Definition: Stigma
Stigma is the discrediting, devaluing, and shaming of a person because of characteristics or attributes that they possess.55Types of stigma experienced by patients with mental illness and mental health nurses in Indonesia: a qualitative content analysis | International Journal of Mental Health Systems | Full Text (biomedcentral.com)
Stigma can lead to negative social experiences such as:
Isolation
Having limited contact with other people, your community, or your society more broadly.
Discrimination
Being treated unfairly because of who you are or because you have certain characteristics.
Rejection
Being deliberately excluded from relationships or interactions.
Marginalisation
Being treated as if you are not important and have no influence.
Stigma can affect a person’s access to appropriate and professional medical treatment, if it relates to a health condition. Stigma can affect a person’s family and friends, and is strongly influenced by cultural and contextual value systems that change over time and across contexts.
People experiencing homelessness face discrimination and exclusion as a result of their housing status. This is reflected in their interactions with the communities they live in, local authorities, law enforcement, and even the health care system.56Stigma & Social Isolation | IGH Hub
Similarly, gambling harm is highly stigmatised. In part, this is because gambling is more often seen as within a person’s control or choice than other harmful products like tobacco or drugs.57Gambling Disorder and Stigma: Opportunities for Treatment and Prevention - PMC (nih.gov) However, we know that like other harmful products, individual factors only make up one piece of the puzzle – a person’s life circumstances and the society they live in play a significant role in the development of gambling harm.
While homelessness can be relatively visible, gambling can often be hidden from sight as people may have access to gambling on a mobile device without showing any obvious signs of gambling-specific harm.
Grappone (2017) identified seven key forms of stigma in relation to mental health.59https://www.nami.org/Blogs/NAMI-Blog/October-2018/Overcoming-Stigma We have adapted these to illustrate how stigma can impact on people experiencing harm from their gambling:60GREO (2019) Evidence brief Stigma and gambling.pdf
Public Stigma
When society reacts negatively towards individuals experiencing harm from their gambling, based on negative beliefs and attitudes.
Results in stereotypes, labelling, discrimination, and prejudice.
For example, when a newspaper describes people experiencing gambling harm as “selfish” or “irresponsible”.
Perceived Stigma
When people experiencing harm from their gambling are aware of the negative beliefs and attitudes others have about gambling harms.
Results in fears of being discriminated against, and decreases help-seeking behaviours.
For example, when someone is experiencing gambling harms they think that no one would employ them because they are not trustworthy.
Self-Stigma
When someone experiencing harm from their gambling internalises negative public stereotypes about themselves.
Results in feelings of shame, guilt, worthlessness, and reluctance to seek help.
For example, someone experiencing gambling harm is reluctant to seek help because they think they should be able to just stop gambling.
Label Avoidance
When a person chooses not to seek support for their gambling to avoid being assigned a stigmatising label.
Results in lack of support for people experiencing harm, and social isolation.
For example, when a person experiencing gambling harm does not seek support because they are afraid of being labelled ‘problem gambler’.
Stigma by Association
When the effects of stigma are extended to someone linked to a person experiencing gambling difficulties.
Results in social ostracism, loss of support networks and resources.
For example, a partner of someone who has been experiencing gambling harm does not reach out for support as they are afraid of what their peers and support network might say.
Structural Stigma
Institutional policies or other societal structures that result in decreased opportunities for people experiencing harm from their gambling.
For example, if an organisation, does not offer support or signposting for those experiencing gambling harm, depsite providing support for other mental health conditions
Health and Social Practitioner Stigma
Any time a health professional allows stereotypes and prejudices about gambling harm to negatively affect a patient’s care.
Results in loss of trust, fewer referrals to existing support, and reluctance to seek help in future.
For example, when a GP is informed a patient is experiencing harm from gambling, but decides not to provide support or signposting and focus on ‘more important’ conditions first.