The findings from the 2012–13 project illustrated that there is stigma attached to mental health issues on campus. Stigma is defined as attributes that discredit individuals and reduce them from being “whole” and “usual” to “tainted” and “discounted.”17 Students view this stigma as a source of stress because it prevents them from accessing services that help them improve and sustain their mental health and limits opportunities to develop a sense of community on campus. The 2013–14 Mental Health Needs Assessment (MHNA) investigated how UBC students perceive and experience mental health stigma on campus in order to advance and advocate for anti-stigma learning environments at UBC.
Methods
Drawing on participatory action research (PAR), the research team invited students to engage in the process as co-researchers to empower them and enable them to take actions to counteract mental health stigma. Twenty-four co-researchers were recruited in the fall of 2013 through online and social media postings, posters, and classroom announcements. Co-researchers were predominantly female domestic students. Data were collected in October and November 2013 through 13 semi-structured interviews, three focus groups, and three Photovoice sessions. Dialogue from the interviews, focus groups, and Photovoice sessions was audio-taped and transcribed verbatim. Thematic analysis was applied to the transcribed data as well as to the captions that the co-researchers developed for the photographs they had taken. In March 2014, the preliminary findings were presented to seven co-researchers for verification and action plans were discussed.
Findings
The findings highlighted: (1) the personal and environmental factors that contribute to and perpetuate stigma of mental illness; (2) the stigma’s adverse effects on students’ academic performance and social engagement as well as their feeling of connectedness to the community; and (3) the need to develop awareness of mental health and illness among students, faculty, and staff, and to improve mental health services and resources on campus.
Expectations, Reactions, and Uncertainty: Understanding Mental Health Stigma on Campus
The co-researchers identified three main factors that contribute to the stigma of mental illness on campus: high academic expectations, negative reactions to mental health issues, and uncertainty about mental health and illness. Co-researchers indicated that UBC is a competitive environment where students feel pressured to excel academically. Students seem to feel pressured to withhold mental health concerns to avoid appearing “weak” or “inadequate,” and therefore do not seek help. This tendency to keep their concerns to themselves is reinforced by negative reactions (e.g., fear, avoidance, blame, stereotyping) to any disclosure of mental health concerns. The co-researchers indicated that much of the stigma about mental health stems from a lack of education and awareness.
A Triple Threat: Consequences of Mental Health Stigma to Being, Doing, and Belonging
The consequences of mental health stigma had a significant effect on students, compromising their sense of self, academic performance, and social lives. The pressure to keep mental health concerns private appears to create a situation where students feel alone in the face of their situation and inadequately prepared to cope with it. The co-researchers described mental health stigma as leading to feelings of isolation, alienation, and feeling like an outsider—i.e., not belonging. This creates a barrier to forming meaningful friendships or becoming engaged with the broader UBC community. Furthermore, the reluctance to admit a need for help interferes with a student’s ability to perform academically.
Breaking Down Mental Health Stigma through Awareness and Enhanced Service Delivery
The co-researchers offered a variety of suggestions for reducing mental health stigma on campus. The most frequently identified suggestions included promoting conversation, raising awareness about mental health in general as well as the services available on campus, and improving the delivery of services. It was suggested that educating students about the prevalence of mental health concerns would reduce stigma and ameliorate students’ feelings of being alone in their experience. One co-researcher emphasized the importance of using inclusive language when promoting existing services. Specific suggestions arising from the action planning session are listed in Table 3.
Table 3: Actions Suggested by Co-researchers
Conclusions
Due to the small sample size, the findings are not transferable to all students at UBC. It should be noted that because female, domestic students accounted for the majority of the sample, the findings may not capture male and international students’ perspectives and experiences of mental health stigma. Including students as co-researchers in the research process helped us to develop recommendations that reflect their perspectives and needs.
References
17 Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall.
Posted: Feb 22, 2016