example, though recent studies have been unable to demonstrate the effectiveness of mandatory treatment ( 48, 49), more than 40% of the 1996 GSS sample agreed that people with schizophrenia should be forced into treatment ( 50). Additionally, the public endorses segregation in institutions as the best service for people with serious psychiatric disorders ( 19, 51).

STRATEGIES FOR CHANGING PUBLIC STIGMA

Change strategies for public stigma have been grouped into three approaches: protest, education, and contact ( 12). Groups protest inaccurate and hostile representations of mental illness as a way to challenge the stigmas they represent. These efforts send two messages. To the media: STOP reporting inaccurate representations of mental illness. To the public: STOP believing negative views about mental illness. Wahl ( 32) believes citizens are encountering far fewer sanctioned examples of stigma and stereotypes because of protest efforts. Anecdotal evidence suggests that protest campaigns have been effective in getting stigmatizing images of mental illness withdrawn. There is, however, little empirical research on the psychological impact of protest campaigns on stigma and discrimination, suggesting an important direction for future research.

Stigma is further diminished when members of the general public meet persons with mental illness who are able to hold down jobs or live as good neighbors in the community. Research has shown an inverse relationship between having contact with a person with mental illness and endorsing psychiatric stigma ( 54, 57). Hence, opportunities for the public to meet persons with severe mental illness may discount stigma. Interpersonal contact is further enhanced when the general public is able to regularly interact with people with mental illness as peers.

SELF-STIGMA

Low self-esteem versus righteous anger describes a fundamental paradox in self-stigma ( 64). Models that explain the experience of self-stigma need to account for some persons whose sense of self is harmed by social stigma versus others who are energized by, and forcefully react to, the injustice. And there is yet a third group that needs to be considered in describing the impact of stigma on the self. The sense of self for many persons with mental illness is neither hurt, nor energized, by social stigma, instead showing a seeming indifference to it altogether.

We propose a situational model that explains this paradox, arguing that an individual with mental illness may experience diminished self-esteem/self-efficacy, righteous anger, or relative indifference depending on the parameters of the situation ( 64). Important factors that affect a situational response to stigma include collective representations that are primed in that situation, the person's perception of the legitimacy of stigma in the situation, and the person's identification with the larger group of individuals with mental illness. This model has eventual implications for ways in which persons with mental illness might cope with self-stigma as well as identification of policies that promote environments in which stigma festers.

CONCLUSIONS

Researchers are beginning to apply what social psychologists have learned about prejudice and stereotypes in general to the stigma related to mental illness. We have made progress in understanding the dimensions of mental illness stigma, and the processes by which public stereotypes are translated into discriminatory behavior. At the same time, we are beginning to develop models of self-stigma, which is a more complex phenomenon than originally assumed. The models developed thus far need to be tested on various sub-populations, including different ethnic groups and power-holders (legislators, judges, police officers, health care providers, employers, landlords). We are also learning about stigma change strategies. Contact in particular seems to be effective for changing individual attitudes. Researchers need to examine whether changes resulting from anti-stigma interventions are maintained over time.

All of the research discussed in this paper examines stigma at the individual psychological level. For the most part, these studies have ignored the fact that stigma is inherent in the social structures that make up society. Stigma is evident in the way laws, social services, and the justice system are structured as well as ways in which resources are allocated. Research that focuses on the social structures that maintain stigma and strategies for changing them is sorely needed.

References

39. Corrigan PW. Rowan D. Green A, et al. Challenging two mental illness stigmas: personal responsibility and dangerousness. Submitted for publication. [[ PubMed] Google Scholar]

47. Segal S. Baumohl J. Moyles E. Neighborhood types and community reaction to the mentally ill: a paradox of intensity. J Health Soc Behav. 1980;21:345-359. [[ PMC free article] [ PubMed] Google Scholar]

50. Pescosolido B. Monahan J. Link B, et al. The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems. Am J Public Health. 1999;89:1339-1345. [[ PMC free article] [ PubMed] Google Scholar]

63. Corrigan PW. Empowerment and serious mental illness: treatment partnerships and community opportunities. Psychiatr Q. 1984 in press. [[ PubMed] Google Scholar]

64. Corrigan PW. Watson AC. The paradox of self-stigma and mental illness. Clin Psychol Sci Pract. 1984 in press. [ Google Scholar]

Articles from World Psychiatry are provided here courtesy of The World Psychiatric Association

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Understanding the impact of stigma on people with mental illness

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Many people with serious mental illness are challenged doubly. On one hand, they struggle with the symptoms and disabilities that result from the disease. On the other, they are challenged by the stereotypes and prejudice that result from misconceptions about mental illness.

