Perception of stigma among family members of individuals with schizophrenia and major affective disorders in rural Ethiopia

Social Psychiatry and Psychiatric Epidemiology (Impact Factor: 2.58). 01/2001; 36(6):299-303. DOI: 10.1007/s001270170048
Source: PubMed

ABSTRACT Background: Many studies from the Western world have reported on stigmatisation of people with mental illnesses and its negative consequences,
but few studies have addressed the issue in traditional rural societies. The present study aimed to estimate the extent and
socio-demographic distribution of stigma as perceived by relatives of mentally ill individuals in rural Ethiopia. Method: A total of 178 relatives of individuals who were diagnosed as suffering from schizophrenia or major affective disorders in
a community-based survey were interviewed using the Family Interview Schedule. Results: About 75 % of the respondents perceived that they were stigmatised or had experienced some sort of stigma due to the presence
of mental illness in the family, 42 % were worried about being treated differently and 37 % wanted to conceal the fact that
a relative was ill. Those from the older age group (45+) and urban residents were more likely to perceive stigma as a major
problem, but otherwise differences were few between socio-demographic groups. The illness was attributed to supernatural forces
by 27 % and praying was suggested as a preferred method to deal with the problem by 65 %. Conclusion: Stigma was found to be a common problem, with few differences between socio-demographic groups or between types of mental
disorder. Beliefs about causes differ from those held by professionals. Popular beliefs and attitudes must be taken into account
when planning for intervention.

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    ABSTRACT: In China, caregivers for family members with schizophrenia play an important role in treatment and recovery but may experience stigma and discrimination simply because of their family relationship. The object of this study was to measure the degrees and correlates of stigma and discrimination experiences among this group. Four hundred twenty-seven caregivers participated in this hospital-based and cross-sectional study in Ningbo and Guangzhou, China. Data were collected by trained interviewers using fixed questionnaires. Stigma and discrimination experiences were measured by the Modified Consumer Experiences of Stigma Questionnaire (MCESQ). Caregivers' social support was measured by the Social Support Rating Scale. Parametric analysis, nonparametric analysis and multivariate linear regression were used. The mean (SD) score of MCESQ was 2.44(0.45), 2.91(0.71) for stigma experiences and 1.97(0.37) for discrimination experiences on a five-point score ("1 = never" and "5 = very often"). Approximately 65% of caregivers reported that they tried to conceal their family members' illness, and 71% lacked the support of friends. The experience of stigma was significantly negatively associated with the perceived social support of caregivers (standard β = -0.2,p<0.001). Caregivers who were children of the patients experienced fewer stigmas than other (standard β = -0.18, p<0.001). Urban residence (standard β = -0.12, p<0.01) and patients did not complete primary school education (standard β = -0.13, p<0.01) were negatively related with stigmas. In addition, stigma and discrimination was more experienced in Zhejiang than in Guangdong (p<0.05). In conclusion, this study performed that caregivers of people with schizophrenia in China experienced general stigmas and rare discrimination and found the relations with social support, kinship, patient's educational level and regional differences. More interventions and supports should been given to caregivers who are lack of social support, who live in rural area and who are the patients' parents, spouses or siblings.
    PLoS ONE 09/2014; 9(9):e108527. DOI:10.1371/journal.pone.0108527 · 3.53 Impact Factor
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    ABSTRACT: Background: Global mental health (GMH) advocates for access to and the equitable provision of mental health care. Although the treatment gap is a useful construct to measure access and equitability of care, it fails to communicate the real-life consequences of the treatment gap and the urgent need to address care disparities. Objective: The aim of this article is to present a perspective on the practical application of the principles of GMH to understand the real-life impact of the treatment gap and the approaches taken to improve treatment coverage in Ethiopia. Design: A case study method is used. Results: Multiple international collaborations undertaken in Ethiopia and facilitated by GMH to improve care, capacity, and the evidence base for increased treatment coverage are described briefly. A series of steps taken at the local and national levels to address the treatment gap are highlighted. The stories of two patients are also presented to illustrate the real-life consequences of the treatment gap and the potential transformational impact of addressing the treatment gap on patients, families, and communities. Conclusions: GMH has a key role to play in addressing the treatment gap, which improves the life of people with mental disorders, their families, and their communities. However, national-level policy support and coordination are essential for any realistic improvement in treatment coverage. The reflections offered through the case examples may have utility in similar low-income settings.
    Global Health Action 09/2014; 7:25447. DOI:10.3402/gha.v7.25447 · 1.65 Impact Factor
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    ABSTRACT: Family interventions for schizophrenia have been amply demonstrated to be effective and are recommended by most of the international clinical guidelines. However, their implementation in the clinical setting as well as in treatment protocols of patients with psychosis has not been fully achieved yet. With the increasing deinstitutionalization of patients, family has begun to assume the role of care performed by psychiatric hospitals, with a high emotional cost for caregivers as well as the recognition of burden experiences. Families have been the substitute in the face of the scarcity of therapeutic, occupational, and residential resources. For this reason, the viability of patients' care by their families has become a challenge. This article aims to discuss the most important aspects of family interventions, their impact on families, and the most important challenges that need to be overcome in order to achieve well-being and recovery in both patients and caregivers.
    Neuropsychiatric Disease and Treatment 01/2015; 11:145-51. DOI:10.2147/NDT.S51331 · 2.15 Impact Factor

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