This article is the third in a series on youth mental health co-written by youth development researcher Kathryn Bates and young people with experience of mental health conditions. The messages and formats of each article were led by the youth co-writers, and draw on both lived experiences and evidence from the research.

In the UK alone, almost a thousand children and adolescents were admitted to inpatient care for mental health issues in 2021/22. Despite efforts by governments and charities in recent years to increase awareness of these issues and reduce the stigma attached to them, young people with severe mental health challenges who are admitted to hospitals for inpatient care continue to experience stigma. Kathryn interviews Saarah, an English and Creative Writing student, about her experience being committed to inpatient care in the UK with paranoid schizophrenia. They discuss how caregivers and teachers can support young people in inpatient care, and how the stigma around severe mental health conditions can be reduced.

Kathryn: You’ve said that stigma has affected how you manage your mental health condition. Can you explain?

Saarah: After my first full episode of psychosis in my teens, I became a shell of my former self. I lost my confidence. I didn’t want other people to know I was mentally ill. I tried to disguise my condition as a physical illness; I would say I was on medication, but for a physical problem. I didn’t want people to think there was something “wrong” with me.

Even now, I especially dislike discussing symptoms with someone who is unfamiliar with mental health illnesses. I don’t like how the symptoms expressed themselves in me. I found my delusions embarrassing, even though they weren’t my fault; I was simply unwell. It’s still something I avoid talking about.

I also rarely ask for help. I know that help and support are available from a variety of mental health organisations, but I avoid using these services unless I really need to. I don’t feel confident reaching out. As a teenager, I felt that my mental health illness was what stood out about me. I didn’t know anyone going through the same thing and I didn’t know how to talk about it. It seemed better to keep my mental health condition a secret.

Kathryn: Do you find your diagnosis of schizophrenia helpful?

Saarah: Yes, because it allows me to label my experiences. It tells me that other people have been through a similar thing, which makes me feel less alone. Before I suffered from psychosis, I wasn’t well-versed in mental health conditions. That put me off talking about it, because I was worried that people won’t understand.

Schizophrenia affects approximately 1 in 300 people worldwide. It is unique to each person, and symptoms can include feeling disconnected from emotions, wanting to avoid others, a lack of interest in things, and disorganised thinking – as well as hallucinations and delusions, both of which are manifestations of psychosis.

Kathryn: How can caregivers and teachers support young people who are receiving inpatient care for mental health conditions?

Saarah: They should check in regularly with the young person. When I was in hospital, the mental health staff tended to be busy with other things. They were also supporting several people every day. Sometimes they didn’t fully understand how I was feeling or how I was coping. Asking how a young person is feeling will reveal how that person is dealing with everything and make it possible to support their recovery. But it’s also important to find out what young people are and are not comfortable discussing.

Caregivers and teachers should be careful not to put pressure on individuals to get back to studying or catch up on what they’ve missed. Young people can feel pressured to hurry up and be well, but recovery is a slow process. Pressuring them to get back to “real life” can hinder recovery. If they’re consumed by their illness, they may not be able to consider their future at that time. They need to focus on getting well.

“Empowering young people by providing information about their condition and treatment is an important part of the recovery process.”

Caregivers and teachers should also support young people in understanding their diagnosis. This includes sitting down and explaining medication in detail. Explain why they are taking it, what symptoms it is designed to treat, and why it might help. Empowering young people by providing information about their condition and treatment is an important part of the recovery process.

Finally, caregivers and teachers should make sure young people are able to make friends. It is a confusing time and they will be surrounded by strangers. If they’re not getting on with their peers, they can feel isolated. Stigma from peers can also negatively impact confidence in their studies.

More from this series on youth mental health
Loneliness in young people should not be ignored

The danger of stigma around mental health conditions

Saarah’s experience suggests there is still a long way to go in reducing stigma for those experiencing serious mental health conditions.

Saarah is not alone in her reluctance to ask for help because of stigma. Research on young people is lacking, but a review of 144 studies involving adults found that those who felt more stigma were less likely to seek help for their mental health condition. This was especially true in the case of stigma associated with seeking treatment for mental health issues and internalised stigma – shame around one’s own mental health issues. Roughly a quarter of participants reported that stigma was a barrier to them seeking help, which could prevent them from getting the support they need to manage their mental health.

Where does stigma around mental health conditions come from? The media play an important role. Media coverage of mental health conditions is mostly negative, and reporting often associates mental illness with violence, even though such occurrences are rare. According to a review of 12 studies, those who read negative news articles and social media posts about mental illness had more stigmatizing attitudes, whereas the attitudes of those who read posts that were positive about mental illness were less stigmatizing. This suggests that traditional and social media together can influence attitudes around mental health.

“Traditional and social media together can influence attitudes around mental health.”

We should be aware of the tone of the media coverage we’re consuming and act accordingly. If you see inappropriate or discriminatory coverage of mental health conditions, you can complain. We can all get into the habit of using the right language to avoid reinforcing stigma. For example, instead of trivialising someone’s experience by saying “just get on with it”, respond with compassion and without judgment.

We shouldn’t take news coverage of mental health research at face value. Alarmist language, such as the headline “Smartphones and social media are destroying children’s mental health” in the Financial Times, is misleading and not always backed by evidence. In the podcast I co-produce with young people, we interview researchers about media coverage of mental health research and provide information about the evidence behind the headlines to offer a more balanced view. 

If you, or a child in your care, are experiencing stigma owing to mental health issues, the charity Mind suggests reaching out to an advocate for support and playing an active role in planning treatment, among other things. The Mental Health Foundation has advice on what to do if you or a child have been discriminated against because of a mental health condition.

Saarah’s experience and the research on mental health stigma show clearly that more needs to be done. Efforts to highlight young people’s experiences of mental health issues should include individuals with serious mental health conditions. Critical consumption of media coverage of mental health, learning about and using non-stigmatising language, and – as Saarah explained – checking in with young people can help adults better support young people with severe mental health issues.

Footnotes

Saarah is an English and Creative Writing student.

This interview has been edited for clarity.

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