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Review

Stigma as a psychological construct

In the literature, there have been several attempts at creating instruments to measure and understand stigma as a psychological construct in the context of mental health. In this vein, the Internalized Stigma of Mental Illness (ISMI) scale and the Perceived Devaluation-Discrimination Scale, among others, seek to quantify stigma more objectively [ 4, 5]. The ISMI scale, as defined by Ritsher et al. (2003), measures the subjective experience of stigma, including the internalization of negative stereotypes and beliefs about mental illness [ 4]. It includes five subscales: Alienation, Stereotype Endorsement, Discrimination Experience, Social Withdrawal, and Stigma Resistance. These subscales were further defined as follows: (i) Alienation: The feeling of being less than a full member of society due to one's mental illness, (ii) Stereotype Endorsement: The extent to which the individual agrees with common negative stereotypes about people with mental illness, (iii) Discrimination Experience: Personal experiences of rejection or exclusion due to mental illness, (iv) Social Withdrawal: The extent to which the individual avoids social situations for fear of being stigmatized, and (v) Stigma Resistance: The individual's ability to resist or counteract stigma. The Perceived Devaluation-Discrimination Scale, as described by Link (1987), measures the extent to which individuals believe that most people will devalue or discriminate against someone with a mental illness [ 5]. It focuses on the individual's perceptions of societal attitudes, rather than their personal experiences with stigma. Overall, while the ISMI scale can give insights into the internalization and personal experience of stigma, the Perceived Devaluation-Discrimination Scale can provide a view of societal attitudes and perceived discrimination. The above are crucial to understanding the full landscape of stigma in psychiatry across different cultures by helping identify where interventions might be most needed and most effective, whether at the level of societal attitudes, personal beliefs, or both. The pervasive nature of stigma presents a daunting challenge to psychiatry, necessitating a rigorous and nuanced approach to its understanding and mitigation. However, despite recent awareness campaigns, the field still struggles with the barriers that stigma imposes on patient care, necessitating additional analysis of the effects.

Individual and societal impact of stigma

Stigmatization of mental illness across cultures is a significant barrier to psychiatric care. The stigma can lead to delayed diagnosis and treatment-seeking behaviors, reduced quality of life, and an increased risk of social exclusion and discrimination [ 2]. Furthermore, mental illness stigma often intersects with other forms of stigma, such as gender, race, and socio-economic status, leading to further marginalization of already vulnerable populations making it challenging to provide equitable, culturally sensitive, and effective psychiatric care to individuals with mental illness. Accumulating research suggests that stigma toward mental illness is common in various cultures, which can affect mental illness diagnosis, treatment, and management [ 6]. Furthermore, some studies reveal that mental health stigma manifests differently across cultures and can be influenced by cultural beliefs, attitudes, and values [ 7]. The stigma surrounding psychiatry and mental health disorders has numerous detrimental effects on individuals and communities, including:

1. Delayed Treatment-Seeking Behavior

Stigma plays a significant role in delaying treatment-seeking behavior for individuals struggling with mental health issues. The fear of being labeled, ostracized, or misunderstood due to their condition often deters individuals from seeking help promptly. According to a study by Clement et al. (2015), stigma was associated with an increased likelihood of delaying or avoiding seeking help for mental health concerns [ 8]. Consequently, symptoms may worsen over time, escalating the condition's severity and making treatment and prospective recovery more challenging. Healthcare delays can also lead to decreased self-esteem and increased depressive symptoms, creating a vicious cycle of self-blame, isolation, and hopelessness. Prolonged untreated mental health issues can further impair an individual's functionality in various life domains, including work, relationships, and self-care, thus reducing their overall quality of life [ 9].

2. Social Isolation and Discrimination

Stigma can lead to social isolation and discrimination for those affected by mental health issues. Brohan and Thornicroft (2010) found that individuals with mental health disorders often face discrimination in multiple life domains, including employment and interpersonal relationships [ 2]. The negative stereotypes and misconceptions surrounding mental illness often result in a lack of understanding and empathy from others, leading to social exclusion [ 10]. Individuals with mental health issues might face discrimination in various aspects of life, including the workplace, where they might encounter bias in hiring, job retention, and career advancement. Furthermore, to complicate matters, discrimination can further strain personal relationships, as friends and family may distance themselves due to discomfort, fear, or misunderstanding, exacerbating feelings of isolation and loneliness [ 9].

