Clinical Psychologist Cindi Cassady, PhD, discusses ways youth can help in the fight against the stigma of mental illness in Rwanda.

1. Talk Openly About Mental Health

Many people feel embarrassed or ashamed about being depressed, having anxiety or being told they have a mental health disorder. Unfortunately, this limits people in finding resources that could help them to feel better or recover completely from the mental illness. Youth are more likely than older people to be more open about mental health issues and also more likely to search the internet to find answers to their questions about mental illness. They often fear what their friends or parents will say if they tell them they are worried something is wrong. Some take the opportunity to share their experience with others on social media and want people to understand that having a mental illness is really no different than having a physical illness.  

“I fight stigma by talking about what it is like to have bipolar disorder and PTSD on Facebook. Even if this helps just one person, it is worth it for me.” -I.K.

2. Educate Yourself and Others

Youth are very comfortable searching online for information and using social media to find support related to questions or concerns about mental health and drug abuse problems. There are many positive aspects to doing self-research online, but also some negative aspects. Not all information we find on the internet is from accurate or scientific sources and may not be helpful for your specific situation or problem. In some cases, the information disseminated on the internet is also stigmatizing.  It is important for young people and their families to know at Ndera Hospital and Icyizere Center, we help people find resources and professionals who can provide accurate, professional information and treatment. If you are a young person and have been diagnosed with a mental health disorder, such as depression or anxiety, you are in a unique position to become very knowledgeable about the illness and to educate yourself and your friends, which will contribute to reducing stigma in our society.  

“I take different opportunities to educate people and share my personal story on my blog because I noticed that my friends and family don’t really understand my struggle with depression. They think I just need to be strong, have courage and be positive and it will go away. I want them to know that seeing a therapist doesn’t mean I’m crazy or mad.” – J.S.

3. Be Conscious of Language and Labeling

It is good to remember that just because a person has a mental or neurological illness, he or she does not stop being a whole person. Their depression, epilepsy or PTSD is just one small part of their identity. People fear being labeled umusazi and may delay getting the help they need before their condition becomes very serious. They often see religious leaders or traditional healers first. Public stigma about mental health describes the negative attitudes, beliefs, and behaviors held within the community or Rwandan culture. This stigma can cause people to reject or to be afraid of a family member and to discriminate against people with mental illness.

“I fight stigma by reminding people that I am much more than my mental health diagnosis of schizophrenia.  I am not a schizophrenic.  I am a young man with 27 years, I have a Master’s degree in Engineering, and I have schizophrenia. It is an illness that I have learned how to live with, because it is a part of my life.” – H.R.

4. Encourage Equality Between Physical and Mental Illness

Many of us learn to live with chronic medical conditions such as diabetes, asthma or high blood pressure. We visit our doctors regularly, exercise, pay attention to nutrition, take the medication prescribed for us to control our medical condition and no one stigmatizes us because of our medical disease. Also, mental illness comes in all different “shapes and sizes.” For example, two people both diagnosed with depression, may experience depression very differently, with one being able to function at work and home, but feels constantly sad, can’t sleep, or cries for no reason. The other person might not be able to leave her bed in the morning, cannot take care of her children and has suicidal thoughts. Both of them have depression but the severity of the illness is different.

“I find that when people understand the true facts of what a mental illness is, being a disease, they think twice about making negative comments. I also remind them that they wouldn't think badly of someone with diabetes, heart disease or cancer.” – M.K.

5. Show Compassion for Those with Mental Illness

Stigma can negatively impact self-esteem, getting help and feeling socially included. A person with a mental illness did not do anything to cause their depression or PTSD. If they know that others may blame them or see them as weak for having depression or anxiety, they may stay quiet and suffer for a long time. Youth can be a great force for social change and reduce mental health stigma by openly discussing mental health issues in group forums, by blogging about their own experiences, and educating themselves and their friends about mental health issues.

“I try to be available to listen to my friend when she is feeling sad or has a panic attack. Sometimes we text and she tells me about how she is feeling. She knows she can trust me not to talk to our other friends about what she shares with me and she knows I care about her.” – A.B.

6. Choose Empowerment Over Shame

Having a mental illness does not mean that you can’t live a normal life, have a successful career, get married, or have children. It’s important for anyone with a mental illness to actively participate in their treatment and recovery process. Taking responsibility in this process might mean asking questions about your medication, asking to meet with a psychologist, or even arriving to appointments on time.

“I fight stigma by choosing to live an empowered life. To me, that means owning my life and my story and refusing to allow others to influence how I view myself or how I feel about myself.” – D.I.

7. Be Honest About Treatment

Rwandans are aware of the stigma attached to coming to Ndera Hospital to see a psychologist or psychiatrist and many avoid seeking help because of this stigma. Young people in Rwanda are exposed to many different cultures on the internet, through watching YouTube, and have friends from different countries on Facebook, Instagram and Twitter.  They are more likely than older adults to view help-seeking as a sign of strength and more likely to believe that suicide is preventable. If you are comfortable sharing your mental health experience with someone else, you may be the role model they need to seek help and you may even have saved their life! 

“I fight stigma by saying that I see a therapist and a psychiatrist. Why can people say they have an appointment with their medical doctor without fear of being judged, but this lack of fear does not apply when it comes to mental health professionals?” – Y.N.

8. Be Aware That Movies and Media Frequently Contribute to Stigmatizing Mental Illness

The media and movies often portray people with mental illness as crazy killers, dangerous individuals or criminals. The fact is, the majority of violent crimes and homicides are committed by people who do not have mental health problems. People with mental health problems are more dangerous to themselves than they are to others, as is the case with suicide. The truth is, people with mental health problems come from all backgrounds and socio-economic groups and have much more going on in their lives rather than simply their mental health problem. Depression doesn’t care who you are or how much money you have.

“If I’m with my friends or family watching the news and there is a news story about someone who jumped off a building, I feel bad because most of the time, they will say negative things about the person who died or her family and it seems they don’t understand why these things happen to people. I wish reporters would also tell people who are watching, how to get help if they experience depression. I think they have a social responsibility to try to help people even though they are journalists or reporters.”– R.K.

9. Don’t Allow Self-Stigma to Stop You from Getting Help

The majority of mental illnesses develop during the teenage years, and such mental health conditions can significantly interfere with psychosocial development. However, many adolescents are afraid to tell their parents they need help, or do not know how to help their friends who may be struggling. If you are worried you might have a mental health problem or a problem with addiction to alcohol or drugs, don’t be afraid to ask for professional help. If you notice one of your friends seems different or is withdrawing from other friends, is isolating more than usual, seems sad or quiet most of the time, don’t be judgmental. Try to be supportive and help them find a mental health professional.

“I fight stigma by not having stigma for myself—not hiding from this world in shame, but being a productive member of society. I volunteer at church, have friends, and I’m a peer mentor and a mother. I take my treatment seriously. I want to show others they can live a meaningful life even if they have a mental illness – C.N.