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[Show abstract][Hide abstract] ABSTRACT: Specification of the earliest institution devoted primarily to the treatment of the mentally ill in the Western World remains elusive. Uncertainty arises from limited documentation and gradual evolution of most candidate sites from hospices for the poor, foreign, or homeless, or as clinical centers for the care of a range of persons with general medical and psychiatric disorders. Plausible candidates identified in the late fourteenth and early fifteenth centuries include Bethlem Asylum in London. Much less often considered are two centers in medieval Spain: the Moorish Maristan at Granada (1365) and the Christian Hospital of Our Lady Mary for Lunatics, the Insane and Innocents at Valencia (1409). Since the early Spanish sites are not well known, we have summarized available information concerning their foundation, facilities, theories and practices, as arising from the cultural and political background of the times and regions.
[Show abstract][Hide abstract] ABSTRACT: Our paper provides an overview of current stigma discourse, the origins and nature of the stigma associated with mental illnesses, stigmatization by health providers, and approaches to stigma reduction. This is a narrative review focusing on seminal works from the social and psychological literature, with selected qualitative and quantitative studies and international policy documents to highlight key points. Stigma discourse has increasingly moved toward a human rights model that views stigma as a form of social oppression resulting from a complex sociopolitical process that exploits and entrenches the power imbalance between people who stigmatize and those who are stigmatized. People who have a mental illness have identified mental health and health providers as key contributors to the stigmatization process and worthy targets of antistigma interventions. Six approaches to stigma reduction are described: education, protest, contact-based education, legislative reform, advocacy, and stigma self-management. Stigma denigrates the value of people who have a mental illness and the social and professional support systems designed to support them. It creates inequities in funding and service delivery that undermine recovery and full social participation. Mental health professionals have often been identified as part of the problem, but they can redress this situation by becoming important partners in antistigma work.
Canadian journal of psychiatry. Revue canadienne de psychiatrie 08/2012; 57(8):457-63. · 2.55 Impact Factor