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Reducing stigma and discrimination against older people with mental disorders: a technical consensus statement
- Authors:
- GRAHAM Nori, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(8), August 2003, pp.670-678.
- Publisher:
- Wiley
This technical consensus statement is jointly produced by the Old Age Psychiatry section of the World Psychiatric Association and the World Health Organization, with the collaboration of several NGOs and the participation of experts from different Regions. It is intended to be a tool for: promoting debate at all levels on the stigmatisation of older people with mental disorders; outlining the nature, causes and consequences of this stigmatisation; and promoting and suggesting policies, programmes and actions to combat this stigmatisation.
Stigma and discrimination against older people with mental disorders in Europe
- Author:
- LIMA Carlos A. de Mendonca
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(8), August 2003, pp.679-682.
- Publisher:
- Wiley
The European Office of the World Health Organization (WHO/EURO) has established a Task Force On Destigmatization. Upon the release of the Technical Statement on Old Age Psychiatry Reducing stigma and discrimination against older people with mental disorders, the Task Force run a small survey in two European subregions to investigate the extent of stigma and discrimination with reference to the elderly person affected from a psychiatric disorder in the countries of those subregions. WHO/EURO mental health counterparts completed a short questionnaire inquiring on the inclusion of epidemiological studies on the elderly in their country's research program; the time devoted to the teaching to old age psychiatry during psychiatric residence; the degree of coverage of services for the elderly person and their caregivers; and the extent of stigma present in society with regard to three psychiatric disorders. Stigma and discrimination seem to be present both in the health sector and among the public at large. The development of effective health and social facilities to support older persons with mental disorders should be a high priority of any strategy to reduce stigma and discrimination. These facilities should coordinate their efforts with those of other sectors of society to reach the highest possible impact.
Stigma and disclosure: Implications for coming out of the closet
- Authors:
- CORRIGAN Patrick W., MATTHEWS Alicia K.
- Journal article citation:
- Journal of Mental Health, 12(3), June 2003, pp.235-248.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
There are costs and benefits for people with psychiatric disorders to decide to disclose publicly these disorders. The gay and lesbian community has struggled with the same tension and their discoveries about coming out may prove useful for the disclosure concerns of persons with mental illness. Lessons learned about coming out by the gay and lesbian community include a variety of models that map the stages for successfully coming out; e.g., identity confusion, comparison, identify acceptance, immersion, and identity synthesis. Navigating these stages requires consideration of the costs and benefits of disclosure; we review some of these including social avoidance and disapproval as key costs and improved psychological well-being and interpersonal relations as benefits. The paper ends with a review of levels of disclosure for people who opt to come out.
'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.
A mental health service users perspective to stigmatisation
- Authors:
- GREEN Gill, et al
- Journal article citation:
- Journal of Mental Health, 12(3), June 2003, pp.223-234.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Previous campaigns to combat stigma emphasise the need for people who do not have mental health problems to behave in a non-stigmatising socially inclusive way towards those who do. Less attention has been given to the role of people with mental health problems in the construction of stigma or the impact it has upon them. To enhance services' contribution to supporting their clients in dealing with stigma, this study explores the nature and impact of stigma from the perspective of the lived experience of mental health service users. In-depth interviews were conducted with 27 Caucasian service users. All respondents, whatever their diagnosis, reported being affected by stigma. Fear of stigma was found to be more commonplace (reported by 25 respondents) and more restrictive than overt discrimination (reported by 14 respondents). It is suggested that traditional campaigns that highlight discrimination may have a negative impact on the mentally ill because they highlight the prevalence of hostile attitudes. In so doing the stigmatised stereotype is perpetuated.
Etiological paradigms of depression: the relationship between perceived causes, empowerment, treatment preferences, and stigma
- Authors:
- GOLDSTEIN Benjamin, ROSSELLI Francine
- Journal article citation:
- Journal of Mental Health, 12(6), December 2003, pp.551-563.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
There is a growing trend to view depression as a biological illness rather than a psychosocial condition, even though there is no consensus as to what causes depression. Furthermore, there are mixed data on the impact of advocating the biological model. This study examined public perceptions concerning the etiology of depression as well as the relationship between such perceptions and treatment preferences, empowerment, and stigma. Survey techniques were used to assess how 66 college students view the etiology of depression. Etiology beliefs, as well as demographic data, were regressed upon measures of treatment preference, empowerment, and stigma. Factor analysis produced three distinct models of etiology: biological, psychological, and environmental. Regression analyses showed that endorsement of the biological model was associated with increased empowerment, preference for psychotherapy, and decreased stigma. Endorsing the psychological model was associated with an increased belief that people can help themselves and increased stigma. Endorsing the environmental model was associated with a mixture of positive and negative beliefs concerning depression. Endorsement of each etiological model is associated with both positive and negative consequences. The current public emphasis on viewing depression as biologically based should thus be viewed with some caution.
Interpersonal contact and the stigma of mental illness: a review of the literature
- Authors:
- COUTURE, PENN David L.
- Journal article citation:
- Journal of Mental Health, 12(3), June 2003, pp.291-305.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Stigmatization of mental illness is widespread in Western societies and other cultures. Stigma is detrimental to the well being of persons with mental illness. This can lead to discrimination in housing and employment. It is for these reasons that practitioners have sought methods for reducing stigma. One strategy is increasing interpersonal relations with people with mental illness. This article reviews the literature on the subject.
Reducing psychiatric stigma and discrimination: evaluation of educational interventions in UK secondary schools
- Authors:
- PINFOLD Vanessa, et al
- Journal article citation:
- British Journal of Psychiatry, 182(4), April 2003, pp.342-346.
- Publisher:
- Cambridge University Press
The persistent and disabling nature of psychiatric stigma has led to the establishment of global programmes to challenge the negative stereotypes and discriminatory responses that generate social disability, but these initiatives are rarely evaluated. The purpose of this article was to assess the effectiveness of an intervention with young people aimed at increasing mental health literacy and challenging negative stereotypes associated with severe mental illness. A total of 472 secondary school students attended two mental health awareness workshops and completed pre- and post-questionnaires detailing knowledge, attitudes and behavioural intentions. Young people use an extensive vocabulary of 270 different words and phrases to describe people with mental health problems: most were derogatory terms. Mean positive attitude scores rose significantly from 1.2 at baseline to 2.8 at 1-week follow-up and 2.3 at a 6-month follow-up. Changes were most marked for female students and those reporting personal contact with people with mental illness. Short educational workshops can produce positive changes in participants' reported attitudes towards people with mental health problems.