3. Reduced Treatment Adherence

Stigma can significantly impact adherence to mental health treatments. Sirey et al. (2001) found that perceived stigma predicted treatment discontinuation in older adults with depression [ 11]. People living with mental health conditions may avoid or discontinue treatment due to fear of being identified as a mental health patient. This fear could stem from concerns about the stigma associated with visiting mental health facilities, taking psychiatric medications, or being seen engaging in therapeutic activities [ 12]. Non-adherence to treatment regimens can lead to suboptimal treatment outcomes, hinder recovery, and increase the risk of relapse or worsening symptoms. Furthermore, stigma can diminish self-efficacy, making individuals less likely to actively engage in their treatment process, which is crucial for successful recovery.

4. Perpetuation of Misconceptions

Stigmatizing attitudes towards mental illness contribute to the perpetuation of harmful stereotypes and misinformation. AsCorrigan and Watson (2007) discussed, stereotypes such as appearing dangerous, unpredictable, or culpable for their illness can make people with mental illness perceived inaccurately as dangerous or to blame for their condition, both internally and externally [ 12]. Stereotyping, deeply embedded in societal attitudes, can foster a culture of fear, rejection, and discrimination against individuals with mental health conditions. Misconceptions often result in people with mental health issues being perceived inaccurately as dangerous, unpredictable, or responsible for their condition. In addition, misinformation can hinder public understanding and acceptance of mental illness, exacerbating stigma while negatively influencing policy and legislation, leading to inadequate funding and support for mental health services.

5. Influence of Gender on Stigma

The impact of stigma on individuals with mental illness is known to vary across different social and demographic categories, including gender. Research evidence indicates that the experience of stigma related to mental illness can be significantly different for men and women, and these differences can be further influenced by cultural context.

In some societies, women seem to face higher levels of stigma related to mental health issues compared with men. A study by Al Krenawi et al. (2006) conducted in the Bedouin-Arab community found that women experienced a significantly higher degree of stigma associated with mental illness than their male counterparts [ 13]. This may be due to traditional gender roles and societal expectations, which often place women in a more subordinate position and associate mental illness with weakness or vulnerability. Women with mental illnesses may therefore face dual discrimination - first for their gender and then for their mental health condition. This can make women less likely to seek help for mental health issues, further exacerbating their condition and creating a vicious cycle of stigma and untreated mental illness.

However, the influence of gender on stigma is not uniform across all cultures. Ayalon and Areán's (2004) study on older adults in an Arab cultural context found that men reported higher levels of perceived stigma related to mental illness than women [ 14]. This discrepancy might be rooted in traditional masculine norms prevalent in many Arab societies, which value strength, stoicism, and emotional control. Mental illness, which is often erroneously perceived as a sign of emotional weakness or lack of control, can be particularly stigmatizing for men in these contexts. Furthermore, the expectation for men to be the primary earners and providers in the family can make the potential economic impacts of mental illness, such as unemployment or reduced productivity, particularly stigmatizing.

These findings underscore the importance of considering gender and cultural context in understanding and addressing stigma related to mental illness. It is crucial to develop and implement culturally sensitive strategies that consider these differences in the experience of stigma. This might involve, for example, promoting mental health literacy, challenging harmful gender norms, and providing gender-specific mental health services. We can move toward a more equitable and effective mental health care system by acknowledging and addressing the unique stigma-related challenges different groups face.

Ethnic and cultural variations in stigma

The stigma surrounding psychiatry, as research suggests, manifests differently across cultures due to various factors [ 7]. This stigma operates at various levels, including individuals, families, healthcare providers, and society, and cultural norms, religious beliefs, and social attitudes influence its manifestations and implications.

At the individual level, mental health issues may be internalized differently depending on cultural background. For instance, some Asian cultures may view mental health issues as a sign of personal weakness or a failure of self-control [ 15]. The internalization of stigma can significantly influence an individual's self-perception and willingness to seek help. In the family context, cultural beliefs also play a significant role in shaping attitudes toward mental health. A study by Yang and Kleinman (2008) found that in Chinese culture, mental illness is often attributed to social and interpersonal factors, such as family conflict [ 16]. Such attributions can contribute to a sense of shame or blame within the family, exacerbating the stigma experienced by the individual with mental illness.

Healthcare providers are not immune to these cultural beliefs and they can influence their practice. In some cultures, mental illnesses are viewed through a supernatural lens rather than a medical one. Girma et al. (2013) found that in Ethiopian culture, mental illness is commonly associated with supernatural causes, such as evil spirits or curses [ 17]. This widely held belief can influence healthcare providers' approach and potentially limit the provision of evidence-based psychiatric care.

Lastly, at the societal level, these cultural perceptions and beliefs can contribute to the broader social stigma surrounding mental health, leading to discrimination and social exclusion. Differences in societal perceptions across cultures can lead to distinct forms of discrimination, further compounding the challenges faced by individuals with mental health issues. Hence, understanding and addressing cultural stigma in psychiatry involves a multifaceted approach that considers individual, family, healthcare providers, and societal levels. Each level offers potential avenues for stigma reduction and improved mental health outcomes.

