Article

Stigma: the feelings and experiences of 46 people with mental illness - Qualitative study

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London, UK.
The British Journal of Psychiatry (Impact Factor: 7.34). 03/2004; 184:176-81. DOI: 10.1192/bjp.184.2.176
Source: PubMed

ABSTRACT Stigma defines people in terms of some distinguishing characteristic and devalues them as a consequence.
To describe the relationship of stigma with mental illness, psychiatric diagnosis, treatment and its consequences of stigma for the individual.
Narrative interviews were conducted by trained users of the local mental health services; 46 patients were recruited from community and day mental health services in North London.
Stigma was a pervasive concern to almost all participants. People with psychosis or drug dependence were most likely to report feelings and experiences of stigma and were most affected by them. Those with depression, anxiety and personality disorders were more affected by patronising attitudes and feelings of stigma even if they had not experienced any overt discrimination. However, experiences were not universally negative.
Stigma may influence how a psychiatric diagnosis is accepted, whether treatment will be adhered to and how people with mental illness function in the world. However, perceptions of mental illness and diagnoses can be helpful and non-stigmatising for some patients.

0 Bookmarks
 · 
110 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although studies suggest that fear plays an important role in shaping mental health service users' experiences, evidence is patchy and the contexts, conditions and consequences of fear have rarely been researched. This paper explores the role of fear in adult mental health service users' lives and describes its implications for mental health services. Four community health service user focus groups (N32) were held. Each group was reconvened after 7-14 days. An initial thematic analysis generated a service user definition of continuity of care (reported elsewhere). A Straussian 'secondary grounded theory analysis' was conducted to gain a deeper understanding of participants' experiences. 'Being afraid' was identified as a core process, with power and control, and stigma and discrimination found to have explanatory power in determining how and why fear manifests. Consequences included distrusting staff, cooperating reluctantly, learning reticence, delaying help-seeking, avoiding services, feeling unsafe in the community and avoiding exposure as a service user. Our model suggests that fear plays a substantial role in the lives of adult mental health service users. This has particular consequences for therapeutic relationships, engagement with services and engagement with the wider community. This lack of engagement is associated with adverse outcomes. Further research into the role of fear and the factors that mediate against it is warranted.
    Social Psychiatry and Psychiatric Epidemiology 02/2015; DOI:10.1007/s00127-015-1028-z · 2.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Stigma is a common and pervasive problem for many people with psychosis. Much of the research examining internalised stigma has utilised quantitative methodology; however, it has been argued that to conceptualise experiences of psychosis, research should also attend to subjective experience. This study explores accounts of stigma from nine people with psychosis through semi-structured interviews that were analysed using Interpretative Phenomenological Analysis. Three super-ordinate themes of judgement, disclosure and psychological distress were identified. Analysis of the data found that stigma was experienced directly and indirectly through social judgements. In particular, it was considered that negative messages and the absence of positive images of psychosis in the media perpetuated social judgements. Difficulties were reported in relation to disclosure, including avoidance from others following disclosure and coping strategies to conceal experiences of psychosis. Ultimately, judgement and issues of disclosure had a negative impact on psychological well-being, either contributing to, or resulting in, psychological distress, including increased paranoia, anxiety and lowered self-esteem. Potential exits from the negative effects of stigma, including peer support, were identified in the data. Implications for future research and clinical practice, including interventions to reduce internalised stigma, are suggested.
    Psychosis 10/2013; 6(3):195-205. DOI:10.1080/17522439.2013.834458
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background This mixed methods study explored the characteristics of and experiences with perceived discrimination in an ethnically diverse urban sample of adults experiencing homelessness and mental illness.Methods Data were collected in Toronto, Ontario, as part of a 4-year national randomized field trial of the Housing First treatment model. Rates of perceived discrimination were captured from survey questions regarding perceived discrimination among 231 ethnoracially diverse participants with moderate mental health needs. The qualitative component included thirty six in-depth interviews which explored how individuals who bear these multiple identities of oppression navigate stigma and discrimination, and what affects their capacity to do so.ResultsQuantitative analysis revealed very high rates of perceived discrimination related to: homelessness/poverty (61.5%), race/ethnicity/skin colour (50.6%) and mental illness/substance use (43.7%). Immigrants and those who had been homeless three or more years reported higher perceived discrimination on all three domains. Analysis of qualitative interviews revealed three common themes related to navigating these experiences of discrimination among participants: 1) social distancing; 2) old and new labels/identities; and, 3) `homeland¿ cultures.Conclusions These study findings underscore poverty and homelessness as major sources of perceived discrimination, and expose underlying complexities in the navigation of multiple identities in responding to stigma and discrimination.Trial registrationCurrent Controlled Trials ISRCTN42520374. Registered 18 August 2009.
    BMC Psychiatry 12/2014; 14(1):353. DOI:10.1186/s12888-014-0353-1 · 2.24 Impact Factor

Full-text (2 Sources)

Download
64 Downloads
Available from
Jul 29, 2014