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Reducing Stigma in Adolescent Mental Health

In the Caribbean, large percentages of adolescents experience significant mental health challenges. Of those affected, it is postulated that only one third access timely and consistent intervention. Untreated mental illness predisposes to long-standing individual difficulties, academic decline, challenges with interpersonal relationships, poor quality of life and results in a load burden to the public health and social support systems. While we recognize that mental health services have not kept pace with demands, there is unfortunately another significant factor which impedes timely and effective mental health services for young people. It is stigma.

By definition, stigma is conceptualized as feelings of disgrace, shame, and self-blame that results in social exclusion, isolation, and embarrassment. In an attempt to avoid labels, young people and their parents opt not to seek support, accept guidance or follow up with recommendations. This is all too often a reality on our islands. All methods and programs to support mental health prevention and intervention must include strategies to continue to reduce the stigma associated with mental health concerns. As a result, affected youth will not hesitate to declare their concerns; parents will feel empowered to access services and the wider community will reduce behaviours of ridicule or punishment. In as much as young people affected by states of mental illness are often subject to negative comments, abandonment or inappropriate language by others, many youth themselves live in states of guilt or shame when they recognize their own emerging mental health concerns. Stigma can indeed be self-imposed. The strategies best effective against this, are knowledge and mental health literacy. Parental education is the second layer of intervention. Parents often grapple with their own guilt or feelings of failure when their young people are affected and this alone creates a barrier to accessing support. Our educational and support systems also need to be continually revamped, to ensure that labelling language, prejudices of exclusionary behaviour are reduced. As wider communities, our cultures continue to be fearful or judgemental of mental illness. For some, it is assumed that those with mental illness are always violent and engaged in criminal activity. There are misconceptions about treatment, with beliefs that medications themselves make mental illness worse. The intersection between mental health and spirituality cannot be downplayed in our culture, as some will prefer to seek approaches of divinity as opposed to medical management. Overall, a complex combination of the above factors work against timely interventions due to prevailing stigma. Cultural shifts will take time and consistent efforts, but they all begin with intentional efforts to remove stigma as a barrier to the recognition, acceptance and further management of adolescent mental health concerns.

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