Asian Cultures

In many Asian societies, mental health issues are often perceived as a sign of personal weakness or a failure of self-control. The concept of 'face' is significantly influential, and the stigma associated with mental illness can be seen as bringing shame to the family [ 15]. For instance, a strong cultural emphasis on academic and professional achievement in South Korea contributes to stigmatizing attitudes toward mental illness, which may discourage individuals from seeking help [ 18].

African Cultures

Mental illnesses in some African cultures are often attributed to spiritual or supernatural causes such as curses or possession by evil spirits. This understanding can contribute to high levels of stigma and deter individuals from seeking psychiatric help [ 19]. In Ethiopia, the belief in supernatural causes of mental illness has been reported, leading to the stigmatization of affected individuals [ 17].

Arab Cultures

Mental illness in Arab societies is frequently viewed as a form of divine punishment. Religious belief perpetuating mental health stigma can lead to delayed or avoided treatment as individuals may resort to religious or spiritual interventions [ 20].

Latin American Cultures

In some Latin American cultures, mental illness is often attributed to personal weakness or lack of willpower. This perspective could stigmatize individuals with mental health disorders and discourage them from seeking psychiatric care [ 21].

Western Cultures

In Western societies, stigma often stems from misconceptions about mental illness, including the belief that individuals with mental health disorders are dangerous or unpredictable. While mental illness is recognized more as a health issue, stigma still exists, often resulting in social exclusion and discrimination [ 12].

Additionally, culture-bound syndromes, defined here as a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease within specific cultures or societies, are a critical component of a discussion on cultural stigma in psychiatry. That is to say, culture-bound syndromes refer to unique mental health conditions closely tied to specific cultures or ethnic groups. For instance, among the Latino community, 'Ataque de Nervios,' characterized by uncontrollable shouting, crying, trembling, and sometimes aggressive behavior, is a recognized condition often associated with a stressful event such as a panic attack [ 21].

Hence, a clinician's awareness and understanding of such culture-bound syndromes can enhance their diagnostic and therapeutic effectiveness. In fact, a study conducted by Hughes and Wintrob (1995) in New York discovered a significant improvement in therapeutic relationships when clinicians were knowledgeable about culture-bound syndromes prevalent in their patients' cultures, such as 'Qigong Psychotic Reaction' in Chinese immigrants, a condition associated with overdoing Qigong, a type of spiritual martial art [ 22].

Furthermore, cultural competence, which includes knowledge about culture-bound syndromes, has a substantial impact on treatment outcomes. Culturally competent care, defined by an understanding and respect for cultural differences, can improve patient satisfaction and adherence to treatment. A systematic review by Truong et al. (2014) demonstrated the positive effect of cultural competence on healthcare outcomes, including in a Native American population suffering from 'Ghost Sickness,' a culture-bound syndrome characterized by feelings of terror, weakness, and a sense of impending doom, often linked to the perceived presence of the supernatural [ 23].

Simultaneously, addressing culture-bound syndromes can influence and reduce mental health stigma across cultures. Misinterpretation of these syndromes can contribute to stigma, as individuals might be wrongly diagnosed or misunderstood. For instance, Kirmayer's (2012) study on cultural variations in depression and anxiety found that misunderstanding culture-bound syndromes, such as 'Taijin Kyofusho,' a Japanese syndrome characterized by an intense fear that one's body or bodily functions are displeasing to others, could lead to misdiagnosis and increase stigma [ 24]. Practices that raise awareness of culture-bound syndromes offer a deeper, richer perspective on cultural influences on mental health. Awareness and understanding of these syndromes can enhance diagnostic and treatment approaches, optimize patient outcomes, and potentially contribute to reducing mental health stigma across various cultures.

Taken together, these studies highlight the importance of understanding cultural contexts when addressing the stigma surrounding mental health disorders and psychiatric care. The cultural beliefs and attitudes towards mental health disorders, summarized below in Table , influence how stigma is manifested and the approaches needed to reduce it effectively. By acknowledging cultural variations, more culturally appropriate and effective strategies can be developed to combat stigma and improve mental health care across different societies worldwide.

Strategies for addressing mental health stigma

Several strategies have been proposed in the literature to address the stigma surrounding psychiatry across cultures:

1. Public Awareness Campaigns

Awareness campaigns can be instrumental in dismantling misconceptions and fostering understanding of mental health disorders. Public awareness campaigns can dispel myths, reduce stigma, and encourage empathy towards affected individuals by promoting accurate information about mental illnesses, their prevalence, and the possibilities for recovery. For instance, a study by Pinfold et al., (2003) showed that public campaigns using direct social contact with people with mental illness could significantly improve public attitudes towards mental health [ 25]. The study by Pinfold et al., (2003) implemented educational interventions in UK secondary schools, consisting of video presentations and direct social contact with individuals who had personal experiences with mental illness [ 25]. The UK campaign's goal was to challenge common myths about mental illness and replace them with accurate information. The results showed that students exposed to this intervention demonstrated less fear and avoidance of people with mental health problems and were more likely to see them as individuals rather than defining them by their illness.

