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Trani JF, Yen BJ, Duncan A, Bakhshi P, Palmo T, Jadhav S, Deshpande S. People with mental illness stigmatize mental illness less: A comparison study between a hospital-based sample of people with mental illness and a non-clinical general population sample in urban India. Transcult Psychiatry 2023; 60:954-972. [PMID: 37551092 DOI: 10.1177/13634615231179265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Evidence shows that stigma negatively influences the quality of life of persons with severe mental illness. Nonetheless, stigma towards mental illness is lower among persons with a lived experience of mental illness compared to the rest of the population. Understanding the association between stigma of mental illness and the mental status of individuals living in urban India and whether this association is moderated by demographic factors opens a new avenue for prevention of social exclusion. Persons diagnosed with schizophrenia, bipolar disorder, or severe unipolar depression (cases, n = 647) were recruited from among hospital patients in New Delhi between November 2011 and June 2012 and matched with non-psychiatric urban dwellers by age, sex, and location of residence (controls, n = 649). Propensity score matching with multivariable linear regression was used to test whether stigma towards mental illness, measured by a 13-item Stigma Questionnaire, differed between cases and controls. Cases reported significantly lower stigma scores than controls (b = -0.50, p < 0.0001). The strength of the association between mental illness and stigma was not affected after controlling for age, caste, sex, education, and employment status, while wealth marginally reduced the strength of the association. These findings suggest individuals with a lived experience of mental illness, in New Delhi, India, may be more tolerant towards mental illness and support the need to involve persons with lived experience in the development and implementation of health promotional campaigns and programs aimed at reducing stigma towards mental illness.
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Affiliation(s)
- Jean-Francois Trani
- Brown School and Institute of Public Health, Washington University in St Louis, USA
- National Pedagogical school Health and Solidarity, National Center for Arts and Crafts, France
| | - Bing-Jie Yen
- School of Public Health, Indiana University Bloomington, USA
| | - Alexis Duncan
- Brown School and Institute of Public Health, Washington University in St Louis, USA
| | - Parul Bakhshi
- School of Occupational Therapy, Medical School, Washington University in St Louis, USA
| | - Trinley Palmo
- Students health and wellness, University of Virginia, USA
| | | | - Smita Deshpande
- Department of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, PGIMER-Dr. Ram Manohar Lohia Hospital, New Delhi, India
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2
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Guni JN, Wanjala SW, Manguro G, Gichuki C, Lim MS, Pham MD, Luchters S, Orwa J. Using social practice theory in measuring perceived stigma among female sex workers in Mombasa, Kenya. BMC Public Health 2023; 23:972. [PMID: 37237349 DOI: 10.1186/s12889-023-15809-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Perceived stigma is a complex societal phenomenon that is harboured especially by female sex workers because of the interplay of a myriad of factors. As such, a precise measure of the contribution of different social practices and characteristics is necessary for both understanding and intervening in matters related to perceived stigma. We developed a Perceived Stigma Index that measures the factors that greatly contribute to the stigma among sex workers in Kenya, and thereby inform a framework for future interventions. METHODS Social Practice Theory was adopted in the development of the Perceived Stigma Index in which three social domains were extracted from data collected in the WHISPER or SHOUT study conducted among female sex workers (FSW), aged 16-35 years in Mombasa, Kenya. The three domains included: Social demographics, Relationship Control and Sexual and Gender-based Violence, and Society awareness of sexual and reproductive history. The factor assessment entailed Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and the internal consistency of the index was measured using Cronbach's alpha coefficient. RESULTS We developed a perceived stigma index to measure perceived stigma among 882 FSWs with a median age of 26 years. A Cronbach's alpha coefficient of 0.86 (95% confidence interval (CI) 0.85-0.88) was obtained as a measure of the internal consistency of our index using the Social Practice Theory. In regression analysis, we identified three major factors that contribute to the perceived stigma and consists of : (i) income and family support (β = 1.69; 95% CI); (ii) society's awareness of the sex workers' sexual and reproductive history (β = 3.54; 95% CI); and (iii) different forms of relationship control e.g. physical abuse (β = 1.48; 95%CI that propagate the perceived stigma among the FSWs. CONCLUSION Social practice theory has solid properties that support and capture the multi-dimensional nature of perceived stigma. The findings support the fact that social practices contribute or provoke this fear of being discriminated against. Thus, in offering interventions to curb perceived stigma, focus should fall on the education of the society on the importance of acceptance and integration of the FSWs as part of the society and the eradication of sexual and gender based violence meted out on them. TRIAL REGISTRATION The trial was registered in the Australian New Zealand Clinical Trials Registry, ACTRN12616000852459.
