O estigma da doença mental: que caminho percorremos?

Mental illness stigma has been the focus of increasing attention in the past few years, with an exponential increase in scientific publications on the subject. This phenomenon is a source of suffering for the patient undermining the achievement of personal goals and full social integration. In this article, the authors present a selective review of the literature on mental illness stigma, going through its definition, origins, repercussions, patients’ subjective experiences and strategies to challenge stigma. The literature presents stigma as being a complex phenomenon, whose definitions derive from different epis- temological roots (sociology, psychology and psychiatry). Its impact on the lives of people with a mental illness is well acknowledged and seems to translate into decreased oppor tunities, loss of self-esteem and self-concept, decreased quality of life, social support and empowerment, thus limiting the adoption or performance of regular social roles. Stigma has also been shown to compromise access to health care, not only psychiatric treatment but also general medical care, thus increasing the morbidity and mortality in this vulnerable population. A considerable amount of effort has been put into the comprehension of this phenomenon and to designing strategies for fighting stigma, which also include promoting health-care professionals’ awareness of the topic in order to improve clinical practice and global quality of care.