Lessons learned from unintended consequences about erasing the stigma of mental illness.
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ABSTRACT:
SUBMITTER: Corrigan PW
PROVIDER: S-EPMC4780288 | biostudies-other | 2016 Feb
REPOSITORIES: biostudies-other
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Project description:Self-stigma is associated with poor clinical and functional outcomes in Serious Mental Illness (SMI). There has been no review of self-stigma frequency and correlates in different cultural and geographic areas and SMI. The objectives of the present study were: (1) to review the frequency, correlates, and consequences of self-stigma in individuals with SMI; (2) to compare self-stigma in different geographical areas and to review its potential association with cultural factors; (3) to evaluate the strengths and limitations of the current body of evidence to guide future research. A systematic electronic database search (PubMed, Web of Science, PsycINFO, Scopus, and Ovid SP Cumulative Index to Nursing and Allied Health Literature [CINAHL]) following PRISMA guidelines, was conducted on the frequency, correlates, and consequences of self-stigma in SMI. Out of 272 articles, 80 (29.4%) reported on the frequency of self-stigma (n = 25 458), 241 (88.6%) on cross-sectional correlates of self-stigma and 41 (15.0%) on the longitudinal correlates and consequences of self-stigma. On average, 31.3% of SMI patients reported high self-stigma. The highest frequency was in South-East Asia (39.7%) and the Middle East (39%). Sociodemographic and illness-related predictors yielded mixed results. Perceived and experienced stigma-including from mental health providers-predicted self-stigma, which supports the need to develop anti-stigma campaigns and recovery-oriented practices. Increased transition to psychosis and poor clinical and functional outcomes are both associated with self-stigma. Psychiatric rehabilitation and recovery-oriented early interventions could reduce self-stigma and should be better integrated into public policy.
| S-EPMC8563656 | biostudies-literature
Project description:Although the last decade has seen a proliferation of research on mental illness stigma, lack of consistency and clarity in both the conceptualization and measurement of mental illness stigma has limited the accumulation of scientific knowledge about mental illness stigma and its consequences. In the present article, we bring together the different foci of mental illness stigma research with the Mental Illness Stigma Framework (MISF). The MISF provides a common framework and set of terminology for understanding mechanisms of mental illness stigma that are relevant to the study of both the stigmatized and the stigmatizer. We then apply this framework to systematically review and classify stigma measures used in the past decade according to their corresponding stigma mechanisms. We identified more than 400 measures of mental illness stigma, two thirds of which had not undergone any systematic psychometric evaluation. Stereotypes and discrimination received the most research attention, while mechanisms that focus on the perspective of individuals with mental illness (e.g., experienced, anticipated, or internalized stigma) have been the least studied. Finally, we use the MISF to discuss the strengths and weaknesses of mental illness stigma measurement, identify gaps in the literature, and provide recommendations for future research.
| S-EPMC6261312 | biostudies-literature
Project description:BackgroundEpilepsy and mental illness share similar problems in terms of stigma, as a result of centuries of superstition, ignorance and misbeliefs. Stigma leads not only to discrimination and civil and human rights violations but also to poor access to healthcare and non-adherence or decreased adherence to treatment, ultimately increasing morbidity and mortality. Despite continuous efforts in fighting stigma in these conditions, there is very limited knowledge on the phenomenon of double stigma, meaning the impact of having two stigmatised conditions at the same time.AimsTo discuss double stigma in mental health with special reference to epilepsy.MethodArticles were identified through searches in PubMed up to 31 October 2019 using the search terms 'epilepsy', 'psychiatric disorders', 'stigma' and additional material was identified from the authors' own files and from chosen bibliographies.ResultsDouble stigma is gaining attention for other stigmatised medical conditions, such as HIV, however, the literature on epilepsy is almost non-existent and this is quite astonishing given that one in three people with epilepsy have a lifetime diagnosis of a psychiatric condition. Felt (perceived) stigma and psychiatric disorders, particularly depression, create a vicious circle in epilepsy maintaining both, as depression correlates with stigma and vice versa as well as epilepsy and depression serving as bidirectional risk factors. This phenomenon has no geographical and economic boundaries as similar data have been reported for low-income and high-income countries.ConclusionsGovernments and policymakers as well as health services, patients' organisations, families and the general public need to be aware of the phenomenon of double stigma in order to develop campaigns and interventions tailored for these patients.