2. Cultural Competency Training for Healthcare Professionals

Medical education can equip healthcare providers with the necessary knowledge and skills to understand and respect their patients' cultural backgrounds and experiences, which is critical for reducing stigma in healthcare settings. Research indicates that healthcare providers who lack cultural competence may inadvertently contribute to stigma, further deterring patients from seeking help [ 26]. A study by Kirmayer (2012) found that cultural competence training improved healthcare providers' understanding of cultural influences on health behaviors and led to more effective patient-provider communication, thereby reducing perceived stigma [ 24]. For instance, a study in Australia provided cultural competency training to healthcare providers and found that their understanding of Indigenous Australians' health needs significantly improved [ 24]. They were able to better respect and incorporate Indigenous perspectives in treatment, which led to increased trust and better patient-provider relationships.

3. Peer Support Programs

People with lived experiences of mental health disorders who share their stories, can normalize mental health issues and challenge stigma. By providing real-life examples of individuals living with and managing their mental health disorders, peer-to-peer advocacy programs may debunk myths and reduce the perceived 'otherness' of mental illness. A study by Pitt et al. (2013) showed that peer support reduced self-stigma and improved self-esteem and empowerment among individuals with mental health disorders [ 27]. The study focused on "consumer-providers," individuals who had personally experienced mental health issues and were now providing support services to others. The findings demonstrated that consumer-providers significantly reduced self-stigma among service users, while also improving self-esteem and feelings of empowerment.

4. Community-Based Mental Health Services

Integrating mental health care into primary care and community settings can reduce the stigma associated with seeking psychiatric help. This emphasis on integrating measures for mental well-being along with other routine and standard primary care protocols allows mental health care to be more accessible and less intimidating, encouraging individuals to seek help when needed. A study by Thornicroft et al. (2015) found that community-based mental health services can reduce stigma and discrimination and improve mental health outcomes [ 28]. For instance, a program in India called the MANAS project integrated mental health services into primary care and community settings [ 28]. This approach not only made mental health services more accessible but also more 'normal' and less stigmatizing. The project reported a significant increase in the utilization of mental health services and a decrease in the experience of stigma among service users.

5. Evidence-Based Approach

Another approach to overcoming the barriers created by stigma is to use evidence-based methods to reduce mental illness stigma. A meta-analysis by Corrigan et al. (2016) found that various evidence-based interventions, including education and contact-based interventions, can effectively reduce mental illness stigma across cultures [ 9]. Contact-based interventions involve interaction between people with mental illness and members of the public to challenge negative attitudes and beliefs. Education-based interventions aim to increase knowledge and awareness of mental illness and reduce negative stereotypes. Educational interventions can be delivered in a variety of formats, such as in-person workshops, online courses, and mass media campaigns.

The role of the healthcare provider in ameliorating stigma cannot be overlooked. Moreover, a review by Ayalon and Areán (2004) suggests that mental health providers can play a critical role in reducing mental illness stigma by engaging in culturally sensitive practices [ 14]. For instance, mental health providers can develop cultural competence, which refers to the ability to provide effective services to individuals from diverse cultural backgrounds. Cultural competence involves understanding and respecting cultural differences, tailoring treatment to meet diverse populations' unique needs, and integrating cultural factors into treatment planning.

Research also highlights that stigma towards mental illness has significant implications for treating and managing mental health conditions. For example, several studies suggest that stigma can lead to delayed diagnosis and treatment-seeking behaviors [ 13, 16]. This is concerning because early intervention is critical for managing mental illness and improving outcomes for individuals living with these conditions. Considering the documented impact of stigma on timely diagnosis and treatment-seeking behaviors, strategies such as public awareness campaigns, cultural competency training for healthcare professionals, peer support programs, community-based mental health services, and an evidence-based approach can play a crucial role in combating cultural stigma in psychiatry. These measures collectively contribute to improved awareness, understanding, and acceptance of mental health conditions, thus facilitating early intervention and better management of mental illnesses across diverse cultural contexts.

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Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review

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Stigma, characterized by negative stereotypes, prejudice, and discrimination, is a significant impediment in psychiatric care, deterring the timely provision of this care and hindering optimal health outcomes. Pervasive in all aspects of psychiatric care, ...

