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Stigma and Self-Stigma

Revital Ordan, Psychiatric nurse, Director of the Ambulatory Array, Mental Health Division, Ministry of Health
26 January 2026

Stigma towards people with mental illness is expressed in prejudice, discriminatory behavior, and negative labeling that harm their lives and functioning.

Stigma is expressed in three main forms: 

  • Public stigma: Negative opinions and attitudes in society.
  • Structural stigma: Discrimination in state institutions and legislation.
  • Self-stigma: Internalization of negative labeling by the person themselves.

Self-stigma develops when a person internalizes social prejudices and begins to see themselves as defective or worthless. This process begins with awareness of public stigma, continues with agreement with prejudices, and ends with the application of negative labeling to oneself.

The consequences are widespread and affect self-identity, mental well-being, marital relationships, willingness to receive treatment, employment status, and family relationships. These adverse effects intertwine and create a cycle of isolation and exclusion.

It is important to remember that stigma is a sociocultural phenomenon that can be changed. Recognizing its existence is the first step in dealing with it.

Mental health stigma is a reality that affects the lives of many. It can make it difficult to seek treatment, damage relationships, and cause shame and isolation. Many people with mental illness and their families report experiences of ostracism, judgment, and discriminatory behavior from their environment. To deal with stigma, it is important to first try to understand its meaning and how it works.

What is stigma?

Sociologist Erving Goffman defined stigma as a negative social label that erases a person's entire identity and reduces them to a single trait that is perceived as defective. The term "stigma" comes from an ancient Greek word, which was used to physically mark a person who was considered less valuable. Even today, stigma acts as a prominent status: It defines the person through their difficulty, and can lead to exclusion and loss of value and social status. When a person is viewed only through this label, a separation of "us" versus "them" is created.

At the heart of stigma are prejudices against groups that are perceived as different. These prejudices can be many and varied. When a person is labeled under a certain group, the prejudices attributed to that group also apply to them, even when this has no basis in reality. Prejudices are usually negative in nature, and therefore they evoke emotional reactions of fear, disgust or pity. These feelings may result in behaviors such as ostracism, repulsion, discrimination, avoidance and even a kind of condescension towards the person who is different.

Stigma in the world of mental health manifests itself in three main forms:

Public stigma

The set of negative opinions, images, and attitudes toward those who struggle with a mental disorder. It is evident in cultural discourse, the media, and everyday attitudes. For example, when an employer hesitates to hire someone who has stated that they struggle with a mental illness, or when extended family members avoid mentioning a family member's mental illness.

Structural stigma

Occurs when state institutions establish patterns of prejudice and discrimination. For example, when the mental health field receives less attention or resources, or when there are laws that limit or discriminate against those with mental illnesses compared to people with physical disabilities or the population as a whole.

Self-stigma

When a person internalizes the stereotypes, prejudices, and discrimination toward themselves, and begins to see themselves as defective or worthless.

The mechanism of self-stigma

Many people with mental illness describe that before they themselves experienced mental difficulty, all they knew about the subject came from television and movies. In their minds, those who symbolized mental illness were extreme and frightening characters – murderers, "crazy" or dysfunctional people. When the doctor announced the diagnosis to them, it scared them very much – because that was all they knew about the field.

Self-stigma is one of the most harmful phenomena. The process begins with awareness of public stigma, continues with agreement with prejudices (this process often happens even before the diagnosis) and ends with the acceptance of the diagnosis by applying the negative label to ourselves. In addition, public stigma continues to feed self-stigma by continuing to "provide evidence" that it is supposedly true, by exposure to negative emotions and repulsion or discrimination from the environment. The person, who repeatedly experiences judgmental or ostracizing reactions, stops believing that they are worthy, hides their condition, are ashamed of it, and avoids getting help.

Common signs of self-stigma include thoughts such as: "I'm defective", "I'm weak", "It's my fault", "I'm a burden on the family" or "Everyone thinks I'm crazy". The feeling that I am different or "broken" seeps in. This creates damage to self-image, a decrease in motivation and harm to the chance for recovery and social integration.

It is important to understand that self-stigma is a natural and quite common reaction. When the environment conveys negative messages about mental health, it is completely logical that people will internalize some of these messages.

The consequences of stigma on different areas of life

Stigma, of all kinds – public, structural or self-related, is a real force that affects the lives of many people.

Stigma gradually erodes a person's self-identity and reduces them to a single trait or label – being a sick person. After a while, when a person removes the stigma and truly believes that the disease is all they are, their sense of self, identity, personality traits, hobbies, and everything they love may be damaged and diminished. In contrast, the recovery approach is a mirror image of stigma and self-stigma in particular. It delimits the impact of the disease on the self and encourages finding an identity, even if in new ways, beyond the boundaries of the disease.

Feelings of shame, guilt, low self-worth, dealing with repeated failures in a variety of areas (finding employment, relationships, etc.) and the need to often hide one's mental state from those around them, may cause mental stress and harm mental well-being.

Creating a relationship or starting a family becomes more difficult and complex. Often, the person considers and hesitates when to open up about the issue of mental coping with their partner, out of fear of the reaction.

The negative emotions that are compounded by self- and public stigma may consciously or unconsciously cause a person to avoid acknowledging the problem and allowing it to be present in their life. For example: When a person has to take medicine every morning, they actually receive a daily reminder of their illness and the meanings derived from it due to the stigma – and hence, every morning they experience criticism that harms their identity and value, and therefore they prefer to avoid it. In addition, even coming to a clinic for treatment may be discouraging, out of fear of the reaction of their environment.

Stigma places barriers in various areas of life, for example, employers who are reluctant to recruit, landlords who refuse to rent, and educational institutions that doubt the person's ability to succeed.

Family members, who accompany the person closely, are also affected. Sometimes they are blamed, they are afraid to talk about the situation and are forced to deal with stares, gossip or avoidance from those around them.

Prejudices may also seep into the decision-makers' table in a variety of state and public institutions – this may lead to under-budgeting, gaps in resource distribution, legislation or procedures that discriminate or exclude the population of people with mental health problems. In this regard, it is important to know that a lack of attention or adaptation of the law or entitlements to this population may also create discrimination.

All of these consequences are intertwined: The damage to self-identity and the sense of competence may impair psychological, daily and social functioning. At the same time, public stigma may cause isolation and social exclusion and may create a barrier to receiving treatment, precisely where the person dealing with it needs it most. In the absence of appropriate environmental and legislative measures as part of structural stigma, self- and public stigma are reinforced and discrimination is created that makes it difficult for people dealing with a mental disorder to integrate into society and the community and even harms rehabilitation and recovery processes.

You are not alone

Recognizing stigma is the first step in dealing with it. Stigma is not a decree from heaven or a "law of nature" – it is a sociocultural phenomenon, and therefore it can also be significantly reduced.

If you recognize stigmas towards mental health in your thoughts or in the reactions of your environment, it is important to know that you are not alone in this experience. It is a common and completely understandable experience. Dealing with stigma is a journey that requires time and patience, but it is possible and worthwhile.

Read about how each of us can take part in breaking stigmas

For practical advice and tools for dealing with stigma

Thanks to Amir Tal for his help in writing the article.