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Affiliation(s)
| | - Stanley Wechuli Wanjala
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Social Sciences, School of Humanities and Social Sciences, Pwani University, Kilifi, Kenya
| | | | - Caroline Gichuki
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Megan Sc Lim
- Burnet Institute, Melbourne, Australia
- School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia
- Melbourne school of global and population health, University of Melbourne, Parkville, Australia
| | - Minh D Pham
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Stanley Luchters
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Centre for Sexual Health and HIV AIDS Research, CeSHHAR, Harare, Zimbabwe
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - James Orwa
- Department of Population Health, Aga Khan University, Nairobi, Kenya
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3
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Kaur N, Behere NS, Kulkarni AS. A study of beliefs towards mental illness among teachers in Sikar city, Rajasthan. Indian J Psychiatry 2023; 65:424-430. [PMID: 37325090 PMCID: PMC10263089 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_433_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023] Open
Abstract
Background Understanding the significance of adolescents' mental health, school-based mental health interventions are being implemented with the help of teachers globally. Aim Owing to the dearth of literature concerning the beliefs, and stigma among the teachers, the present study was conducted with an aim to study the mental health beliefs among teachers. Methods This is a cross-sectional study conducted among randomly selected teachers teaching in government and private schools of Sikar city of Rajasthan. A general sociodemographic questionnaire, Beliefs Towards Mental Illness Scale, and a questionnaire about prior exposure to mental health issues was administered. Stata 15.0 was used for statistical analysis, and independent t-test and one-way analysis of variance test were applied to find out associations. Results Majority of the participants were in age group of 31-40 years, married, and postgraduate. The mean Beliefs Towards Mental Illness Scale score of 147 teachers was 49.95 ± 17.34 of 105. Only 2% of the study participants have ever received training related to mental health issues. Teachers who had prior exposure to mental health issues, residing in semi-urban and urban areas showed more positive beliefs. Conclusion Study participants have displayed negative beliefs toward mental health. This brings to light the important interventions like creating knowledge and awareness among the study population by conducting trainings. More research is needed to explore the mental health beliefs among the teachers.
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Affiliation(s)
- Navneet Kaur
- Indian Institute of Public Health-Delhi, Gurugram, Haryana, India
| | - Nilam S. Behere
- Research Scientist, Public Health Foundation of India, Delhi, India
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4
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Perceived risk of COVID-19 diagnosis and stigma among Nigerians. SCIENTIFIC AFRICAN 2022; 18:e01411. [PMID: 36313264 PMCID: PMC9596177 DOI: 10.1016/j.sciaf.2022.e01411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/10/2021] [Accepted: 10/20/2022] [Indexed: 11/26/2022] Open
Abstract
The World Health Organization (WHO) classified Nigeria as one of the 13 African countries with a higher risk of spreading COVID-19. Although the Nigerian government and its health agencies set directives in place to help curb the spread of COVID-19, there are instances of unconcerned attitudes and adherence to false and superstitious beliefs surrounding COVID-19 among Nigerians. The current study examined the general perception of COVID-19 risk among Nigerians. Additionally, it examined the fear of possible stigmatization if an individual is diagnosed with COVID-19. A cross-section of 332 Nigerian men and women responded to measures on perceived vulnerability to diseases, perception of risk of being infected with COVID-19, COVID-19 stigma, and social and demographic characteristics. The findings show that respondents with a higher perception of vulnerability to diseases reported higher COVID-19 risk and perception of COVID-19-related stigma. Further, we found that gender, age, and education impacted COVID-19 risk and perception of COVID-19-related stigma. Our findings suggest that risk perceptions and attitudes towards COVID-19 can impact the level of preparedness against a pandemic. Also, the findings could inform strategies for the proper implementation of health protective measures at national, state, and local government levels during a viral outbreak.
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McCartin M, Cannon LM, Harfmann RF, Dalton VK, MacAfee LK, Kusunoki Y. Stigma and Reproductive Health Service Access Among Women in Treatment for Substance Use Disorder. Womens Health Issues 2022; 32:595-601. [PMID: 35821183 DOI: 10.1016/j.whi.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 05/29/2022] [Accepted: 06/09/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE We aimed to examine the role of perceived and direct stigma on access to reproductive health services among women in treatment for substance use disorders in Michigan. METHODS We draw on self-interview data from a cross-sectional study of female patients aged 18-50 years who accessed substance use disorder treatment at 22 randomly selected facilities in Michigan from December 2015 to May 2017. We conducted logistic regressions to examine associations between perceived stigma and access to three types of reproductive health services (screening exams, birth control, and prenatal care), as well as direct stigma and access to birth control. RESULTS The final sample included 260 women. A notable percentage of women reported inability to access reproductive health services (24% for screening exams, 14% for birth control, and 12% for prenatal care). Women with higher levels of perceived stigma because of substance use were significantly more likely to report inability to access screening exams (odds ratio [OR]: 2.14; confidence interval [CI]: 1.43-3.20) and birth control (OR: 2.17; CI: 1.36-3.77). Women reporting higher levels of direct stigma were also significantly more likely to report inability to access birth control (OR: 3.87; CI: 2.29-6.53), even after accounting for perceived stigma. CONCLUSION Perceived and direct stigma because of substance use may be significant barriers to seeking and accessing reproductive health services for women. Health professionals should reduce stigma in health care in order to increase access to necessary services for this population.
