Search results for ‘Subject term:"mental health problems"’ Sort:
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Queen of the owls: metaphor and identity in psychiatric diagnosis
- Author:
- PROBST Barbara
- Journal article citation:
- Social Work in Mental Health, 13(3), 2015, pp.235-251.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Clinical social workers’ commitment to social justice makes them acutely concerned about discrimination and dis-empowerment, and thus they are sensitive to the impact of stigma on persons diagnosed with a mental disorder. At the same time, it is important to explore whether clinicians’ assumptions about psychiatric diagnoses as stigmatizing mesh with the views and experiences of those who actually receive and live with these diagnoses. To address this question, in-depth interviews were conducted with 30 individuals carrying a range of psychiatric diagnoses. Narrative and thematic analysis yielded several distinct narratives about living with a mental health label. For many participants, diagnosis brought validation; to be "named" was to be welcomed into one’s tribe. For others, diagnosis meant reduction and mistranslation. Findings raise questions about the assumption that diagnostic labels necessarily bring shame and/or loss of self-efficacy. Without minimizing the impact of stigma, clinicians need to remain open to discovering how each client finds meaning in the diagnostic experience. Based on participants’ use of deeply personal images, metaphor is proposed as a creative means for re-claiming identity. Implications for practice and further research are suggested. (Edited publisher abstract)
New perspectives and approaches to understanding dementia and stigma: a compendium of essays
- Editors:
- BAMFORD Sally-Marie, HOLLEY-MOORE George, WATSON Jessica
- Publisher:
- International Longevity Centre UK
- Publication year:
- 2014
- Pagination:
- 62
- Place of publication:
- London
Examines the social stigma which surrounds dementia, highlighting that stigma is impeding early diagnosis, care and research into the disease. The report, published by the International Longevity Centre UK (ILC-UK) in collaboration with the MRC, Alzheimer’s Research UK, Alzheimer’s Society and supported by the drug company Pfizer, discusses the impact the fear around dementia has on those living with the condition, their families and carers, which prevents the research community from capturing a full picture of the disease. According to data in the report, people over the age of 55 fear being diagnosed with dementia more than any other condition and at least 1 in 4 people hide their diagnosis, citing stigma as the reason. The issue of stigma is widely acknowledged as a serious challenge for people with dementia and their carers at the individual, family and societal level, and serves as a barrier to access care, support and treatment. The report considers the causes of stigma and explore this from a multidisciplinary perspective. After holding a high level discussion in the House of Lords, the themes that emerged were explored in this compendium, with contributions from across academia, the public and private sector and the voluntary sector. (Edited publisher abstract)
DSM-V and the stigma of mental illness
- Authors:
- BEN-ZEEV Dror, YOUNG Michael A., CORRIGAN Patrick W.
- Journal article citation:
- Journal of Mental Health, 19(4), August 2010, pp.318-327.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The relationship between diagnostic labels and stigma is examined in the context of the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Three types of negative outcome are considered in detail: public stigma, the phenomenon of large social groups endorsing stereotypes about, and subsequently acting against a stigmatised group; self stigma, the loss of self-esteem and self-efficacy that occurs when people internalise public stigma; and label avoidance, when sufferers do not seek out or participate in mental health services in order to avoid the impact of a stigmatised label. The authors illustrate how a clinical diagnosis may exacerbate these forms of stigma through socio-cognitive processes of groupness, homogeneity and stability. Initial draft revisions recently proposed by the DSM-V work groups are briefly discussed from the framework of mental illness stigma. The authors believe that the initial drafts of DSM-V show a trend of greater transparency and movement toward more dimensional approaches to diagnosis which may help reduce stigma in the future, but also include several proposals that may have a negative impact on stigma.
