The Relationship Between Mental Illness Stigma and Self-Labeling

Objective: One way that stigma may interfere with treatment-seeking is its impact on whether an individual self-labels as someone with mental illness (MI). While identifying and labeling oneself as experiencing MI is an important early step in seeking treatment, self-labeling may also make individuals more susceptible to the negative effects of internalized, anticipated, and experienced stigma. In the present study, we examined the relationship between MI stigma and self-labeling. We hypothesized that endorsement of stereotypes, prejudice, and discrimination would be higher among those individuals who do not self-label and that those who did self-label would endorse higher levels of anticipated, internalized, and experienced stigma. Method: We conducted a survey of stigma and mental health via MTurk. The sample included 257 individuals who met criteria for a current probable diagnosis of depression, generalized anxiety, or posttraumatic stress disorder (PTSD). We compared those individuals who responded "yes" to ever experiencing MI (n = 202) to those who responded "no" (n = 52) on demographic variables, mental health symptoms and treatment history, and stigma. Results: Individuals who did not self-label as having MI were more likely to be younger, male, and single. They also endorsed higher levels of stereotypes, prejudice, discrimination, and experienced stigma. Self-labelers endorsed more internalized stigma than those who did not self-label. Conclusions and Implications for Practice: Findings suggest that associations between stigma and self-labeling are complex. Consistent with modified labeling theory, stigma may both act as a barrier to adopting a label of MI and increase vulnerability to stigma if the label is adopted. Impact and Implications Individuals who do not self-label as having a mental illness (MI) endorse higher levels of stereotypes, prejudice, discrimination, and experienced stigma; individuals who self-label as having MI endorse higher levels of internalized stigma compared to non-self-labelers. Stigma may therefore act both as a barrier to adopting a label of MI and increase vulnerability to stigma if the label is adopted.