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Affiliation(s)
| | - Lindsay M Cannon
- Department of Sociology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Roxanne F Harfmann
- Department of Psychological Science, University of Vermont, Burlington, Vermont
| | - Vanessa K Dalton
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Lauren K MacAfee
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont, Burlington, Vermont
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6
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Lin Q, Kolak M, Watts B, Anselin L, Pollack H, Schneider J, Taylor B. Individual, interpersonal, and neighborhood measures associated with opioid use stigma: Evidence from a nationally representative survey. Soc Sci Med 2022; 305:115034. [PMID: 35636049 PMCID: PMC9288898 DOI: 10.1016/j.socscimed.2022.115034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022]
Abstract
Despite growing awareness of opioid use disorder (OUD), fatal overdoses and downstream health conditions (e. g., hepatitis C and HIV) continue to rise in some populations. Various interrelated structural forces, together with social and economic determinants, contribute to this ongoing crisis; among these, access to medications for opioid use disorder (MOUD) and stigma towards people with OUD remain understudied. We combined data on methadone, buprenorphine, and naltrexone providers from SAMHSA’s 2019 directory, additional naltrexone providers from Vivitrol’s location finder service, with a nationally representative survey called “The AmeriSpeak survey on stigma toward people with OUD.” Integrating the social-ecological framework, we focus on individual characteristics, personal and family members’ experience with OUD, and spatial access to MOUD at the community level. We use nationally representative survey data from 3008 respondents who completed their survey in 2020. Recognizing that stigma is a multifaceted construct, we also examine how the process varies for different types of stigma, specifically perceived dangerousness and untrustworthiness, as well as social distancing measures under different scenarios. We found a significant association between stigma and spatial access to MOUD — more resources are related to weaker stigma. Respondents had a stronger stigma towards people experiencing current OUD (versus past OUD), and they were more concerned about OUD if the person would marry into their family (versus being their coworkers). Additionally, respondents’ age, sex, education, and personal experience with OUD were also associated with their stigma, and the association can vary depending on the specific type of stigma. Overall, stigma towards people with OUD was associated with both personal experiences and environmental measures.
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Affiliation(s)
- Qinyun Lin
- Center for Spatial Data Science, University of Chicago, USA.
| | - Marynia Kolak
- Center for Spatial Data Science, University of Chicago, USA
| | | | - Luc Anselin
- Center for Spatial Data Science, University of Chicago, USA
| | - Harold Pollack
- School of Social Service Administration, University of Chicago, USA
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Kehyayan V, Mahfoud Z, Ghuloum S, Marji T, Al-Amin H. Internalized Stigma in Persons With Mental Illness in Qatar: A Cross-Sectional Study. Front Public Health 2021; 9:685003. [PMID: 34178932 PMCID: PMC8232048 DOI: 10.3389/fpubh.2021.685003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/07/2021] [Indexed: 11/30/2022] Open
Abstract
Stigma impacts persons with mental illness (PWMI), their families and network of friends, the public and health care professionals. Stigma is a major barrier for PWMI to seeking treatment, which contributes to the burden of disease, disability, and mortality. Research on stigma is relatively scant in the Middle East region and particularly in Qatar. To address stigma effectively in each culture, it is essential to study its nature in the context where the PWMI experience stigma. The purpose of this study was to assess the prevalence of internalized stigma in PWMI in Qatar. A cross-sectional study of PWMI receiving outpatient mental health services in Qatar was done. We interviewed 417 PWMI using a modified 18-item version of the short form of the Internalized Stigma of Mental Illness (ISMI) Scale. Descriptive and regression models were used to analyze the data. The Cronbach alpha for the modified 18-items ISMI was 0.87. Participants' average score on this scale was 2.07 ± 0.38 with 41 (9.8%) of them scoring more than 2.5 which is considered “high” stigma score. In multivariate logistic regression, high stigma (modified ISMI score >2.5) was significantly higher among PWMI with no formal education and among those who reported lower levels of social support. The reported levels of internalized stigma in this vulnerable population of Qatar fall at the lower spectrum reported worldwide. An anti-stigma education program designed for the context of Qatar emphasizing on education and support for PWMI may be conducive to creating an all-inclusive society.