| S-EPMC7443902 | biostudies-literature
Project description:Psychiatric emergencies are severe behavioral changes secondary to worsening mental illness. Such situations present a risk to the patient and other people, so they need immediate therapeutic intervention. They are associated with feelings of fear, anger, prejudice, and even exclusion. The attitudes of professionals and factors related to the workplace culture in health can help to perpetuate stereotypes and interfere with the quality of care. Stigma has undesirable consequences in patients with mental disorders. Certain measures can reduce stigma and provide a more dignified way for patients to recover from the crisis. This article aims to discuss the causes of stigma, ways of dealing with it, and achievements that have been made in psychiatric emergency care settings.
| S-EPMC7319091 | biostudies-literature
Project description:An expert survey was designed to support the development of a workplace-based multi-country intervention tackling depression, anxiety, and mental illness-related stigma in small- and medium-sized enterprises (SMEs). Academic experts and representatives of SME organisations, specific sector organisations, labour or advocacy groups, and occupational health organisations, were contacted across eight European countries and Australia. The survey comprised closed and open text questions to assess expert opinion about interventions for employees with mental health difficulties, interventions supporting their managers, and anti-stigma interventions. The survey was available in six languages. The online platform Qualtrics was used for data collection. Quantitative data was analysed through descriptive statistics and qualitative data was analysed through thematic analysis. Sixty-five of 146 experts responded, representing a 42% response rate. Results showed only 26.2% of experts agreed that employees could speak openly about mental health issues, and 81.5% of experts indicated a large or medium unmet need for support for employees with mental health issues. Psychoeducational materials, face-to-face workshops and interventions based on cognitive behavioural therapy were ranked most likely to be taken up by employees. Experts rated as most useful for managers' guidelines on how to act if an employee has mental health issues (67.7%). The greatest number of experts indicated workshops of people with lived experience of mental illness (80.0%) and awareness campaigns (78.5%) were most required to tackle stigma. Responses were consistent between experts from different countries and areas of expertise. Experts in this multinational survey assessed that interventions supporting mental health in the workplace and tackling stigma are greatly needed. A multicomponent intervention with a wide range of materials and tools is supported.
| S-EPMC9305029 | biostudies-literature
Project description:We present an exploratory factor analysis of the 8-item Daily Indignities of Mental Illness (DIMI) scale, created to measure the detection and perceptions of recurring stigma among individuals with recent psychiatric hospitalizations. Structured in-person interviews were conducted with individuals with recent psychiatric hospitalizations in metropolitan New York. The 8-item DIMI scale's internal consistency for the sample (n = 65), measured by Cronbach's alpha, was 0.869. Statistically significantly higher DIMI scale scores were observed among individuals with more than 2 psychotic episodes and those reporting seeing relatives less often after hospitalization. The DIMI scale possesses good internal consistency for research contextualizing perceptions around the occurrence or recurrence of mental illness-related stigma among individuals with recent psychiatric hospitalizations.
| S-EPMC5756102 | biostudies-literature
Project description:BackgroundWhile many studies have explored the concept and correlates of stigma towards individuals with mental illness, few have investigated the role of personality in this process. In the current study, we firstly examined the relationship between personality and stigma towards mental illness; and then explored the moderating effects of personality traits on the relationship between contact experience/s and stigma.MethodsParticipants were recruited from public medical (N = 502) and nursing schools (N = 500) from April to September 2016 in Singapore for this cross-sectional survey, and they were randomly assigned to a vignette describing one of the following mental disorders: major depressive disorder, obsessive compulsive disorder, alcohol abuse, schizophrenia, and dementia. Stigma was measured by the 'Personal and Perceived scales of the Depression Stigma Scale' and the 'Social Distance Scale'. These scales together had a 3-factor structure based on a previous national study in Singapore, namely 'weak-not-sick', 'dangerous/unpredictable' and 'social distance'. Personality was measured by the 20-item short form of the International Personality Item Pool-five factor model measure.ResultsRegression suggested agreeableness and openness to experience were negatively associated with all three domains of stigma. 'Weak-not-sick' and extraversion were positively associated; and 'social distance' was positively associated with higher scores on conscientiousness and neuroticism. Both close- and non-close contact were associated with more positive attitudes towards mental illness among the participants. Openness to experience moderated the relationships of close contact experience with 'weak-not-sick' and 'dangerous/unpredictable', but in different directions. The association between close contact and 'social distance' were moderated by agreeableness.ConclusionsUnlike non-close contact experience, close contact with people with mental illness worked differently on stigma for individuals with different personality traits. Future studies are needed to further explore the underlying mechanisms for such differences.
