Stigma a barrier to wellness and the counselling process : an ecological approach to familiarity and proximity

Abstract

Background: Wellness refers to a holistic concept of health and has become a major philosophical foundation of the counselling profession. Unlike other mental health professions, counselling takes a predominantly strengths-based approach to practice. Counselling aims to provide a positive environment where individuals, families and groups can grow and develop in accordance with their strengths and capabilities. Unfortunately the counselling profession only has the capacity to work with individuals who present for treatment. Previous research suggests that one of the major barriers to the counselling process is mental health related stigma. Methods: This study utilised an ecological systems perspective to gain a clearer understanding of familiarity and social proximity as they relate to perceived social and internalised stigma within a Maltese context. A web-based questionnaire was utilised to assess levels of stigma among a university population (N = 294) in Malta. Data was analysed using standardised statistical techniques including descriptive and inferential statistics. Results: Analysis of the data revealed that the majority of respondents exhibited high levels of perceived social stigma along with moderate to low levels of internalised stigma. Significantly higher levels of internalised stigma were associated with negative perceptions of mental health. Lower contact and exposure to mental health related concerns was reported among the 17- 25 age group. Higher levels of perceived social stigma were associated with biproxy experience with mental health service utilisation. Lower levels of internalised stigma were associated with higher levels of exposure and contact with mental health issues. Finally, increased perceived social stigma was associated with increased internalised stigma. Conclusion: The present study offers some insight into mental health stigma in Malta. This study recovered remarkably high levels of perceived social stigma. In light of this, as a wellness driven entity counselling needs to promote mental health, provide education to enhance knowledge about the importance of mental health and to work at an advocacy level to reduce the impact that stigma has within society.