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Affiliation(s)
- Vahe Kehyayan
- Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
| | - Ziyad Mahfoud
- Department of Population Health Science, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Suhaila Ghuloum
- Mental Health Services, Hamad Medical Corporation, Department of Psychiatry, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Tamara Marji
- Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
| | - Hassen Al-Amin
- Department of Population Health Science, Weill Cornell Medicine - Qatar, Doha, Qatar.,Department of Psychiatry, Weill Cornell Medicine - Qatar and Mental Health Services, Hamad Medical Corporation, Doha, Qatar
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8
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Wang M, Wang Y, Xu J, Meng N, Li X, Liu Z, Huang J. Individual-level socioeconomic status and contact or familiarity with people with mental illness: a cross-sectional study in Wuhou District, Chengdu, Southwest China. BMC FAMILY PRACTICE 2021; 22:71. [PMID: 33836653 PMCID: PMC8035729 DOI: 10.1186/s12875-021-01422-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/19/2021] [Indexed: 02/08/2023]
Abstract
Background People with mental illness (PWMI) often suffer from public stigma, which can make them unwilling to seek help and reduce access to early treatment. The aims of this study were to determine attitudes towards PWMI among the general public in a Chinese sample and to explore the relationships with sociodemographic characteristics. Methods A community-based, cross-sectional study was conducted from March to June 2019. The participants’ attitudes towards PWMI were evaluated by the Chinese version of the Social Distance Scale (SDSC). An independent-sample T-test and one-way ANOVA were used to determine the association of categorical variables with the outcome variable. Multiple linear regression and Spearman correlations were computed to explore the correlation between SDSC scores and individual-level socioeconomic status (SES). Results A total of 1437 participants were recruited, and their total SDSC score was 12.53 (SD: 3.11). Univariate analysis results showed that age, education level, educational attainment, and individual-level SES as well as whether they were caregivers/family members of PWMI were correlated with SDSC scores. The results of regression analysis showed a significant effect caused by contact or familiarity with PWMI (B = -1.134, β = -.190, P < 0.001), as well as for individual-level SES (B = -.339, β = -.110, P < 0.001). Spearman correlation results showed that SDSC scores were negatively correlated with individual-level SES (r = -.078, p < 0.01) and contact or familiarity with PWMI (r = -.168, p < 0.001). Conclusion This study reveals that public stigma towards PWMI is common in Southwest China. Individuals who are not a family member or a caregiver of PWMI or have low education level or low individual-level SES need to be provided more anti-stigma interventions. Contacting with PWMI is also a potentially beneficial measure to reduce social distance. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01422-y.
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Affiliation(s)
- Mengmeng Wang
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ya Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Jiajun Xu
- Mental Health Center, West China Hospital, Sichuan University, Guoxuexiang No.37, Chengdu, 610041, Sichuan, China.
| | - Na Meng
- Mental Health Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Xiaolin Li
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Zheng Liu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Junqiang Huang
- Chengdu Dekang Hospital, Sichuan University, Chengdu, 610041, China
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9
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Fox JR. Exorcising memories of internalised stigma: The demons of lived experience. World J Psychiatry 2021; 11:63-72. [PMID: 33747804 PMCID: PMC7953364 DOI: 10.5498/wjp.v11.i3.63] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/14/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023] Open
Abstract
Public stigma and self-stigma impact negatively on the lives of people with mental health issues. Many people in society stereotype and discriminate against people with mental ill-health, and often this negative process of marginalisation is internalised by people with lived experiences. Thus, this negative internalisation leads to the development of self-stigma. In this article, I reflect on my own experiences of shame and self-stigma as a person with mental ill-health socially bullied by peers from my community and social groups. I present a personal narrative of both public and self-stigmatisation which I hope will enable me to exorcise memories of internalised stigma, which are encountered as my demons of lived experience. Using reflexivity, a process used widely in health and social care fields, I consider how social bullying shattered my fragile confidence, self-esteem, and self-efficacy in the early days of my recovery; the impact of associative stigma on family members is also explored. Following this, the potential to empower people who experience shame and stigma is explored alongside effective anti-stigma processes which challenge discrimination. I connect the concept of recovery with the notion of empowerment, both of which emphasise the importance of agency and self-efficacy for people with mental ill-health. Finally, I consider how the concepts of empowerment and recovery can challenge both the public stigma held by peers in the community and the self-stigma of those with lived experiences.
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Affiliation(s)
- Joanna Ruth Fox
- School of Education and Social Care, Anglia Ruskin University, Cambridge CB1 1PT, United Kingdom
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10
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Yang LH, Ho-Foster AR, Becker TD, Misra S, Rampa S, Poku OB, Entaile P, Goodman M, Blank MB. Psychometric Validation of a Scale to Assess Culturally-Salient Aspects of HIV Stigma Among Women Living with HIV in Botswana: Engaging "What Matters Most" to Resist Stigma. AIDS Behav 2021; 25:459-474. [PMID: 32839870 PMCID: PMC8530255 DOI: 10.1007/s10461-020-03012-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Perceived stigma deters engagement in HIV care and is powerfully shaped by culture. Yet few stigma measures consider how cultural capabilities that signify "full personhood" could be engaged to resist stigma. By applying a theory conceptualizing how culturally-salient mechanisms can worsen or mitigate HIV stigma in relation to "what matters most" (WMM), we developed the WMM Cultural Stigma Scale for Women Living with HIV in Botswana (WMM-WLHIV-BW) and psychometrically evaluated it among 201 respondents with known and unknown HIV status. The two subscales, Cultural Factors Shape Stigma (CFSS) and Cultural Capabilities Protect against Stigma (CCPS) were reliable (both [Formula: see text]). Among WLHIV, the CFSS Subscale showed initial construct validity with depressive symptoms (r = .39, p = .005), similar to an established HIV stigma scale, whereas the CCPS Subscale showed initial construct validity with self-esteem (r = .32, p = .026) and social support number (r = .29, p = .047), suggesting that achieving local cultural capabilities mitigates stigma and is linked with positive psychosocial outcomes. This culturally-derived scale could help WLHIV in Botswana experience improved stigma-related outcomes.
