The relationship of multiple aspects of stigma and personal contact with someone hospitalized for mental illness, in a nationally representative sample

Effects of labeling and interpersonal contact upon attitudes towards schizophrenia: implications for reducing mental illness stigma in urban China

PURPOSE

As mental illness stigma contributes to poor outcomes for schizophrenia in China, locating strategies to reduce public stigma is imperative. It is currently unknown whether diagnostic labeling and contact with different help-seeking sources increase or decrease public stigma in China. Further, it remains unresolved whether prior personal contact acts to reduce stigma in this context. Advancing understanding of these processes may facilitate stigma-reduction strategies.

METHODS

We administered an experimental vignette randomly assigning one of four labeling conditions to respondents to assess social distance towards a psychotic vignette individual in a sample of 160 Northern, urban Chinese community respondents.

RESULTS

As expected, respondents given a "non-psychiatric, indigenous label" + "lay help-seeking" condition endorsed the least social distance. Unexpectedly, the labeling condition with a "psychiatric diagnostic label" + "lay help-seeking" condition elicited the greatest social distance. Unlike Western studies, personal contact did not independently decrease community stigma. However, prior contact reduced social distance to a greater extent in the labeling condition with a "non-psychiatric, indigenous label" + "lay help-seeking" condition when compared with all other labeling conditions.

CONCLUSION

The results indicate that cultural idioms do provide some protection from stigma, but only among respondents who are already familiar with what mental illness is. Our finding that the condition that depicted untreated psychosis elicited the greatest amount of stigma, while the "treated psychosis" condition was viewed relatively benignly in China, suggests that improved access to mental health services in urban China has the potential to decrease public stigma via labeling mechanisms.

Mental health consumers and caregivers as instructors for health professional students: a qualitative study

PURPOSE

The purpose of this study was to explore the self-reported effect of consumer and caregiver-led education for pharmacy students and to explore the goals, challenges and benefits of mental health consumer educators providing education to health professional students.

METHODS

Five focus groups (mean duration 46 min, SD 22 min) were held with 23 participants (11 undergraduate pharmacy students, 12 mental health consumer educators) using semi-structured interview guides. The focus groups were digitally audio-recorded, transcribed verbatim and thematically content analyzed using a constant comparison approach.

RESULTS

Three major themes emerged from the data; raising awareness about mental health, impact on professional practice and impact on mental health consumers. The students reported decreased stigma, improved attitudes toward mental illness and behavior changes in their professional practice. The primary reason for becoming an educator was to raise awareness and reduce mental health stigma. However, educators also benefited personally through empowerment, improved confidence and social skills.

CONCLUSION

Providing students the opportunity to have contact with consumers with a mental illness in a safe, educational setting led to decreases in stigma, the fostering of empathy and self-reported behavior changes in practice. Sharing personal stories about mental illness is a powerful tool to decrease mental health stigma and may be an important aspect of a person's recovery from mental illness. Contact with mental health consumers in an educational setting is recommended, particularly for future health care professionals. Appropriate training and support of consumers is crucial to ensure the experience is positive for all involved.

Mental Health Illiteracy? Perceiving Depression as a Disorder

World Health Organization statistics reveal that depression is not only one of the leading causes of disability in the world today but it is an illness on the rise. I review research into public attitudes to depression and the effectiveness of recent education campaigns. I contend that while there appears to be evidence that depression is met with serious and persistent stigma, there is a dearth of research in this area. In this article, I forward an explanation for how we might understand the apparent persistence of, and some of the stigmatizing responses to, depression; I term this hypothesis the “Cheater-Detection Model of Depression Stigmatisation” (CDMD). This article proposes that certain behavioral traits associated with depression (specifically: fatigue, cognitive and motor retardation, occupational impairment) may be detected (erroneously) via a specific suite of cognitive mechanisms which were selected for their capacity to gauge cooperation and social exchange among individuals. I argue that the symptoms of depressive behavior which interfere with social and occupational capacities may trigger responses which were selected for in order to avoid exploitation by “cheaters” (that is to say, individuals who are perceived to benefit from social exchange but who are not judged to reciprocate). Evolutionary psychology informs us that perception of cheating behavior tends to elicit affective responses such as anger and avoidance: I argue that some symptoms of depression tend to induce “false-positive” stigmatizing responses. I conclude that until we understand the cognition underlying stigmatization we cannot expect to target it effectively.

Mental illness stigma among nurses in psychiatric wards of teaching hospitals in the north-west of Iran

BACKGROUND

Stigma is one of the obstacles in the treatment and regaining the mental health of people with mental illness. The aim was determination of mental illness stigma among nurses in psychiatric wards. This study was conducted in psychiatric wards of teaching hospitals in Tabriz, Urmia, and Ardabil in the north-west of Iran.

MATERIALS AND METHODS

This research is a descriptive analysis study in which 80 nurses participated. A researcher-made questionnaire was used, which measured demographic characteristics and mental illness stigma in the three components of cognitive, emotional, and behavioral. All data were analyzed using SPSS13 software and descriptive and analytical statistics.

RESULTS

Majority of nurses (72.5%) had medium level of stigma toward people with mental illness. About half of them (48.8%) had great inclination toward the social isolation of patients. The majority of them (62.5%) had positive emotional responses and 27.5% had stereotypical views. There was a significant correlation between experience of living with and kinship of nurses to person with mental illness, with prejudice toward and discrimination of patients. There was also a significant correlation between interest in the continuation of work in the psychiatric ward and prejudice, and also between educational degree and stereotypical views.

CONCLUSIONS

The data suggest there is a close correlation between the personal experience of nurses and existence of mental illness stigma among them. Therefore, the implementation of constant educational programs on mental illness for nurses and opportunities for them to have direct contact with treated patients is suggested.

The vicious circle of perceived stigmatization, depressiveness, anxiety, and low quality of life in substituted heroin addicts

BACKGROUND

Perceived stigmatization of drug addicts may interact with negative mood states and thus may contribute to the maintenance of addictive behavior.

METHODS

Opiate maintenance patients (n = 106) and an unselected comparison group (n = 144) rated self-report questionnaires about perceived stigmatization, quality of life (QoL), depressiveness, anxiety, self-esteem, addiction characteristics, and social support.

RESULTS

63% of opiate maintenance patients felt discriminated in contrast to 16% of the comparison group. Perceived stigmatization was rated higher by opiate maintenance patients, and all domains of QoL were rated lower, even when statistically controlling depressiveness, anxiety and social factors. Perceived stigmatization was correlated to depressiveness, anxiety, low self-esteem and low QoL, but not addiction characteristics and social support. Structural equation models revealed anxiety and the pathway depressiveness enhancing feelings of being stigmatized resulting in low self-esteem to explain 74% of variance in mental QoL, whereas anxiety and a pathway stigmatization inducing depressiveness leading to low self-esteem explained 49% of variance in physical QoL.

CONCLUSIONS

A vicious circle of stigmatization, negative affective states and low QoL was confirmed. In addition to societal antistigma campaigns, antidepressive and anxiolytic therapy might have the potential to diminish feelings of being stigmatized and to improve QoL.