Stigma and discrimination: A socio-cultural etiology of mental illness.
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Stigma and discrimination against mental illness represent chronic social stressors that can inflame psychiatric symptoms and limit functional adjustment. The implication is that the prevalence and severity of mental illness is determined, at least to a certain extent, by aversive socio-cultural factors. In a hostile social environment, these factors may seriously limit the effectiveness of professional interventions; whereas, removing social barriers to functioning often results in a favorable clinical outcome. For example, studies show that inclusive settings with supportive employment decrease psychiatric symptoms and the use of mental health services. By extrapolation, these results point to the possibility that a society-wide reduction in the prevalence and severity of mental illness may come from benevolent changes in the social climate, not just from innovative treatments. Public health policies rarely take this possibility into consideration in resource allocation decisions.Keywords:
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A stigma is a mark of infamy or disgrace. People who are stigmatized are subject to abuse and social exclusion. Negative attitudes towards people with mental illness are attributed to stigma. In the literature, stigma is regarded as something that is attached to a person--like a badge or label. This is undermined by two facts. Firstly, it is the person who is regarded as disgraceful, not the illness or diagnosis, and secondly, the diagnosis of mental illness is itself evaluative. Mental illness is by definition bad, so to be diagnosed as mentally ill is to be defined as bad (or somehow wrong). The stigmatization of the mentally ill will not stop until this negative evaluation is removed from diagnosis.
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Stigmatization of individuals with mental illnesses is widespread and serves as a major barrier to treatment. In a survey of 116 undergraduates, the authors examined the impact of diagnosis, attitudes about treatment, and psychiatric terminology on stigma associated with mental illness. Stigmatization of schizophrenia was significantly higher than stigmatization of depression. More positive attitudes toward treatment were associated with significantly less stigma. However, psychiatric terminology had no impact on attitudes toward mental illness. Significantly less stigmatization of mental illness was found among females than among males. Reducing the stigmatization of mental illness continues to be an important goal for mental health professionals.
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Psychiatric patients carry the additional burden of stigma.The views of 300 psychiatric out-patients and day-patients and 100 mental health workers concerning stigma were sought. The control group comprised 50 cardiac out-patients.A fair proportion of patients with schizophrenia or depression perceived that stigma had a negative effect on their self-esteem, relationships and job opportunities. The majority felt a need for an increase in public awareness of mental illness. In contrast, the cardiac patients reported very little stigmatization.The diagnostic label of mental illness may render the person vulnerable to stigmatization. Possible causes of stigma and ways of reducing stigma are discussed.
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Effects of stigma on psychiatric treatment. The Experience of Stigma. Stigma: families suffer too. A letter from a resident. The stigmatized patient. Historical Aspects of Stigma. Shame, stigma, and mental illness in ancient Greece. Stigma during the medieval and renaissance periods. The Devon Asylum: a brief history of the changing concept of mental illness and asylum treatment. Madness and the stigma of sin in American Christianity. Societal Issues. The consequences of stigma for persons with mental illness: evidence from the social sciences. Stigma and stereotype: homeless mentally ill persons. Cinematic stereotypes contributing to the stigmatization of psychiatrists. The stigmatized family. Fighting stigma: how to help the doctor's family. Institutional Issues. The stigma of mental illness for medical students and residents. Societal factors in the problems faced by deinstitutionalized psychiatric patients. The psychiatric hospital and reduction of stigma. The stigma of electroconvulsive therapy: a workshop. The stigmatization of psychiatrists who work with chronically mentally ill persons. Overcoming stigma: the Mad Hatters.
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Abstract Stigma involves negative beliefs and devaluations of people in socially identified groups, which some people internalize. Research has increasingly explored mental illness self-stigma, when people with mental illness believe society's negative beliefs are true of them (e.g., they are hopeless due to mental illness). Self-stigma predicts poorer functional and treatment outcomes. Forensic psychiatric patients experience multiple stigmas, yet no research has explored how stigmas due to mental illness, race, and criminal history influence each other. This review discusses relevant stigma research, which suggests that self-stigma in forensic psychiatric populations likely interferes with rehabilitation and avoiding re-arrest. Forensic psychiatric stigma is particularly relevant given increasing social attention on violence, incarceration, mental illness, and race. Conclusions discuss targets for future research. Keywords: forensic psychiatric patientsmental illnessoffendersraceself-stigmastigma
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This study examined how two types of public education programs influenced how the public perceived persons with mental illness, their potential for violence, and the stigma of mental illness. A total of 161 participants were randomly assigned to one of three programs: one that aimed to combat stigma, one that highlighted the association between violence and psychiatric disorders, and a control group. Participants who completed the education-about-violence program were significantly more likely to report attitudes related to fear and dangerousness, to endorse services that coerced persons into treatment and treated them in segregated areas, to avoid persons with mental illness in social situations, and to be reluctant to help persons with mental illness.
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