How does diagnostic labelling affect social responses to people with mental illness? A systematic review of experimental studies using vignette-based designs
- Authors:
- O'CONNOR Cliodhna, et al
- Journal article citation:
- Journal of Mental Health, 31(1), 2022, pp.115-130.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: An outstanding question in the stigma literature is the extent to which negative responses are provoked by diagnostic labels, rather than observable symptoms of mental illness. Experimental studies frequently use vignettes to identify the unique effects of diagnostic labels on social responses to people with mental illness, independent of their behaviour or socio-demographic characteristics. Aims: The current article identifies, evaluates, and synthesises the body of experimental vignette studies of labelling effects. Methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were subjected to quality evaluation and narrative synthesis. Results: Of 1511 articles screened, 22 met inclusion criteria. Most studies focused on the diagnostic categories of attention deficit hyperactivity disorder, schizophrenia spectrum disorders, and autism spectrum disorder. The literature reported diverse effects, with diagnostic disclosure either exacerbating, mitigating, or not affecting stigma. The quality of studies was generally acceptable but the review identified an over-reliance on convenience sampling and unvalidated measures. Conclusions: Results highlight the complexity of labelling effects, which diverge across diagnostic categories and social contexts. The review emphasises the need for expansion of diagnostic labels and contexts studied, standardisation of validated attitude scales, incorporation of behavioural outcomes, and diversification of samples. (Edited publisher abstract)
Personal consequences of the diagnosis of schizophrenia: a preliminary report from the inquiry into the schizophrenia label
- Authors:
- THOMAS Philip, et al
- Journal article citation:
- Mental Health and Social Inclusion, 17(3), 2013, pp.135-139.
- Publisher:
- Emerald
Purpose – The purpose of this survey was to describe the impact of the diagnosis of schizophrenia on the lives of people who receive the diagnosis. Design/methodology/approach – The authors designed a questionnaire to investigate attitudes to and experiences of the diagnosis of schizophrenia. After a pilot study, they made the questionnaire available online and, through a network of service user and other organisations, solicited responses. Findings – Of the 470 responses, 27.4 per cent were from service users. Content analysis of their responses revealed three main categories: concern with the consequences of the diagnosis and its negative impact on their lives, the life contexts of individuals before receiving the diagnosis, and concerns with medication and treatment. This paper deals with the first two. Research limitations/implications – It is impossible to generalise the results of this survey because respondents self-selected, and thus might be expected to have strong feelings against (or for) the diagnosis of schizophrenia. Practical implications – The diagnosis of schizophrenia in this sample had devastating negative implications. It was experienced as harmful and stigmatising. Very few people understood their experiences as a biomedical disorder. Social implications – A gulf exists between the experiences of people diagnosed with schizophrenia and the concerns of academics and others currently involved in debates about the merits of different systems of diagnosis. Originality/value – This survey is valuable because it draws attention to experiences of diagnosis that are easily lost in the storm of academic controversies about diagnosis in psychiatry. (Publisher abstract)
Unchaining Prometheus: does a caste allocation hypothesis begin to explain the pervasive effects of diagnostic labelling and stigma on service users?
- Author:
- COOTE David
- Journal article citation:
- Ethnicity and Inequalities in Health and Social Care, 2(2), July 2009, pp.20-29.
- Publisher:
- Emerald
Diagnostic labelling has been seen to be a predictor of several different negative outcomes. This review draws on the claims of Wright and colleagues' that the ‘labelling’ field needs theoretical development. By comparing and contrasting the two main approaches to understanding diagnostic practices, Modified Labelling Theory and the medical model the authors further hypothesise on the social function of diagnostic practices. The focus of this review is on four conceptual books and articles. Three empirical studies are also reviewed. Then models are advanced that explain the conceptual overlap that occurs within the debate.
Factors affecting timely recognition and diagnosis of dementia across Europe: from awareness to stigma
- Authors:
- VERNOOIJ-DASSEN Myrra J. F. J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(4), April 2005, pp.377-386.