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Affiliation(s)
- Lawrence H Yang
- School of Global Public Health, New York University, 715 Broadway, New York, NY, 10003, USA.
- Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Ari R Ho-Foster
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Timothy D Becker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Supriya Misra
- School of Global Public Health, New York University, 715 Broadway, New York, NY, 10003, USA
| | - Shathani Rampa
- Department of Psychology, University of Botswana, Gaborone, Botswana
| | - Ohemaa B Poku
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Melody Goodman
- School of Global Public Health, New York University, 715 Broadway, New York, NY, 10003, USA
| | - Michael B Blank
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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11
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Jena S, Zieger A, Böge K, Salunkhe G, Schomerus G, Patel K, Padhi BK, Ta TMT, Mungee A, Hahn E. Public Attitudes Toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Odisha State, India. Front Psychiatry 2021; 12:745604. [PMID: 34658978 PMCID: PMC8517327 DOI: 10.3389/fpsyt.2021.745604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Integration of psychiatric care with public health services and offering mental health care services to patients from lower socioeconomic status remains a global challenge. Scarcity of funds and professional workforce in psychiatric hospitals contribute to this situation. However, negative attitudes in the population are also a known impediment to patients seeking mental health services. This study aimed to assess the attitudes toward psychiatric hospitals among the urban and rural population in India. Subjects and Methods: The study was carried out amongst the general population in Odisha, India. The total sample (n = 988) includes 496 respondents from an urban-setting, and 492 respondents from rural parts of the district. Participants were selected by using simple random-sampling from the Asian Institute of Public Health (AIPH) data base. A standardized seven-item questionnaire was adopted, with responses indicated on a 5-point Likert-scale. Interviews were fully structured and conducted face-to-face. Results: Level of education (B = -0.192, ß = -0.320, p < 0.000) and urban-rural comparison (B = -0.272, ß = -0.189, p < 0.000) significantly influenced attitudes toward psychiatric hospitals. Gender, age, and religious beliefs did not show any significant effect on attitudes toward psychiatric hospitals. Individuals in rural areas and those with lower education levels showed more negative attitudes toward psychiatric hospitals. Conclusion: Negative attitudes toward psychiatric hospitals from those living in rural areas as well as those with lesser education may be reflective of the lack of availability, accessibility, affordability, and credibility of such mental health services. The Mental Health Care Act in India is a progressive legislation which might improve the situation of the provided services and, consequently, reduce negative attitudes in the years to come.
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Affiliation(s)
- Sunita Jena
- Asian Institute of Public Health, Utkal University, Bhubaneswar, India
| | - Aron Zieger
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
| | - Gayatri Salunkhe
- Center of Medicine and Society, University of Freiburg, Freiburg, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Kripalini Patel
- Asian Institute of Public Health, Utkal University, Bhubaneswar, India
| | - Bijaya Kumar Padhi
- Asian Institute of Public Health, Utkal University, Bhubaneswar, India.,Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
| | - Aditya Mungee
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Berlin, Germany
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12
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Rural community attitude towards mental healthcare: a mixed-method study in Khurda district of Odisha, India. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00057-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mental health is a global concern due to its hasty escalation. The shifting social dynamics in rural India intensify care-seeking behaviors, which means immediate action is required. Mental illness, however, is seen as a neglected disorder. This study examined the attitude of rural people towards mental health care in rural Odisha, India. An explanatory mixed-method study was conducted among 395 participants age between 18 to 65 years in two rural blocks of Khurdha district, Odisha. A total of 16 in-depth interviews were conducted among the caretakers of the patients.
Results
The educational level, religion, age, and gender (p < 0.05) had significantly associated with attitudes towards mental healthcare facilities; female having lower-education had more negative attitudes towards mental healthcare facilities. The major barriers for the mental healthcare were the rejection of mental illness by patients due to fear of societal stigma, faith on religious healers, and lack of availability of mental health services.
Conclusions
Perspective of people should be considered along with their location, gender, and education when strategizing the psychiatric healthcare system as their perception/attitude serves as facilitators/barriers for achieving mental healthcare goals and psychiatric hospital goals.
