A groundbreaking new analysis has brought careful attention to a critical but often misunderstood topic: the very different types of stigma surrounding mental health, and how failing to distinguish between them can undermine anti-stigma efforts worldwide—including those in Thailand. As mental health takes center stage during Thailand’s post-pandemic recovery, this research holds urgent lessons for policymakers, care providers, and ordinary citizens.
Stigma remains one of the most persistent barriers to effective mental health care. The latest insights, as reported in STAT News, explain that “mental health stigma” is not a single problem, but rather a pair of related but distinct social responses—each with unique consequences. The article draws upon international data and personal testimonies to shed light on how societies, including Thailand, routinely conflate two very different stigmas: one tied to psychotic disorders such as schizophrenia, and another linked to common, nonpsychotic disorders like depression and anxiety.
In practical terms, this distinction matters for Thai readers because it reveals why so many mental health campaigns fall short. Efforts that lump all mental illness together may miss the mark, leaving people isolated or misunderstood, and may slow progress against an escalating mental health crisis. Mental disorders represent one of the largest contributors to years lived with disability globally, and in Thailand, mental health-related hospitalizations and suicide rates have been climbing since the pandemic era, according to the Department of Mental Health, Ministry of Public Health.
The article’s central argument is rooted in lived experience. A physician, reflecting on his time as the sole medical provider in a rural town, detailed how his own depression was kept secret out of fear of community disapproval. He deliberately sought treatment far from home to avoid being recognized. This account, while set in the West, parallels experiences in rural Thailand, where robust social networks can be a source of support but also of stigma-driven secrecy. “By internalizing the prevailing stigma against mental illness, I was discriminating against myself,” he observed. This phenomenon, known as ‘self-stigma’, is common globally and in Thailand, where shame and loss of face deter many from seeking help.
Crucially, the research differentiates two primary types of stigma:
Psychosis-Linked Stigma: Disorders such as schizophrenia evoke reactions rooted in fear and mistrust, with the public often suspecting those affected to be violent or unpredictable. Media coverage of violent incidents sometimes exacerbates these perceptions. But the reality is quite different: Only a minority of those with psychotic disorders exhibit violence, and they are statistically more likely to be victims than perpetrators, according to peer-reviewed research. In Thailand, as elsewhere, such stigma can result in social exclusion, inappropriate institutionalization, and obstacles in accessing community-based care. Despite some progress, a 2019 survey by the Thai Department of Mental Health found that over half the population believed people with schizophrenia “could not be trusted.”
Stigma Around Depression and Anxiety: More common mental conditions—such as depression—elicit a different, if equally damaging, response. Here, the public often conflates normal emotional reactions to life’s ups and downs with clinical disorders. As a result, people with these illnesses are not so much feared as judged: perceived as weak or lacking resilience. The STAT News article cites data from Singapore where 50.8% of respondents see depression as a sign of personal weakness, and similar attitudes are found across Asia, including Thailand. This mindset leads to the suggestion that those with depression simply “snap out of it” or “try harder”—destructive advice which ignores the biological and psychological realities of the illness.
Expert voices add weight to these concerns. A senior scientist at Johns Hopkins University’s Department of Mental Health, with experience implementing service programs in over 25 countries, highlighted that “both types of stigma hold us back from addressing mental health as a major global health and social issue.” Available statistics are sobering: Half the global population will develop some form of mental illness in their lifetime, and mental illnesses cause one-third of all disability. In 2023, more people died by suicide (740,000) than from HIV or malaria.
In the Thai setting, the issue is further complicated by cultural factors. Buddhism, practiced by the majority, often promotes compassion and non-judgement but can also be associated with karma-based explanations of illness, which may subtly reinforce the view that those struggling with mental health problems are reaping the consequences of past actions or insufficient spiritual merit. A 2022 qualitative study by researchers at Chulalongkorn University found that older Thai adults viewed mental illness as a sign of family or personal failing, while younger Thais are more likely to frame it in medical or psychological terms—a generational gap that shapes how stigma is experienced and resisted.