| S-EPMC6219152 | biostudies-literature
Project description:BackgroundThere has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties.MethodA narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009.Results57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties.ConclusionsThe review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose.
| S-EPMC2851715 | biostudies-literature
Project description:ImportanceStigma, the prejudice and discrimination attached to mental illness, has been persistent, interfering with help-seeking, recovery, treatment resources, workforce development, and societal productivity in individuals with mental illness. However, studies assessing changes in public perceptions of mental illness have been limited.ObjectiveTo evaluate the nature, direction, and magnitude of population-based changes in US mental illness stigma over 22 years.Design, setting, and participantsThis survey study used data collected from the US National Stigma Studies, face-to-face interviews conducted as 1996, 2006, and 2018 General Social Survey modules of community-dwelling adults, based on nationally representative, multistage sampling techniques. Individuals aged 18 years or older, including Spanish-speaking respondents, living in noninstitutionalized settings were interviewed in 1996 (n = 1438), 2006 (n = 1520), and 2018 (n = 1171). The present study was conducted from July 2019 to January 2021.Main outcomes and measuresRespondents reacted to 1 of 3 vignettes (schizophrenia, depression, alcohol dependence) meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria or a control case (daily troubles). Measures included beliefs about underlying causes (attributions), perceptions of likely violence (danger to others), and rejection (desire for social distance).ResultsOf the 4129 individuals interviewed in the surveys, 2255 were women (54.6%); mean (SD) age was 44.6 (16.9) years. In the earlier period (1996-2006), respondents endorsing scientific attributions (eg, genetics) for schizophrenia (11.8%), depression (13.0%), and alcohol dependence (10.9%) increased. In the later period (2006-2018), the desire for social distance decreased for depression in work (18.1%), socializing (16.7%), friendship (9.7%), family marriage (14.3%), and group home (10.4%). Inconsistent, sometimes regressive change was observed, particularly regarding dangerousness for schizophrenia (1996-2018: 15.7% increase, P = .001) and bad character for alcohol dependence (1996-2018: 18.2% increase, P = .001). Subgroup differences, defined by race and ethnicity, sex, and educational level, were few and inconsistent. Change appeared to be consistent with age and generational shifts among 2 birth cohorts (1937-1946 and 1987-2000).Conclusions and relevanceTo date, this survey study found the first evidence of significant decreases in public stigma toward depression. The findings of this study suggest that individuals' age was a conservatizing factor whereas being in the pre-World War II or millennial birth cohorts was a progressive factor. However, stagnant stigma levels for other disorders and increasing public perceptions of likely violence among persons with schizophrenia call for rethinking stigma and retooling reduction strategies to increase service use, improve treatment resources, and advance population health.
| S-EPMC8693212 | biostudies-literature
Project description:BackgroundLarge efforts have been made to erase the stigma of mental illness, but it is unclear whether they have succeeded on a population level. We examine how attitudes toward people with depression or schizophrenia have evolved in Germany since 1990, and whether there are different developments for both disorders.MethodsUsing data from the three decades, four wave repeated cross-sectional representative population study in the "old" (western) states in Germany with surveys in 1990 (n = 2,044), 2001 (n = 4,005), 2011 (n = 1,984), and 2020 (n = 2,449), we calculate time-trends for social distance and emotional reactions toward someone with major depression or acute schizophrenia.ResultsSocial distance worsened in six out of seven situations for schizophrenia, whereas improving in two out of seven situations for depression. Emotions related to fear and uneasiness increased for schizophrenia, whereas tending to decrease for depression. Pro-social reactions like the desire to help increased for depression, but decreased for schizophrenia. Initially observed differences, favoring depression over schizophrenia, widened over the 30-year study period. For schizophrenia, the biggest negative changes occurred between 1990 and 2001, whereas some improvements with regard to depression occurred more recently.ConclusionContrary to expectations, stigma has become more severe regarding acute schizophrenia in Germany over the last 30 years, whereas only slightly improving for depression. The apparent normalization of mental health problems seems not to directly translate into improving attitudes toward people with severe mental illness. Re-focusing of anti-stigma efforts on people with severe mental illness seems necessary.
| S-EPMC9724218 | biostudies-literature