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O'Ferrall-González C, Almenara-Barrios J, García-Carretero MÁ, Salazar-Couso A, Almenara-Abellán JL, Lagares-Franco C. Factors associated with the evolution of attitudes towards mental illness in a cohort of nursing students. J Psychiatr Ment Health Nurs 2020; 27:237-245. [PMID: 31663221 DOI: 10.1111/jpm.12572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/28/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: People with mental health difficulties have poorer physical health than the general population. The stigmatizing attitude of health professionals impacts the quality of care for these people. There is a broad background on the effectiveness of activities based on theoretical training, clinical practices or social contact to improve nursing students' attitudes towards people with mental health difficulties. There is an important need to assess whether the benefits identified in the short term are maintained in the longer term. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The positive evolution of attitudes towards mental illness does not last over time. Some students' attitude towards people with a mental health difficulty worsened in the final stage of their training after completing clinical practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is necessary for tutors incorporate an understanding of stigma throughout the degree training and to discuss with the students the emotional aspects experienced during the performance of clinical practices. The design of any anti-stigma intervention must include the factor of "time". ABSTRACT: Introduction The stigma of health professionals is a contributing factor to morbi-mortality among people with mental health difficulties. There is a lack of research on long-term outcomes in nursing students. Objective To identify factors associated with the evolution of stigmatizing attitudes towards mental illness in a cohort of students trained in mental health. Method A prospective observational study of the impact of training in mental health care. Age, gender, stigma, level of previous familiarity with mental illness, self-education by Internet, academic performance and the place where practicums are conducted were evaluated on three occasions over 15 months. Results Academic performance, online consultation and the size or origin of the theoretical group were indicators of better attitudes. The positive evolution of attitudes does not last over time. Discussion Instability over time could be explained by students' experience in the practicum, although the time itself has been identified as a determining factor. Practical implications Further studies should be promoted in academia to assess the content of mental health training and its influence on the evolution of the stigmatizing attitude. It is also necessary to address stigma in small groups, where students with better academic results lead anti-stigma activities.
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Affiliation(s)
- Cristina O'Ferrall-González
- Department of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain.,Research Group PAIDI CTS-391, University of Cádiz, Cádiz, Spain
| | - José Almenara-Barrios
- Department of Biomedicine, Biotecnology and Public Health, University of Cádiz, Cádiz, Spain
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Deshpande SN, Nimgaonkar VL, Bhatia T, Mishra NN, Nagpal R, Parker LS. Ethical Practices and Legal Challenges in Mental Health Research. Asian Bioeth Rev 2020; 12:87-102. [PMID: 33717331 PMCID: PMC7747337 DOI: 10.1007/s41649-020-00116-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022] Open
Abstract
Considerations of justice and concern for well-being support conducting mental health research and addressing ethical concerns specific to mental health research are critical. We discuss these concerns, provide recommendations to enable the ethical conduct of mental health research, and argue that participants' interests should be given primary weight in resolving apparent dilemmas. We also comment on provisions of two legislative actions in India relevant to mental health research: Rights of Persons with Disability Act 2016 and the Mental Health Care Act 2017. Both conform to the 2006 United Nations Convention on Rights of Persons with Disabilities of which India is a signatory. Both provide protections and enumerate rights relevant to people with mental health conditions but with differing focus. The commonalities and differences between the three are discussed in the background of international literature on research in mental health conditions. Studies involving deception and future directions for ethical requirements regarding genetic research are discussed.
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Affiliation(s)
- Smita N. Deshpande
- Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Vishwajit L. Nimgaonkar
- Program for Genetics and Psychosis, Department of Psychiatry and Department of Genetics, University of Pittsburgh, Pittsburgh, PA USA
| | - Triptish Bhatia
- Indo-US Projects, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | | | | | - Lisa S. Parker
- Center for Bioethics & Health Law, University of Pittsburgh, Pittsburgh, PA USA
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Dreier M, Ludwig J, Härter M, von dem Knesebeck O, Baumgardt J, Bock T, Dirmaier J, Kennedy AJ, Brumby SA, Liebherz S. Development and evaluation of e-mental health interventions to reduce stigmatization of suicidality - a study protocol. BMC Psychiatry 2019; 19:152. [PMID: 31101103 PMCID: PMC6525463 DOI: 10.1186/s12888-019-2137-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worldwide, approximately 800,000 persons die by suicide every year; with rates of suicide attempts estimated to be much higher. Suicidal persons often suffer from a mental disorder but stigma, lack of available and suitable support, and insufficient information on mental health limit help seeking. The use of internet-based applications can help individuals inform themselves about mental disorders, assess the extent of their own concerns, find local treatment options, and prepare for contact with health care professionals. This project aims to develop and evaluate e-mental health interventions to improve knowledge about suicidality and to reduce stigmatization of those affected. In developing these interventions, a representative telephone survey was conducted to detect knowledge gaps and stigmatizing attitudes in the general population. METHODS First, a national representative telephone survey with N = 2000 participants in Germany was conducted. Second, e-mental health interventions are developed to address knowledge gaps and public stigma detected in the survey. These comprise an evidence-based health information package about suicidality, information on regional support services, a self-administered depression test-including suicidality-and an interactive online intervention including personal stories. The development is based on a trialogical exchange of experience between persons affected by suicidality, relatives of affected persons, and clinical experts. Australian researchers who developed an e-mental health intervention for individuals affected by rural suicide were invited to a workshop in order to contribute their knowledge and expertise. Third, the online intervention will be evaluated by a mixed methods design. DISCUSSION From representative telephone survey data, content can be developed to address specific attitudes and knowledge via the e-mental health interventions. These interventions will be easily accessed and provide an opportunity to reach people who tend not to seek professional services, prefer to inform themselves in advance and/or wish to remain anonymous. Evaluation of the online intervention will provide information on any changes in participants' self-stigma and perceived-stigma of suicidality, and any increase in participants' knowledge on suicidality or self-efficacy expectations. TRIAL REGISTRATION German Clinical Trial Register DRKS00015071 on August 6, 2018.