Understanding the nuances of stigma is vital for designing effective support. The research points out that anti-stigma campaigns should be tailored to the specific type of stigma they’re targeting:
For psychotic disorders, the focus must be on countering myths about violence and promoting the reality that with treatment, most people can live stable, productive lives. For example, Thailand’s recent pilot programmes for community-based psychiatric care, endorsed by the Ministry of Public Health, have shown promise but are sometimes undermined by local resistance rooted in fear. Introducing community ambassadors who have successfully managed psychotic illnesses can help humanize these conditions and dispel misinformation.
In the case of depression and anxiety, messaging must center not on danger, but on challenging the idea that these are simply matters of personal strength or willpower. Highlighting stories of well-known individuals, including public figures and celebrities, who have experienced and recovered from depression can help dismantle stereotypes. The success of international figures such as Olympic swimmer Michael Phelps—who has spoken about his own experiences with depression—suggests this approach resonates across cultures. In 2023, a prominent Thai actress disclosed her struggle with depression; public reaction was overwhelmingly supportive, signaling that attitudes are slowly changing.
Evidence-based recommendations from the latest analysis include targeting three groups: youth, who are developing beliefs about mental health; employers, who can shape workplace culture and policies; and government bodies, which set the legislative landscape. In Thailand, youth engagement has grown through university mental health clubs and online communities. However, workplace mental health remains under-addressed: a 2024 survey by the Thai Chamber of Commerce revealed that less than 10% of employers offer mental health benefits or training, despite a growing awareness of stress and burnout.
The article further advocates for “social exposure” as an anti-stigma tool: Direct, positive interaction with people who have mental illness—whether in community settings, schools, or workplaces—consistently reduces prejudice and fear. In Thailand, this principle is behind the recent introduction of peer support programs in psychiatric wards and the increasing visibility of people with lived experience at national health forums.
Importantly, the research underscores the dangers of focusing only on one type of stigma. Overlooking the “weakness” stereotype associated with common disorders can entrench discrimination and limit investment in services. Conversely, neglecting fear and mistrust associated with psychosis leaves policy and public opinion unchanged where it matters most. For Thailand, where mental health budgets remain a small percentage of total health spending and media portrayals of mental illness often skew negative, a two-pronged approach is urgently needed.
Going forward, what practical steps can Thailand take? First, public health campaigns—like the “You Are Not Alone” initiative—should explicitly distinguish between stigma based on fear versus that based on perceptions of weakness. Messages should be tailored, with data-backed references to Thailand’s unique social fabric and the Buddhist ethic of compassion. Second, policymakers and educators can integrate mental health literacy, including lessons on stigma, into curricula from an early age—a practice shown internationally to decrease prejudice. Third, Thai businesses should be incentivized to adopt mental health-friendly practices, reducing barriers for workers facing stress, anxiety, or depression.
Above all, family members, teachers, and community leaders play a critical role. Open conversation and compassionate support can counteract both types of stigma, paving the way for those in need to seek help early. Highlighting success stories, both public and private, reinforces the message that recovery is possible—and that neither fear nor blame should define Thailand’s collective response to mental health.
For readers, the most immediate action is to seek further understanding: Learn about the differences between types of mental illness, challenge your own preconceptions, and consider how you respond when someone shares their struggles. If stigma is to be defeated in Thailand, change begins with the attitudes and small decisions of everyday people—at home, at work, in the temple, and beyond.
For more information on mental health support services, readers can consult local health centers, the Department of Mental Health’s official website, or online resources such as the Thai Mental Health Hotline (1323), which provides confidential advice and referrals.
Sources: STAT News, Department of Mental Health, Ministry of Public Health, WHO Mental Health Key Facts, NCBI - Violence and Mental Illness, Thai Chamber of Commerce, Chulalongkorn University studies.