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Language Guidelines

We want people to talk about mental health often. The more awareness about mental health, the more chance there is of helping people who are experiencing challenges associated with mental illnesses. If you feel unsure about what language to use when talking about mental health, you are not alone. We are here to help you navigate these important-and potentially life-saving-conversations.

While there are specific terms and phrases to avoid when speaking about mental illness, there are some general rules that can help you choose your words more carefully.

Avoid:

Anything that reinforces stereotypes, prejudice or discrimination against people with mental illness and suicidal ideation.

Anything that implies mental illness makes people more creative, fragile or violent.

Anything that refers to or defines people by their diagnosis.

Choosing our words carefully is about more than avoiding stigmatizing terms. The language we use can also have a positive, empowering effect, which makes choosing the right words just as important as avoiding harmful ones.
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Breathwork meditation may deepen relaxation, improve your mood, and soothe physical illness.

Breathing is something we constantly do, often without paying any attention to it. However, this simple action can be used as a tool to improve your mental and physical health. Breathwork meditation involves consciously and mindfully changing your breathing patterns to improve relaxation.

There are many reported benefits of breathwork meditation, from reducing stress and anxiety to improving sleep and mood. It may also help with the symptoms of certain physical illnesses.

Popular breathwork meditation exercises include 4-7-8 breathing, box breathing, and alternate nostril breathing.

Breathwork meditation refers to any technique that combines breathing exercises with mindfulness. When engaging in breathwork meditation, you'll intentionally and consciously change your breathing pattern while paying attention to the sensations that arise in your body.

Many people use breathwork meditation to deepen relaxation, improve focus, and unwind before bedtime.

Combining breathwork with meditation allows you to potentially reap the benefits of both techniques. People use breathwork meditation to improve their mental, emotional, and physical well-being.

According to research, breathwork may:

Meditation and mindfulness, on the other hand, have the following reported benefits:

Overall, breathwork meditation is a free, low risk activity that may improve your mental state as well as your physical health.

Most breathwork exercises incorporate an element of mindfulness and meditation. Although some kinds of breathwork have been studied more than others, no research suggests certain breathwork techniques are better than others. It's up to you to decide which breathwork meditation exercises work best for you.

4-7-8 breathing

Doing a 4-7-8 breathwork meditation exercise involves inhaling for 4 seconds, holding your breath for 7 seconds, and exhaling for 8 seconds. This is repeated several times.

Alternate nostril breathing

Alternate nostril breathing involves covering one nostril and alternating on each inhale and exhale. A popular alternate nostril breathing practice is Anulom Vilom, which is a specific type of pranayama (controlled breathing) in yoga.

To practice Anulum Vilom, you hold one nostril closed while inhaling, then hold the other nostril closed while exhaling. Reverse and repeat the process several times.

Bhramari Pranayama (bumblebee breath)

Also called bumblebee breath, Bhramari Pranayama involves breathing deeply and making a high-pitched humming sound while you exhale. Breathwork teachers typically advise you to place your index fingers over your ear while you hum.

Box breathing

With box breathing, you'll inhale for 4 seconds, hold your breath for 4 seconds, exhale for 4 seconds, and then hold your breath again for 4 seconds. Repeat as many times as you'd like.

Buteyko breathing technique

This breathing technique was developed by a Ukrainian doctor, Konstantin Buteyko, in the 1950s. The technique, which is taught by accredited teachers, teaches you to breathe more gently and slowly by doing exercises that require you to hold your breath for long periods of time.

To learn the Buteyko breathing technique, the Buteyko Breathing Association recommends attending at least 5 hours of in-person training and practicing the exercises for 15 to 20 minutes, 3 times a day, for at least 6 weeks.

Diaphragmatic breathing

For a simple breathwork meditation, try diaphragmatic breathing. It involves breathing while engaging your diaphragm.

To practice diaphragmatic breathing, place one hand on your chest and the other hand on your stomach. Take deep breaths, keeping your chest still and allowing your belly to expand fully.

If you're trying to do a breathwork meditation exercise, remember that it's a skill. Like any other skill, it gets easier with practice. If you initially find it challenging to focus, that's okay - it'll get easier.

To enhance your breathwork meditation practice, try the following:

Experiment with different techniques to figure out which you prefer.

Practice it regularly - every day, if possible!

Close your eyes. This might help you focus on your breathing better.

If you're not sure where to start, try a guided breathwork journey. YouTube and Spotify have plenty of guided breathwork meditations of varying lengths.

Try mindfulness apps, which often include guided breathwork meditation exercises.

Although you can create an effective breathwork practice on your own, you can find a certified breathwork practitioner online to aid your journey.