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Affiliation(s)
- Mareike Dreier
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W26, 20246, Hamburg, Germany.
| | - Julia Ludwig
- Department of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W26, 20246, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna Baumgardt
- Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Bock
- Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg Dirmaier
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W26, 20246, Hamburg, Germany
| | - Alison J Kennedy
- National Centre for Farmer Health, School of Medicine, Deakin Unversity, Waurn Ponds, Victoria, Australia
| | - Susan A Brumby
- National Centre for Farmer Health, School of Medicine, Deakin Unversity, Waurn Ponds, Victoria, Australia
- Western District Health Service, Hamilton, Victoria, Australia
| | - Sarah Liebherz
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W26, 20246, Hamburg, Germany
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Guttikonda A, Shajan AM, Hephzibah A, Jones AS, Susanna J, Neethu S, Poornima S, Jala SM, Arputharaj D, John D, Natta N, Fernandes D, Jeyapaul S, Jamkhandi D, Prashanth HR, Oommen AM. Perceived Stigma Regarding Mental Illnesses among Rural Adults in Vellore, Tamil Nadu, South India. Indian J Psychol Med 2019; 41:173-177. [PMID: 30983667 PMCID: PMC6436406 DOI: 10.4103/ijpsym.ijpsym_297_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Stigma is an important factor that determines whether individuals seek treatment for mental illnesses. Studies assessing public perceptions regarding mental illnesses are scarce in India. This study documents the stigma perceived by a rural population toward patients with mental illness and their families. MATERIALS AND METHODS A cross-sectional pilot study was done in five villages, selected by simple random sampling, from a rural block in Vellore, Tamil Nadu. Households in each village were selected by systematic random sampling. From the selected households, 150 subjects aged 18-65 years, without known mental disorders, were chosen by convenience sampling, based on availability. Stigma was assessed using the Devaluation of Consumers Scale (DCS) and Devaluation of Consumer's Families Scale (DCFS). RESULTS The proportion with high perceptions of stigma associated with mentally ill persons was 63.8%, among the 150 interviewed rural respondents (women: 112, median age: 37 years). The proportion which perceived that there was public stigma toward families of those with mental illnesses was 43.4%. Older respondents (>37 years) had higher perceptions of stigma (odds ratio: 2.07; 95% confidence interval: 1.02-4.20) than others. CONCLUSION The high perception of stigma associated with persons who are mentally ill as well as their families needs to be kept in mind while planning interventions to decrease the treatment gap for psychiatric morbidity, especially in rural areas.
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Affiliation(s)
| | | | - Aleena M Shajan
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - Adeline Hephzibah
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - Akhila S Jones
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jerlyn Susanna
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sunil Neethu
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sharon Poornima
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sarah M Jala
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - D Arputharaj
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - David John
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nehemiah Natta
- MBBS Students, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dolorosa Fernandes
- Community Health Department, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shalini Jeyapaul
- Community Health Department, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dimple Jamkhandi
- Community Health Department, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Anu M Oommen
- Community Health Department, Christian Medical College, Vellore, Tamil Nadu, India
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Prevalence of and factors contributing to anxiety, depression and cognitive disorders among urban elderly in Odisha – A study through the health systems’ Lens. Arch Gerontol Geriatr 2019; 80:38-45. [DOI: 10.1016/j.archger.2018.09.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/28/2018] [Accepted: 09/28/2018] [Indexed: 11/18/2022]
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Khubchandani J, Soni A, Fahey N, Raithatha N, Prabhakaran A, Byatt N, Moore Simas TA, Phatak A, Rosal M, Nimbalkar S, Allison JJ. Caste matters: perceived discrimination among women in rural India. Arch Womens Ment Health 2018; 21:163-170. [PMID: 29034410 PMCID: PMC5857209 DOI: 10.1007/s00737-017-0790-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 10/06/2017] [Indexed: 11/30/2022]
Abstract
The aim of this study is to examine the relationship of caste and class with perceived discrimination among pregnant women from rural western India. A cross-sectional survey was administered to 170 pregnant women in rural Gujarat, India, who were enrolled in a longitudinal cohort study. The Everyday Discrimination Scale and the Experiences of Discrimination questionnaires were used to assess perceived discrimination and response to discrimination. Based on self-report caste, women were classified into three categories with increasing historical disadvantage: General, Other Backward Castes (OBC), and Scheduled Caste or Tribes (SC/ST). Socioeconomic class was determined using the standardized Kuppuswamy scale. Regression models for count and binomial data were used to examine association of caste and class with experience of discrimination and response to discrimination. Sixty-eight percent of women experienced discrimination. After adjusting for confounders, there was a consistent trend and association of discrimination with caste but not class. In comparison to General Caste, lower caste (OBC, SC/ST) women were more likely to (1) experience discrimination (OBC OR: 2.2, SC/ST: 4.1; p trend: 0.01); (2) have a greater perceived discrimination score (OBC IRR: 1.3, SC/ST: 1.5; p trend: 0.07); (3) accept discrimination (OBC OR: 6.4, SC/ST: 7.6; p trend: < 0.01); and (4) keep to herself about discrimination (OBC OR: 2.7, SC/ST: 3.6; p trend: 0.04). The differential experience of discrimination by lower caste pregnant women in comparison to upper caste pregnant women and their response to such experiences highlight the importance of studying discrimination to understand the root causes of existing caste-based disparities.
