Mental Health Stigma: An Ongoing Battle for Acceptance in the Maldives
Written by: Rishfa Abdul Sattar, Psychologist, Institute for Counselling and Psychotherapy (ICP)
As the world marks this year’s World Mental Health Day under the theme “Mental health is a universal human right,” it is imperative to acknowledge that the stigma associated with mental health remains deeply entrenched within our island nation. Globally, one in every eight people lives with a mental health disorder.
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In the Maldives, according to the STEPS Survey on Risk Factors for Non-Communicable Diseases, jointly conducted by the Government and the World Health Organisation, one in five individuals experiences various aspects of depression. Anxiety and depressive disorders are the most prevalent mental health conditions, both in the Maldives and worldwide.
In addition to the barriers to accessing affordable and professional mental health care, pervasive stigmas surrounding mental health pose a significant challenge for our community. Mental health stigma encompasses negative attitudes, beliefs, and stereotypes that society holds about individuals with mental health conditions. These stigmas manifest in various ways.
They can lead to misconceptions about mental health conditions, viewing them as personal weaknesses rather than legitimate medical issues. Such misconceptions often result in individuals with mental health conditions being unfairly labeled or reduced to their condition, diminishing their identity as individuals. Stigmas can also lead to avoidance and exclusion due to fear or misunderstanding, socially isolating those with mental health conditions. Discriminatory behaviors may manifest in various aspects of life, including employment, education, and relationships.
Furthermore, stigmas can lead to self-stigmatisation, causing individuals with mental health conditions to internalise negative beliefs and stereotypes, damaging their self-esteem and deterring them from seeking help. Ultimately, these stigmas can create a barrier to treatment, discouraging individuals from seeking help and potentially worsening their mental health.
In the Maldives, individuals with mental health conditions often face derogatory name-calling, shame, and, particularly for men, accusations of weakness. Some have even been demoted or terminated from their jobs and isolated from their families due to their mental health conditions. As a result, some individuals seek help and treatment in secret, shouldering the burden of mental illness in solitude.
Mental health stigma can have a detrimental impact on those grappling with mental health conditions. Extensive research by Yanos et al. revealed that self-stigma among individuals with severe mental illnesses is associated with lower self-esteem, reduced hope, difficulties in social relationships, increased psychiatric symptoms, work-related challenges, and a decreased likelihood of remaining in treatment.
For individuals experiencing mental health conditions, there are strategies to combat stigma. Seeking help and treatment despite fear of labels or discrimination is crucial. Viewing your mental health condition as a part of yourself, rather than your entire identity, is essential.
Just as someone with a broken wrist is not defined by their injury, individuals with depression can say, “I have depression” rather than “I am depressed,” reinforcing their identity beyond the illness. Recognizing that much of the stigma arises from a lack of understanding or experience with mental illness can help individuals not take it personally. Sharing facts and figures about one’s own mental health condition and personal experiences can help dispel misconceptions.
On a societal level, there are several ways to combat stigma. Educating oneself about mental health through credible resources and the lived experiences of others is crucial. Openly discussing mental health, sharing positive experiences, and using factual language can reduce stigma. Comparing and promoting equality between physical and mental illnesses is essential.
Treating individuals with mental health conditions with kindness and compassion, listening to their experiences, and holding space for them can help combat stigma. Finally, normalising help-seeking and treatment for mental disorders is vital.
In December 2022, the Maldivian government and UNICEF launched the National Mental Health Communications Strategy and Campaign, led by the Health Protection Agency (UNICEF). One of the primary objectives of this strategy is to reduce the stigmatisation of mental health and individuals with mental health conditions, fostering a compassionate and nurturing environment.
The implementation of these strategies is urgently needed, as the societal issues stemming from stigma continue to adversely affect those with mental health conditions. Recognising mental health as a universal human right empowers individuals to stand up for their rights and those of others.
Letting go of shame and choosing to empower oneself by owning one’s life, story, self-perception, and self-esteem is the first step in overcoming stigma. Compassion for oneself and others can drive positive changes in society.