Remember that everyone's experience with breathwork meditation is different. If you find it anxiety-inducing, consider practicing other mindfulness techniques.

Breathwork involves consciously changing your breathing patterns, while meditation typically involves observing your breath without trying to manipulate it.

Both breathwork and meditation incorporate elements of mindfulness, which is paying attention to internal and external sensations and focusing on the present instead of getting caught up in racing thoughts of the past or future.

Breathwork meditation can have a wide range of physical and mental benefits. Although it might take some practice, it's a low risk, low cost way to induce relaxation, cope with stress, and improve sleep.

If you're not sure where to start with breathwork meditation, consider using a guided video or podcast or contacting a certified breathwork instructor.

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Breathwork Meditation: Benefits, Exercises, and Tips

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Breathwork meditation has many mental health benefits and it's never too late to learn.

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What is well-being?

The government defines well-being as 'a positive physical, social and mental state'. For our purposes, we are focusing on mental wellbeing.

Mental well-being does not have a single universal definition, but it does encompass factors such as:

The ability to deal with the ups and downs of life, such as coping with challenges and making the most of opportunities

The sense of feeling good about ourselves and being able to function well individually or in relationships

The feeling of connection to our community and surroundings

Having control and freedom over our lives

Having a sense of purpose and feeling valued. Of course, mental well-being does not mean being happy all the time, and it does not mean you won't experience negative or painful emotions, such as grief, loss, or failure, which are a part of normal life. However, whatever your age, mindfulness can help you lead a mentally healthier life and improve your wellbeing.

Of course, mental well-being does not mean being happy all the time, and it does not mean you won't experience negative or painful emotions, such as grief, loss, or failure, which are a part of normal life. However, whatever your age, mindfulness can help you lead a mentally healthier life and improve your wellbeing.

What is mindfulness?

Mindfulness is a way of paying attention to the present moment, using techniques like meditation, breathing and yoga. It helps us become more aware of our thoughts and feelings so that, instead of being overwhelmed by them, we're better able to manage them.

How can mindfulness help?

Mindfulness can be used as a tool to manage your well-being and mental health. Some people call mental health 'emotional health' or 'well-being'. We all have times when we feel down, stressed or frightened; most of the time, those feelings pass, but sometimes they develop into a more serious problem, which could happen to any one of us.

It's important to maintain your mental health, but being mentally healthy doesn't just mean that you don't have a mental health problem. With good mental health, you can:

Make the most of your potential

Cope with life

Play a full part in your family, workplace, community and among friends

While research is still growing in the area of mindfulness, evidence has suggested the benefit of mindfulness to health and wellbeing, with results showing positive effects on several aspects of whole-person health, including the mind, the brain, the body, and behaviour, as well as a person's relationships with others.

Mindfulness has also been shown to help with many conditions, including stress, anxiety, depression, addictive behaviours such as alcohol or substance misuse and gambling, and physical problems like hypertension, heart disease and chronic pain.

Is mindfulness for me?

Mindfulness is recommended as a treatment for some people who experience common mental health problems, such as stress, anxiety and depression. It's also for those who simply want to improve their mental health and wellbeing. Depending on what you're looking for, there are different ways to learn mindfulness, which can help people differently. Anyone can learn and practise mindfulness: children, young people, and adults can all benefit.

How do you learn mindfulness?

Mindfulness can be practised in person through a group course or one-to-one with a trained mindfulness coach. There are online courses, books and audio, too, where you can learn through self-directed practice at home. Even though mindfulness is understood to have Buddhist origins, you don't need to be religious or spiritual to practise mindfulness.

Mindfulness has been incorporated into psychological therapies and stress reduction programmes.

Mindfulness-Based Cognitive Therapy (MBCT)

MBCT is recommended by the National Institute for Health and Care Excellence (NICE) to prevent relapse in recurrent depression. It combines mindfulness techniques, like meditation, breathing exercises, and stretching, with elements from Cognitive Behavioural Therapy to help break the negative thought patterns that are characteristic of recurrent depression.

Mindfulness-Based Stress Reduction (MBSR)

MBSR aims to address prolonged periods of stress that can lead to poor mental and physical health. MBSR can be helpful as a single treatment to manage stress in individuals who do not experience mental ill health, as well as a joint intervention with other treatments for people who have symptoms of anxiety, as MBSR is at the core of psychotherapies such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavioural Therapy (DBT).

How does mindfulness work?

Evidence shows compelling support for Mindfulness-Based Stress Reduction (MBSR), which helps people cope with stress, and for Mindfulness-Based Cognitive Therapy (MBCT), designed to help people with recurring depression. They provide flexible skills to manage your mental health and support wellbeing.