- Publisher:
- Wiley
Timely recognition and diagnosis of dementia is the pre-condition for improving dementia care, but diagnosis often occurs late in the disease process. The aim was to compare facilitators and obstacles to the timely recognition of dementia across eight European Union states, in order to implement established policies for earlier diagnosis. Twenty-three participants from different disciplines, purposively sampled for professional expertise in dementia research and innovative practice, attended two focus groups. Stigma in ageing and dementia, accompanied by a sense that there is little to offer until later on in the disease, underpinned the widespread reluctance of GPs to recognise dementia at an early stage and were major obstacles to the timely diagnosis of dementia across all eight countries. Dementia care services varied widely across Europe. Countries with the greatest development of dementia health care services were characterised by national guidelines, GPs fulfilling a gatekeeper function, multi-disciplinary memory clinics and innovative programmes that stimulated practice and new services. Dementia-related stigma was perceived as being less prominent in these countries. Overcome of delays in the timely diagnosis of dementia needs more than specialist services. They should address the processes associated with stigma, age and dementia, especially where these relate to physician practice and diagnostic disclosure. Stigma is perceived as variable across European States, with a promising finding that its impact is relatively small in countries with the widest range of dementia care services.
‘You don’t bring me flowers any more’: an investigation into the experience of stigma by psychiatric in-patients
- Authors:
- BROMLEY Joanna S., CUNNINGHAM Sara J.
- Journal article citation:
- Psychiatric Bulletin, 28(10), October 2004, pp.371-374.
- Publisher:
- Royal College of Psychiatrists
A structured interview-based questionnaire was used to measure the number of cards and gifts received by 40 people undergoing psychiatric in-patient treatment, compared with an age- and gender-matched group of medical in-patients. The study also assessed the amount of disclosure of admission and diagnosis to family and friends in the two groups. The psychiatric patients received about half as many cards as the medical patients (60 v. 112). Gifts to the psychiatric patients were often practical in nature and seldom included luxury items such as flowers. Disclosure of admission for mental illness (compared with the physical illness group) was significantly lower, both to family members (139 v. 193, P=0.041) and friends (74 v. 332, P=0.0001). The stigma of mental illness is reflected in the secrecy surrounding disclosure of hospital admission and the lack of tokens of support. Clinicians should be aware of the resulting sense of isolation and shame, and the consequences for mental health in view of reduced social networks increasing the risk of future relapse rates. Reduced contact with mentally ill patients has implications for society as a whole in maintaining the status quo of stigma.
'People don't understand': an investigation of stigma in schizophrenia using interpretative phenomenological analysis (IPA)
- Authors:
- KNIGHT Matthew T. D., WYKES Til, HAYWARD Peter
- Journal article citation:
- Journal of Mental Health, 12(3), June 2003, pp.209-222.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Recent investigations provide evidence of stigma against people with a diagnosis of mental illness. The purpose of this study was to provide an account of the life experiences of persons with schizophrenia. Focusing on the individuals' personal reports of events and situations, the issues of stigmatisation and discrimination were explored. Six participants were interviewed using a semi-structured schedule focusing on the areas of personal history, understanding of schizophrenia, social and medical contextualisation, and reflection on impact. The research was conducted using Interpretative Phenomenological Analysis (IPA). Super-ordinate themes of judgement, comparison, and personal understanding of the (mental health) issue emerged. Stigma was evident both as public-stigma and as self-stigma. The ramifications of stigma and discrimination are enduring and potentially disabling. IPA is a constructive tool in exploring these issues.
Stigma: the feelings and experiences of 46 people with mental illness: qualitative study
- Authors:
- DINOS Sokratis, et al
- Journal article citation:
- British Journal of Psychiatry, 184(2), February 2004, pp.176-181.
- Publisher:
- Cambridge University Press
Stigma defines people in terms of some distinguishing characteristic and devalues them as a consequence. The aim was to describe the relationship of stigma with mental illness, psychiatric diagnosis, treatment and its consequences of stigma for the individual. Narrative interviews were conducted by trained users of the local mental health services; 46 patients were recruited from community and day mental health services in North London. Stigma was a pervasive concern to almost all participants. People with psychosis or drug dependence were most likely to report feelings and experiences of stigma and were most affected by them. Those with depression, anxiety and personality disorders were more affected by patronising attitudes and feelings of stigma even if they had not experienced any overt discrimination. However, experiences were not universally negative. Stigma may influence how a psychiatric diagnosis is accepted, whether treatment will be adhered to and how people with mental illness function in the world. However, perceptions of mental illness and diagnoses can be helpful and non-stigmatising for some patients.