Taiwanese Journal of Psychiatry

LETTER TO THE EDITOR
Year
: 2022  |  Volume : 36  |  Issue : 1  |  Page : 49--50

Target stigma in schools: Teach them young


Arghya Pal 
 Department of Psychiatry, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India

Correspondence Address:
Arghya Pal
Department of Psychiatry, All India Institute of Medical Sciences, Munshiganj, Raebareli, Uttar Pradesh
India




How to cite this article:
Pal A. Target stigma in schools: Teach them young.Taiwan J Psychiatry 2022;36:49-50


How to cite this URL:
Pal A. Target stigma in schools: Teach them young. Taiwan J Psychiatry [serial online] 2022 [cited 2022 Jun 29 ];36:49-50
Available from: http://www.e-tjp.org/text.asp?2022/36/1/49/341040


Full Text



Stigma is one of the leading causes of poor use of mental health services all over the world. Stigma is defined as “negative social attitude attached to a characteristic of an individual that may be regarded as a mental, physical, or social deficiency.” Stigma often leads to labeling and disapproval further culminating in discrimination and exclusion. It is well-evident that stigma in mental health is not restricted to any particular age group or geographical boundary but rather is a global phenomenon [1]. To deal with the huge burden of stigma in various facets of mental health services, the International Cricket Council (ICC) and the United Nations Children's Fund (UNICEF) recently came together on the occasion of the ICC Men's T-20 World Cup 2021 to provide impetus to the #OnYourMind campaign. This campaign was launched by the UNICEF to promote the mental well-being of all children and calls for commitment, communication, and action regarding the same. Such steps only highlight the immense burden of mental disorders and the stigma associated with it.

Although various kinds of stigma have been identified, basically, there are three kinds of stigma. It includes internalized stigma (originating within the patients with mental illnesses), public stigma (originating from the labeling and discriminatory practices of the public toward patients with mental illness), and finally, structural stigma (originating of the noninclusive and nonuniform policy of various governing organizations) [2]. The research on stigma has picked up considerably in the past few years. Although the initial research in this field mostly focused on the magnitude of the problem, subsequent ventures are able to unearth models replicating stigma and intervention strategies [3]. Our current understanding makes it clear that this menace is ubiquitous and universal. It has also been acknowledged that there is a need for stringent intervention strategies to counter this menace and improve the quality of life and service utilization [4]. But our attempts to build effective intervention strategies have so far not been successful [5].

One of the main reasons behind the failure to develop anti-stigma is due to the heterogeneity of the problem at hand. It is clear from the research that children are more susceptible to the ill effects of stigma in unique ways that are distinct from adults. They also tend to interpret stigmatizing attributes differently from adults. As a result, no single strategy can be uniformly used across various strata for benefits. We need to identify a specific target population for this purpose and customize our intervention measures accordingly. For example, the current evidence suggests that the anti-stigma approach needs to be more andragogical for the adult population, where the focus is more self-directed and is on achieving a change in behavior. But for adolescents, a pedagogical approach, where an instructor assumes a position of responsibility to teach fundamentals, is more pragmatic. Authors speculate that for adults a direct contact with cases can be effective intervention strategy. However, it is easy to presume that such an approach is resource intensive and often difficult to implement. Whereas the approach should be more pedagogical in the child and adolescent population, where the focus should be more on increasing the knowledge base. A pedagogical approach, on the other hand, is much easily applicable as it caters to a large audience. Using this pedagogical approach in adults has not been able to decrease stigma although it managed to increase the knowledge base in the recipients [5].

I feel that in our fight against stigma in mental health, child and adolescent population is an under-targeted population. The recent report from the UNICEF titled “The State of the World's Children 2021” puts it in the forefront that almost one in seven adolescents between the age of 10 and 19 years has a diagnosable mental disorder. But at the same adolescents of this age do not carry many of the preconceived notions about mental disorders that finally contribute to stigma. Furthermore, adolescents of this age group are good candidates for interventions that employ targeting a group together. A cursory glance at the biology syllabus of this group in Raebareli district [Figure 1] makes it clear that biological background behind mental health does not have any presentation. But a rectification in this fact can go a long way in creating awareness pertaining to the issues of psychiatric disorder and decreasing stigma. To be able to create this awareness in future generations should also augur good news for the time to come and may provide us with sustainable solutions to this perpetual menace of stigma in mental health.{Figure 1}

 Financial Support and Sponsorship



Nil.

 Conflicts of Interest



The author declares no potential conflicts of interest.

References

1Mak WW, Poon CY, Pun LY, et al.: Meta-analysis of stigma and mental health. Soc Sci Med 2007; 65: 245-61.
2Link BG, Phelan JC: Conceptualizing stigma. Annu Rev Sociol 2001; 27: 363-85.
3Livingston JD, Boyd JE: Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med 2010; 71: 2150-61.
4Pal A, Saxena V, Avinash P: Stigma in bipolar affective disorder: a systematic quantitative literature review of Indian studies. Indian J Psychol Med 2021; 43: 187-94.
5Thornicroft G, Mehta N, Clement S, et al.: Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 2016; 387: 1123-32.