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How do people with eating disorders experience the stigma associated with their condition? A mixed-methods systematic review
- Authors:
- O'CONNOR Cliodhna, et al
- Journal article citation:
- Journal of Mental Health, 30(4), 2021, pp.454-469.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Public opinion research shows that eating disorders (EDs) are a major target of stigmatisation. To understand the implications of this stigma, research investigating how stigma is experienced by individuals with EDs is critical. Aim: This paper aims to collate, evaluate and synthesise the extant empirical research illuminating how people with EDs experience the stigma associated with their condition. Method: A systematic mixed-methods literature search was performed. Articles that met a specified set of inclusion criteria underwent a quality assessment and thematic synthesis. Results: Twenty-nine articles were included in the review. Studies were mostly qualitative and of reasonable methodological quality. The literature was characterised by five research themes, illuminating (i) the nature and prevalence of stigma experienced, (ii) stigma in families, (iii) stigma in healthcare contexts, (iv) self-stigmatisation and illness concealment, and (v) stigma resistance. Conclusions: The reviewed research showed that people with EDs have extensive experience of stigma in diverse settings. They report that stigma has negative implications for their psychological wellbeing and likelihood of help-seeking. However, research also shows that people with EDs actively seek to resist and challenge stigma. The review identifies the outstanding gaps and weaknesses in this literature. (Edited publisher abstract)
“You don’t have anorexia, you just want to look like a celebrity”: perceived stigma in individuals with anorexia nervosa
- Authors:
- DIMITROPOULOS Gina, et al
- Journal article citation:
- Journal of Mental Health, 25(1), 2016, pp.47-54.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Minimal research has been conducted on how individuals with Anorexia nervosa (AN) undergoing treatment perceive public stigma. Aim: Explore how affected individuals with AN believe the general public perceives AN. Method: Using thematic analysis, 19 participants with AN were interviewed at the beginning of treatment. Results: Three interrelated themes were ascertained: (1) AN is not an illness; (2) eating disorder behaviours are volitional and the public endorses a socio-cultural explanation for the disorder; 3) affected individuals delay disclosing their illness and experience shame engaging in intensive treatment for AN as a result of their perception of stigma. Conclusions: Individuals with AN viewed the public as trivializing AN by viewing behaviours as within their control and by attributing eating disorder behaviours solely to socio-cultural factors. Participants believed that the public minimizes the challenges associated with treatment. Findings suggest that clinical interventions targeting stigma are required to counteract perceptions held by service users regarding how others view their illness. “Mental health literacy” interventions are needed for health professionals working with high risk groups likely to avoid seeking help due to fears of stigmatisation. (Publisher abstract)
Exploring barriers to South Asian help-seeking for eating disorders
- Authors:
- WALES Jackie, et al
- Journal article citation:
- Mental Health Review Journal, 22(1), 2017, pp.40-50.
- Publisher:
- Emerald
Purpose: Referrals to specialist eating disorder (ED) services from the South Asian (SA) community are under-represented, despite research suggesting that disordered eating attitudes and behaviours of SA people are similar to the population in general. The purpose of this paper is to identify the reasons for this and sought to inform ways to encourage help-seeking. Design/methodology/approach: A qualitative methodology was used to investigate barriers to help-seeking for EDs among the SA community. A key informant focus group was conducted with clinicians working within the local specialist ED service (participants n=16, 12 female, 4 male). Six focus groups were conducted with members of the SA community in Leicester, UK (participants n=28, 23 female, 5 male), recruited from a local university, two charities and Children, Young People and Family Centres. Findings: A number of themes emerged as possible factors for delaying early access to help: lack of knowledge about EDs and their potential seriousness, ideals regarding body shape, family living circumstances and the role of food in the community. Participants acknowledged stigma among their community associated with mental health issues, including EDs and concerns about confidentiality when approaching services, particularly primary care. Originality/value: General practitioners and specialist services need to be aware of the potential barriers to help-seeking for EDs as early specialist help is recommended for effective treatment. An educational campaign around EDs specifically designed with the SA community in mind may improve awareness, reduce stigma and promote early help-seeking. (Edited publisher abstract)
The College’s Anti-Stigma Campaign, 1998-2003: a shortened version of the concluding report
- Authors:
- CRISP Arthur, COWEN Liz, HART Deborah
- Journal article citation:
- Psychiatric Bulletin, 28(4), April 2004, pp.133-136.
- Publisher:
- Royal College of Psychiatrists
In autumn 1996, under the Presidency of Dr Robert Kendell, the College decided to mount a campaign to tackle the stigmatisation of people with mental illnesses. In 1997, a working party proposed goals, content, process and a 5-year governance. Other campaigns, both here and abroad, have either generically addressed ‘mental health problems’ (e.g. Mind’s ‘Respect’ Campaign) or targeted a specific mental illness, e.g. the World Psychiatric Association’s anti-stigma campaign in respect of people with schizophrenia. Our working party decided that it might be timely to recognise the differences in public attitudes to the variety of mental illnesses. The campaign thus addressed six categories of mental illness: anxiety disorders, depressive disorders, schizophrenia, the dementias, eating disorders, and drug and alcohol misuse/addiction. Target populations were identified as doctors, children and adolescents, the workplace, the media and the general public. The working party had also secured funding and arranged for a survey, in July 1998, by the Office for National Statistics of opinions of the British public concerning people with these mental illnesses. The Campaign started on 7 October 1998. Since that time, and drawing upon our survey findings within its initial literature review the Department of Health mounted its own anti-stigma campaign, ‘Mind Out for Mental Health’, which addressed a similar range of mental illnesses.