Contact Us



You may also contact us via phone or email:

Phone: 858-354-4077


Name *
Phone *
OK to leave a detailed message on this phone? *
How did you find CSAM? *

7860 Mission Center Ct, Suite 209
San Diego, CA, 92108


At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.


Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.


Mental Health, & Stigma as a Barrier to Social Support

Jill Stoddard

Written by Lauren Helm, M.A.

In honor of the National Alliance on Mental Illness (NAMI) San Diego's Mental Health Awareness Walk, this blog delves into the importance of social support for those with mental illness, and how stigma may become a barrier to the support that is needed by so many. 

image source:

Social Support

The support we receive from others in our lives can significantly impact our wellbeing. A large number of studies have found that social support reduces and buffers (prevents) stress, thereby leading to numerous psychological and physical benefits. In fact, the quality of the social support that we receive has been linked to the appearance and duration of illness and disability, mortality rates, and psychological soundness (Berkman, 1995; Lin, Ensel, Simeone, & Kuo, 1979; see review by Uchino & Kiecolt-Glaser, 1996).

Our social networks often provide support by offering useful resources, such as emotional, informational, material, or tangible support, which help us in dealing with stress (Cohen, 2004). Stressful life circumstances have been found to have detrimental effects on our health if we do not manage them well, and social support from others helps to reduce the negative effects that stress can have on overall health (Berkman, 1995).

Individuals who have been diagnosed with a mental disorder can be quite vulnerable to experiencing an increased risk of distress, anxiety, and depression (Carter, Mackinnon, Copolov, 1996; Huang, Sousa, Tsai, & Hwang, 2008) often due to mental disorder-related stressors (Carter et al., 1996), and they may be particularly in need of the stress-buffering effects of social support from those in their lives.

In fact, studies have found that social support may even help improve the outcome of mental disorders (Huang et al., 2007; Warren et al., 2007). For example, social support has been linked to the occurrence of mental disorder symptoms. Higher levels of social support are related to improved psychological functioning (Warren et al., 2007), better integration into the community, and less psychological hospitalizations (Huang et al., 2007). The wellbeing of those with mental disorders is greatly influenced by their access to beneficial social support.

Stigma as a Barrier to Social Support

Social interactions, like social support, can alter the course of our health and functioning, and thus alter the course of our lives. Social support can have a multitude of positive effects on health, for the general population and for those experiencing a mental disorder.

However, negative social interactions can have an equally large effect on health in a much less desirable way. Negative social interactions, such as when others withdraw social support, can increase our risk for disease, our stress levels, and our experience of psychological despair (Cohen, 2004). Furthermore, the withdrawal of social support can lead to maladaptive coping and feelings of low-self esteem and competence in the face of stressful circumstances (Schreurs & de Ridder, 1997).

Given that social support may be an essential factor in the recovery and reduction of symptoms for those that have a mental disorder, it is important to take into account what factors may serve as barriers to social support.

One possible barrier to social support is stigma. Stigma is a mark of deviance from social norms. Stigmatized individuals are often classified as “outcasts” who are perceived as deserving less of the benefits that society offers (Cumming & Cumming, 1965; Fife & Wright, 2000; Goffman, 1963; Jones, Farina, Hastorf, Markus, Miller, & Scott, 1984).

Individuals who are stigmatized are looked down upon by society and lose social status (Cumming & Cumming, 1965). Social rejection makes it difficult for stigmatized individuals to continue to interact with their social world, and often those who are stigmatized become socially isolated (Goffman, 1963; Jones et al., 1984), which puts them at risk for developing a negative sense of self, low feelings of competence, and low feelings of control (Goffman, 1963).

Ultimately, stigma impairs the well-being of “outcast” individuals because it acts as a barrier to important types of social interactions and resources and becomes a source of stress within itself.

Since those with mental disorders are often categorized by society as “different,” they become stigmatized and thus denied the societal resources that are needed to achieve an optimal outcome with their disease (Roeloffs, Sherbourne, Unutzer, Fink, Tang, & Wells, 2003). Negative attitudes towards those with mental disorders are common, and discriminatory labels such as “psycho” or “loony” directed at still occur to this day (see review by Putnam, 2008).

The stigma that those with mental disorders experience is evidenced by not only the negative labels they receive, but also by the behaviors and beliefs that others hold towards individuals with a mental disorder. Crisp, Gelder, Rix, Meltzer, and Rowlands (2000) found that people prefer to keep their distance and avoid interactions with those with mentally illness.

Fear and misunderstanding color the general public’s justification for rejecting individuals with mental disorders. People hold numerous negative misconceptions of those with mental disorders, believing that those with mental disorders are “to blame for their disease,” “weak,” and “don’t deserve sympathy” (Putnam, 2008, p. 688). 

