The role of stigma in the quality of life of older adults with severe mental illness
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Stigma and discrimination against older people with mental illness is a seriously neglected problem.(1) To investigate whether stigmatisation of older adults with mental disorder is associated with the type of residential institution they live in or the type of disorder they suffer and (2) to assess the role of stigma experiences in their quality of life.A cross-sectional study was carried out of 131 older adults with severe mental illness, recruited in 18 elder care homes operating supported living programmes and in eight psychiatric hospitals throughout the Netherlands. Stigmatisation was assessed with an 11-item questionnaire on stigma experiences associated with mental illness. Quality of life was assessed with the Manchester Short Assessment of Quality of Life (MANSA). To better ascertain the role of stigma, we also assessed in comparison the relationship of social participation to quality of life.Some 57% of the respondents had experienced stigmatisation. No association emerged between residential type or disorder type and the extent of stigma experiences. Stigmatisation did show a negative association with quality of life, a connection stronger than that between social participation and quality of life.A feeling of belonging, as contrasted with being excluded, is at least as important for the quality of life of older people with severe mental illness as their actual participation in the community.Keywords:
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The stigma surrounding mental illness remains and has, in some instances, grown over time, despite the public's general acceptance of mental illness as a biomedical condition. This chapter explores two questions that continue to puzzle social scientists and thwart easy explanations: why the stigma of mental illness persists and why the negative consequences of stigma are so difficult to eliminate. It discusses how and why the mental illness label remains salient across situations, how the category of mental illness has expanded and assumed new dimensions, and how perceptions of violence continue to ungird much of the stigma surrounding behavioral problems. It also discusses the limited toolkit available to those wishing to cope with stigma's aftermath. The stigma surrounding mental illness persists and remains consequential because of a variety of social, cultural, and structural factors, not all of which have progressed over time.
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SUMMARY A stigma is a mark of infamy or disgrace. People who are stigmatised 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 stigmatisation of the mentally ill will not stop until this negative evaluation is removed from diagnosis.
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Objective: To demonstrate how mass media advertising and community education has been successfully used in New Zealand as part of a comprehensive public health project to reduce stigma and discrimination associated with mental illness. Conclusions: The involvement of people with experience of mental illness in the campaign has been critical to its success. Advertising involving the stories of well-known and famous people who have experienced mental illness has created significant interest, awareness and improved attitudes among the general public. Local community education and other follow-up activities have also contributed to this success.
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To demonstrate how mass media advertising and community education has been successfully used in New Zealand as part of a comprehensive public health project to reduce stigma and discrimination associated with mental illness.The involvement of people with experience of mental illness in the campaign has been critical to its success. Advertising involving the stories of well-known and famous people who have experienced mental illness has created significant interest, awareness and improved attitudes among the general public. Local community education and other follow-up activities have also contributed to this success.
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This article describes the nature of stigma attached to persons with mental illness and their family members. Stigma attached to persons with mental illness and those close to them, and the stigma experienced or internalized by persons with mental illness are delineated. The results present data about prevalence of mental illness in our country and the cross-cultural studies indicating the prevalence of different types of stigma in different cultures. Different modes of stigmatization and their impact on persons with mental illness are discussed, as well as the ways in which mass-media create stereotypes about mental illness. Summaries of the scales used for measuring stigma and anti-stigma programmes are also included.
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