Eradicating microstigmas in mental health, everyone's job

Mental health problems are increasingly being talked about. However, there is still a long way to go, especially to do so in a way that is free from stigmas and micro-stigmas. Getting rid of them is a task that we all have to do and that starts at a very young age . In fact, more and more spaces are being demanded to openly talk about these attitudes, to confront them and combat them. But we must continue working and not fall into trivializing an issue that affects people with mental health problems so much.

What should we know about stigma?

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What are microstigmas?

Microstigmas are thoughts, attitudes, actions or comments that people have automated and seem subtle, even imperceptible, everyday and almost normalized and accepted, but which cover up stigmas. It may seem that they are done without any bad intention or even in a funny way, but it is quite the opposite, they perpetuate the stereotypes, prejudices and discrimination that exist around mental health and people who have or have had a mental health problem.

Microstigmas may seem harmless and you might think they are done without any bad intentions, but they perpetuate stereotypes, prejudices and discrimination and do a lot of harm to people with mental health problems.

There are many microstigmas in mental health that surround us daily and in which we are complicit. Often, these attitudes are accompanied by phrases that we may say without paying attention, talking about the affected person or addressing them directly. Changing the way we speak is the first step to ending microstigmas. Some examples are:

• Asking unnecessary questions of an intimate or personal nature directed at a specific person, which we would not ask if they did not have a mental health problem, simply out of curiosity, impertinence or bias. "Can you have a partner?"; "How has your family reacted after everything that has happened to you?".
• Speaking childishly to an adult or referring to them in a childish way. Also speaking to them condescendingly: "I see you can work like everyone else. Very good!"
• Controlling or overprotecting her , for example at work, with different supervision thinking that she will not be able to do her job;
• Feeling or expressing pity, distrust, disgust , etc., towards another person because they have a mental health problem. "Oh, you could be so good if it weren't for this thing that's happening to you..."; "You're so young and already sick"; "I could never be with someone who has a mental health problem, it's a burden."
• Making assumptions or assumptions about someone's abilities, autonomy, or needs . "He needs help to do a lot of things and will need more as he gets older"; "I'm surprised he was able to do that considering what's going on with him."
• Making assumptions or assumptions about a person's mental health situation or problem . "He'll always be worse; he'll carry it with him his whole life; it's hard to recover from this"; "Look at how hard he's trying to get out of it, but there's no way."
• Criticize their appearance . "You can see that something is wrong with them and they are not well."
• Do not address a person directly and do so to the person accompanying them .
• Exclude a person from decision-making that involves them.
• Not explaining or hiding information from a person for various unrealistic justifications, from not wanting them to worry to thinking they won't understand.

Raquel Montllor Linares

Mental health activist

"Society needs to know that we exist and what happens to us in order to stop seeing us as the odd ones out."

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Although most microstigmas may seem harmless, for the people who receive them they are obvious, uncomfortable and rude. Furthermore, over time, people can internalize them and see themselves represented in them. And, even if they are not true, they become the main source of self-stigma . This can have consequences for the recipients and affect their self-esteem and confidence, even causing them to become socially isolated.

Why do microstigmas appear and how are they perpetuated?

Microstigmas can occur everywhere and come from anyone. This makes them unpredictable and unexpected, and creates a hostile world for many people. In addition, several can occur in the same situation. These microstigmas, like stigmas, come from the negative beliefs and attitudes we have towards people who have or have had a mental health problem. They are the result of a negative view of some characteristic or distinctive condition that is considered a problem, a disadvantage, a difficulty, etc. They also arise from ignorance and a lack of observation, listening and critical reflection on the world and the people around us.

We all give continuity to microstigmas in some way and have thoughts, attitudes and actions that we have learned in our closest environments, such as family or school.

Furthermore, microstigmas are deeply rooted in societies and cultures that have allowed, adopted and nurtured them, which makes their detection and questioning even more difficult, and they are perpetuated over time. All of us give continuity, in some way, to these microstigmas and no one escapes expressing and receiving them. Without questioning ourselves, but sometimes being aware of them, we continue to have thoughts, attitudes, actions or comments that we have learned in many of our primary socialization environments , such as family and school, and that make microstigmas last.

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What can we do to avoid microstigmas?

Individual and community actions are needed to change the beliefs and attitudes present in society and promote inclusion. Below, we propose some actions that we can all take to break with microstigmas:

• Become aware of what microstigmas are and how they can affect the people who receive them.
• Reflect individually to detect which microstigmas are part of your behaviors.
• Reeducate yourself to change them in your day to day life.
• Think about how you can change these microstigmas and what is the best way to act. Acting free from microstigmas involves re-appreciating yourself, treating everyone equally, with tolerance, respect and empathy. You also need to understand that there are very diverse people in the world.
• Find out about the reality of people who have experienced or are experiencing a mental health problem through proven, quality resources.
• Becoming literate about mental health issues is crucial to overcoming microstigmas. Discriminating the most appropriate and truthful information today is complicated. Use sources of information that come from institutions or expert entities.
• Participate in reflection spaces (debates, podcasts, etc.). Find or create, participate in and consume reflection spaces where everyone is welcome to talk about mental health issues and that promote their destigmatization. They can be both virtual and in-person, live or on a delayed basis. It is interesting to consider the individual experiences of people who have received microstigmas, as long as these people want and are prepared to talk about them. This experience can help you consolidate change. It is important to practice active and empathetic listening without judgment.
• Talk about microstigmas and reflect on them with your group of friends and family . You will see that there are people who are also interested in it. Our individual change can also generate changes in our immediate environment, we need to talk about it with the people around us and become agents of promotion of this change. We need to modify our attitudes and thoughts to have relationships and spaces free of microstigmas.