Furthermore, people frequently hold beliefs that those with mental disorders or mental illness are likely to be violent, even though research has found that generally, those with mental illness are not more likely to be violent, and are actually more likely to be the victims of violence than who do not have a mental disorder (Crisp et al., 2000; Putnam, 2008).

Unfortunately, individuals with a mental disorder often feel the unfair sting of social distance. Findings have provided overwhelming evidence that the widespread negative attitudes of the public reinforces the stigmatization of mental disorders and causes increased distress (Putnam, 2008) and social isolation (Crisp et al., 2000) for those who have mental disorders. If those who experience mentally disorders are kept at a distance from the rest of society, their ability to receive quality social support is greatly at risk.

By being labeled as “different,” these individuals have a decreased chance of managing their disorder, and succeeding with their lives. Studies have found that those with mental disorder report receiving much less social support than those without mental illness (Kilbourne, McCarthy, Post, Welsh, & Blow, 2007).

Because social support plays a potentially crucial role in the improvement of symptoms and the recovery from disease, it is imperative that we continue to find ways to effectively reduce mental health stigma.


Learn more about initiatives that combat mental health stigma:


If you or a loved one would like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety or depression, please click here.

Follow us! Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego)



Barry, D. T. (2001). Development of a new scale for measuring acculturation: The East Asian

        Acculturation Measure (EAAM). Journal of Immigrant Health, 3 (4), 193 197.

Berkman, L. F. (1995). The role of social relations in health promotion. Psychosomatic     Medicine, 57, 245-254.

Berscheid, E., Snyder, M., & Omoto, A.M. (1989). The relationship closeness inventory:

            assessing the closeness of interpersonal relationships. Journal of Personality and Social

            Psychology, 57(5), 792-802.

Bogardus, E.S. (1925). Measuring social distances. Journal of Applied Sociology, 1-2. 232-226.

Bogardus, E.S. (1933). A social distance scale. Sociological Social Research, 17, 265-271.

Butt, G., Paterson, B., & McGuinness, L. (2008). Living with the stigma of hepatitis C. Western    Journal of Nursing Research, 30(2), 204-221.

Cacioppo, J.T., & Petty, R.E. (1981). Social Psychological procedures for cognitive response

            assessment: The thought-listing technique. In T.V. Merluzzi, C.R. Glass, & M. Genest

            (Eds.), Cognitive assessment (pp. 309-342). New York: Guilford Press.

Carter, D. M., Mackinnon, A., & Copolov, D. L. (1996). Patients’ strategies for coping with             auditory hallucinations. Journal of Nervous and Mental Disease 184, 159–164.

Chu, T. Q., Kim, H. S., & Sherman, D. K. (2008, February). Culture and the perceptions of         implicit and explicit social support use. Poster presented at the annual meeting of the            Society for Personality and Social Psychology, Albuquerque, NM.

Clark, T. & Rowe, R. (2006). Violence, stigma and psychiatric diagnosis: the effects of a             history            of violence on psychiatric diagnosis. Psychiatric Bulletin, 30, 254-256.

Cohen, A. N., Hammen, C., Henry, R. M. & Daley, S. E. (2004). Effects of stress and social support on recurrence in bipolar disorder. Journal of Affective Disorders 82, 143–147.

Cohen, S. (2004). Social relationships and health. American Psychologist, 676-684.

Cohen, S. & Wills, T. (1985). Stress, social support, and the buffering hypothesis. Psychological             Bulletin, 9(2), 310-357.

Crisp, A., Gelder, M., Rix, S., Meltzer, H., & Rowlands, O. (2000). Stigmatization of people           with mental illness. British Journal of Psychiatry, 177, 4-7.

Cumming, J. & Cumming, E. (1965). On the stigma of mental illness. Community Mental Health    Journal, 1(1), 35-43.

Derogatis, L.R. (1975). The Affects Balance Scale (ABS). Baltimore: Clinical Psychometrics


Elliott, T. R., MacNair, R. R., Herrick, S. M., Yoder, B., & Byrne, C. A. (1991). Interpersonal   reactions to depression and physical disability in dyadic interactions. Journal of       Applied Social Psychology, 21, 1293-1302.

Fife, B. L, & Wright. E. R. (2000). The dimensionality of stigma: A comparison of its impact on   the self of persons with HIV/AIDS and cancer. Journal of Health and Social Behavior,         41(1), 50-67.

Gilligan, C. (1982). In a different voice. Cambridge, MA: Harvard University Press.

Goffman, I. (1963). Stigma: Notes on the Management of Spoiled Identity.  Prentice-Hall, Inc.

            Englewood Cliffs, N.J.