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Affiliation(s)
- Jasmine Khubchandani
- University of Massachusetts Medical School, Albert Sherman Center, 55 Lake Avenue N, Worcester, MA, 01605, USA
| | - Apurv Soni
- University of Massachusetts Medical School, Albert Sherman Center, 55 Lake Avenue N, Worcester, MA, 01605, USA.
| | - Nisha Fahey
- University of Massachusetts Medical School, Albert Sherman Center, 55 Lake Avenue N, Worcester, MA, 01605, USA
| | | | | | - Nancy Byatt
- University of Massachusetts Medical School, Albert Sherman Center, 55 Lake Avenue N, Worcester, MA, 01605, USA
| | - Tiffany A Moore Simas
- University of Massachusetts Medical School, Albert Sherman Center, 55 Lake Avenue N, Worcester, MA, 01605, USA
| | - Ajay Phatak
- Pramukhswami Medical College, Karamsad, India
| | - Milagros Rosal
- University of Massachusetts Medical School, Albert Sherman Center, 55 Lake Avenue N, Worcester, MA, 01605, USA
| | | | - Jeroan J Allison
- University of Massachusetts Medical School, Albert Sherman Center, 55 Lake Avenue N, Worcester, MA, 01605, USA
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Böge K, Zieger A, Mungee A, Tandon A, Fuchs LM, Schomerus G, Tam Ta TM, Dettling M, Bajbouj M, Angermeyer M, Hahn E. Perceived stigmatization and discrimination of people with mental illness: A survey-based study of the general population in five metropolitan cities in India. Indian J Psychiatry 2018; 60:24-31. [PMID: 29736059 PMCID: PMC5914258 DOI: 10.4103/psychiatry.indianjpsychiatry_406_17] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND India faces a significant gap between the prevalence of mental illness among the population and the availability and effectiveness of mental health care in providing adequate treatment. This discrepancy results in structural stigma toward mental illness which in turn is one of the main reasons for a persistence of the treatment gap, whereas societal factors such as religion, education, and family structures play critical roles. This survey-based study investigates perceived stigma toward mental illness in five metropolitan cities in India and explores the roles of relevant sociodemographic factors. MATERIALS AND METHODS Samples were collected in five metropolitan cities in India including Chennai (n = 166), Kolkata (n = 158), Hyderabad (n = 139), Lucknow (n = 183), and Mumbai (n = 278). Stratified quota sampling was used to match the general population concerning age, gender, and religion. Further, sociodemographic variables such as educational attainment and strength of religious beliefs were included in the statistical analysis. RESULTS Participants displayed overall high levels of perceived stigma. Multiple linear regression analysis found a significant effect of gender (P < 0.01), with female participants showing higher levels of perceived stigma compared to male counterparts. CONCLUSION Gender differences in cultural and societal roles and expectations could account for higher levels of perceived stigma among female participants. A higher level of perceived stigma among female participants is attributed to cultural norms and female roles within a family or broader social system. This study underlines that while India as a country in transition, societal and gender rules still impact perceived stigma and discrimination of people with mental illness.
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Affiliation(s)
- Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - Aron Zieger
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - Aditya Mungee
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - Abhinav Tandon
- AKT Neuropsychiatric Centre, Allahabad, Uttar Pradesh, India
| | - Lukas Marian Fuchs
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - Georg Schomerus
- Department of Psychiatry, Ernst Moritz Arndt University, Greifswald, Germany
| | - Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - Michael Dettling
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - Matthias Angermeyer
- Center for Public Mental Health, Untere 12 Zeile 13, A-3482 Gö-sing am Wagram, Austria
| | - Eric Hahn
- Department of Psychiatry, Ernst Moritz Arndt University, Greifswald, Germany
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Mondal H, Mondal S. Pretesting and cognitive interviewing are integral parts in translation of survey instrument. Indian J Psychiatry 2017; 59:251-252. [PMID: 28827883 PMCID: PMC5547877 DOI: 10.4103/psychiatry.indianjpsychiatry_103_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Himel Mondal
- Department of Physiology, M.K.C.G. Medical College, Ganjam, Odisha, India. E-mail:
| | - Shaikat Mondal
- Department of Physiology, Medical College and Hospital, Kolkata, West Bengal, India
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Zieger A. Response to "Pretesting and cognitive interviewing are integral parts in translation of survey instrument". Indian J Psychiatry 2017; 59:253. [PMID: 28827884 PMCID: PMC5547878 DOI: 10.4103/psychiatry.indianjpsychiatry_171_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Aron Zieger
- Department of Psychiatry and Psychotherapy, Charité University Hospital Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany. E-mail:
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