Mindfulness might change the way you relate to experiences. It is becoming widely used in various ways and contexts and is recommended by NICE as a preventative practice for people who experience recurrent depression. Many people testify that practising mindfulness can give more insight into emotions, boost attention and concentration, and improve relationships.

Is mindfulness a fad?

There are a lot of misconceptions around mindfulness, including that it's a fad with no evidence base. Mindfulness doesn't necessarily work for everyone; however, there is growing evidence that regular practice may benefit some individuals.

"Mindfulness was first suggested to me by the mental health and wellbeing team at my university. I guess I paid lip service to mindfulness at first; it seemed very 'touchy feely', like an airy fairy, homeopathic take on treatment. I thought 'how can breathing slowly and thinking "happy thoughts" help me in the long term?' However, my opinion of mindfulness completely changed after the session.

Today, I build mindfulness into my everyday life. Breathing, imagery and meditation exercises I find most useful, and I tend to do these once or twice a day. The biggest shock for me was that I could practise anywhere, anytime, and often without other people knowing. It's actually very empowering to know that I can control my reactions and feelings in any situation without others even being aware of it."

How can I learn mindfulness?

In-person - many academic institutions, organisations, and individuals teach mindfulness across the UK

Online

Books and audio - there are many books, apps and audio materials on the market offering guidance in mindfulness practice.

One-minute mindfulness

Mindfulness can be used in your everyday life and doesn't require much effort or time. You can practise mindfulness in just one minute!

In this section, we describe various one-minute mindfulness practices so that you can try them yourself anywhere and at any time that suits you.

Breathing

This is a chance for you to step out of the daily grind and allow time to be present with yourself; that is, being present with yourself and whatever arises in your mind and body. Take a minute to observe your breathing. Breathe in and out as you normally would: notice the time between each inhalation and exhalation; notice your lungs expanding. When your mind wanders, gently bring your attention back to your breath.

Body scan

It can often feel like we're an observer of our own bodies caught up in our heads. Spend your one mindful minute bringing awareness to your body and your body's sensations. Close your eyes and begin scanning your body. Start with your feet, and then slowly bring your awareness upwards in your body until you reach your hands. What sensations do you feel? Heaviness in the legs? Strain in the back? Perhaps no sensations at all. Now move your focus out of your hands and become aware of your environment and the space around you.

Mindful walking

Mindful walking is something you can practise at any time as you go about your day. It's good to try it slowly at first, but once you're used to it, you can practise it at any pace - even when you're rushing.

Walk slowly: become aware of the sensations in the soles of your feet as they make contact with the floor, and any sensations in the muscles of the legs. You don't have to look down at your feet. When your mind wanders, use the contact of the feet on the floor as an anchor to bring you back into the present moment. Just take a minute to focus on the sensations generated by walking.

Mindful eating

Eating mindfully can take us out of autopilot, helping us appreciate and enjoy the experience more.

The next time you eat, stop to observe your food. Give it your full attention. Notice the texture: really see it, feel it, smell it, take a bite into it - noticing the taste and texture in the mouth - continue to chew, bringing your full attention to the taste of it.

Mindful listening

By taking this time out to tune in to your environment and listen to what it tells you, it will help you to bring mindfulness into the rest of your life - bringing your awareness as you move through the day. Take a minute to listen to the sounds in your environment. You don't need to try and determine the origin or type of sounds you hear, just listen and absorb the experience of their quality and how it resonates with you. If you recognise a sound then label it and move on, allowing your ears to catch new sounds.

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How to look after your mental health using mindfulness

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The government defines well-being as 'a positive physical, social and mental state'. For our purposes, we are focusing on mental wellbeing.

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Promote what others are doing during  the month

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Promote what others are doing during  the month

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Encourage adults to lend a helping hand (2013 - Hero of Hope 

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Encourage adults to lend a helping hand (2013 - Hero of Hope 

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Love the child mind institute and there tips on recognizing anxiety in children and teenagers

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Love the child mind institute and there tips on recognizing anxiety in children and teenagers

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what is mental health should go first in my opinoin

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what is mental health should go first in my opinoin

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Add something about the influence on technology and mental. 

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Add something about the influence on technology and mental. 

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Podcast from surgeon general about how loneliness affects adults and youth. 

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Podcast from surgeon general about how loneliness affects adults and youth. 

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i know it may not have relevance or may not be aplicable but if it is its incredibly interesting

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U.S. Surgeon General Dr. Vivek Murthy On America's Epidemic Of Loneliness

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Listen to this episode from The Rich Roll Podcast on Spotify. I think it's safe to say that many people are suffering, not just from major public health concerns and economic hardship, but also from loneliness-the prevalence of which has skyrocketed in recent years. Studies indicate that about half of U.S.