Graves, R., Cassis, J., 7 Penn, D. (2005). Psychophysiological evaluation of stigma towards

             schizophrenia. Schizophrenia Research, 76, 317-327.

Holmes, E. P., Corrigan, P. W., Williams, P., Canar, J., & Kubiak, M. (1999). Changing public

            attitudes about schizophrenia. Schizophrenia Bulletin, 25, 447–456.

Huurre, T. M., & Aro, H. M. (2002). Long-term psychosocial effects of persistent chronic   illness. A follow-up study of Finnish adolescents aged 16 to 32 years. European Child           and Adolescent Psychiatry, 11(2), 85–91.

Jones, E., Farina, A., Hastorf, A., Markus, H., Miller, D., & Scott, R. (1984). Social Stigma. New

            York; W.H. Freeman.

Jones, S.M., & Guerrero, L.K. (2001) The effects of nonverbal immediacy and verbal person

            centeredness in the emotional support process. Human Communication Research, 27(4),


Kilbourne, A. M., McCarthy, J. F., Post, E. P., Welsh, D. W., & Blow, F. C. (2007). Social         support among veterans with serious mental illness. Social Psychiatry Epidemiology, 42,             639-646.

King, M.G., Burrow, G.D., Stanley, G.V. (1983). Measurement of stress and arousal: validation

            of the stress/arousal adjective checklist. British Journal of Psychology, 74(4), 473-479.

Kim, H. S., Sherman, D. K., & Taylor, S. E. (2008). Culture and social support. American       Psychologist, 63(6), 518-526.

Kiviruusu, O., Huurre, T., & Aro, H. (2007). Psychosocial resources and depression among           chronically ill young adults: Are males more vulnerable? Social Science & Medicine,      65, 173-186.

Lin, N., Ensel, W. M., Simeone, R. S., & Kuo, W. (1979). Social support, stressful life events,        and illness: A model and an empirical test. Journal of Health and Social Behavior,           20(2), 108-119.

Link, B.G., Phelan, J.C., Bresnahan, M., Stueve, A., & Pescosolido, B. (1999). Public             conceptions of mental illness: labels, causes, dangerousness and social distance.      American Journal of Public Health, 89(9), 1328-1333.

Miller, J.B. (1976). Towards a new psychology of women: Boston: Beacon Press.

Penninx, B., Kriegsman, D., van Eijk, J., Boeke, J., & Deeg, D. (1996). Differential effect of            social support on the course of chronic disease: A criteria-based literature study. Families, Systems, & Health, 14(2), 223-244.

Phelan, J., & Basow, S. (2007). College students’ attitudes towards mental illness: an   examination of the stigma process. Journal of Applied Social Psychology. 37(12), 2877-


Putnam, S. (2008). Mental illness: diagnostic title or derogatory term? (Attitudes towards mental      illness) Developing a learning resource for use within a clinical call centre. A systemic       literature review on attitudes towards mental illness. Journal of Psychiatric and Mental            Health Nursing, 15, 684-693.

Roeloffs, C., Sherbourne, C., Unutzer, J., Fink, A., Tang, L., & Wells, K. (2003). Stigma and depression among primary care patients. General Hospital Psychiatry, 25, 311-315.

Schnittker, J. (2005). Chronic illness and depressive symptoms in late life. Social Science &        Medicine, 60, 13–23.

Schreurs, K. & de Ridder, D. (1997). Integration of coping and social support perspectives:        Implications for the study of adaptation to chronic diseases. Clinical Psychology Review,       17(1), 89-112.

Sibicky, M. & Dovidio, J. (1986). Stigma of psychotherapy: Stereotypes, interpersonal reactions,           and self-fulfilling prophecy. Journal of Consulting and Clinical Psychology, 33, 148-154.

Suinn, R. M., Ahuna, C., Khoo, G. (1992). The Suinn-Lew Asian Self-Identity Acculturation   

       Scale: Concurrent and factorial validation. Educational & Psychological Measurement,     

        52(4), 1041-1046.

Turner, R. J., & Turner, J.B. (1999). Social integration and support. In Aneshensel, C. &

            Phelan, J. (Eds.), Handbook of the Sociology of Mental Health (pp. 301-318). New         York; Kluwer Academic/ Plenum Publishers.

Uchino, B. N. & Kiecolt-Glaser. (1996). The relationship between social support and      physiological processes: a review with emphasis on underlying mechanisms and   implications for health. Psychological Bulletin, 119(3), 488-531.

Westmaas, J., & Silver, R.C. (2001). The role of attachment in responses to victims of life crisis.

            Journal of Personality and Social Psychology, 80, 425-438.

Westmaas, J., & Silver, R.C. (2006). The role of perceived similarity in supportive responses to

            victims of negative life events. Personality and Social Psychology Bulletin, 32(11),1537-         1546.