Stigma Despite Recovery (original) (raw)
Related papers
Stigma Despite Recovery: Strategies for Living in the Aftermath of Psychosis
Strategies for Living in the Aftermath of Psychosis In this article, we identify an array of creative strategies used by persons diagnosed with schizophrenia-related illness to deflect and resist social stigma, and address the lived experience of deploying these strategies in the intersubjective context of everyday life. The data are derived from anthropological interviews and ethnographic observations of ninety persons who received treatment at community mental health facilities in an urban North American locale. Nearly all were keenly aware of stigma that permeated their lives. Their predicament is contradictory: on the one hand, they have recovered relative to previous states of psychosis; on the other hand, their subjectivity is saturated by intense awareness of social stigma that seems intractable in relation to temporal or functional criteria. Ironically, these lives can be characterized as fraught with stigma despite recovery. The strategies generated to resist the impact of stigma highlight the fact that persons with these illnesses are often not only exceedingly socially aware but also strategically skilled in response to social assaults on their personhood and survival. We examine these strategies in terms of (1) the social characteristics of each afflicted person, (2) the situational characteristics of managing stigma, (3) the cultural context of recovery, and (4) the illness-specific characteristics of schizophrenia. Keywords: [stigma, culture, mental illness, psychosis, schizophrenia and schizoaffective
Awareness of Stigma Among Persons With Schizophrenia: Marking the Contexts of Lived Experience
This article investigates the subjective experience of stigma attached to schizophrenia-related disorders. We examine data from anthropological interviews from a community sample of 90 out-patients residing in a metropolitan area of the United States. Patients were under treatment with atypical antipsychotic medication, and their symptoms were for the most part relatively well controlled. Overall, 96% of participants reported an awareness of stigma that permeated their daily life. Based on an understanding of stigma as a product of interpersonal, reciprocal social processes, we identify 6 types of social relations and 5 identity domains in which social stigma is routinely encountered by participants. We describe the experience of stigma in each of these 11 subcategories, and suggest that taken together they constitute a framework of social and personal factors involved in the struggle to recover from psychotic illness. Among types of social relations, anonymous social interactions most commonly generated an awareness of stigma. Among identity domains, being a person who regularly takes medication was most commonly associated with an awareness of stigma. The finding that multiple forms of stigma are encountered irrespective of substantial symptomatic, functional, and subjectively perceived improvement creates a complex situation of stigma despite recovery.
Awareness of Stigma Among Persons With Schizophrenia
The Journal of Nervous and Mental Disease, 2009
This article investigates the subjective experience of stigma attached to schizophrenia-related disorders. We examine data from anthropological interviews from a community sample of 90 out-patients residing in a metropolitan area of the United States. Patients were under treatment with atypical antipsychotic medication, and their symptoms were for the most part relatively well controlled. Overall, 96% of participants reported an awareness of stigma that permeated their daily life. Based on an understanding of stigma as a product of interpersonal, reciprocal social processes, we identify 6 types of social relations and 5 identity domains in which social stigma is routinely encountered by participants. We describe the experience of stigma in each of these 11 subcategories, and suggest that taken together they constitute a framework of social and personal factors involved in the struggle to recover from psychotic illness. Among types of social relations, anonymous social interactions most commonly generated an awareness of stigma. Among identity domains, being a person who regularly takes medication was most commonly associated with an awareness of stigma. The finding that multiple forms of stigma are encountered irrespective of substantial symptomatic, functional, and subjectively perceived improvement creates a complex situation of stigma despite recovery. a Total number of subjects equals 86 who indicated awareness of stigma; 4 responses were judged as lacking or insufficient to code presence of awareness of stigma.
Reflections on Mental Health Stigma Narrative and the Lived Experience of Schizophrenia
Canadian Journal of Practical Philosophy, 2020
I offer a preliminary examination on the importance of narrative for helping to overcome the issue of stigma surrounding mental illness, specifically schizophrenia. I maintain that engaging with first-person accounts of schizophrenia allows caregivers, and the broader general public, to better understand the phenomenological lived experiences of persons living with this mental health challenge and to better understand the experience of dealing with stigma. In doing so, I maintain that both caregivers and the public can begin developing more accepting views of schizophrenia and begin to support those who need it the most.
Experiences of stigma and discrimination endured by people suffering from schizophrenia
Indian Journal of Psychiatry, 2008
Objective: It is important to understand stigma in India, given its varied culture and mixture of rural and urban populations. Information from western literature cannot be applied without considering the sociocultural differences. Aims: The research aimed to study the subjective experiences of stigma and discrimination undergone by people suffering from schizophrenia in rural and urban environments in India. Settings and Design: Patients were selected from the outpatient services of six adult psychiatric units of the National Institute of Mental Health and Neurosciences (NIMHANS), India, and from the six outreach centers located in rural areas. Materials and Method: Two hundred patients diagnosed with schizophrenia were selected from rural and urban areas. The experiences of stigma and discrimination were assessed using a semi-structured instrument. Statistical Techniques: Both quantitative and qualitative analyses were done. Results: Signifi cant differences were seen between rural and urban respondents. Urban respondents felt the need to hide their illness and avoided illness histories in job applications, whereas rural respondents experienced more ridicule, shame, and discrimination. The narratives provide direct views of patients, supporting the key fi ndings. Conclusion: Mental health programs and policies need to be sensitive to the consumers' needs and to organize services and to effectively decrease stigma and discrimination.
Psychiatrist 2011 35(4):135-139, 2011
The term 'stigma' was popularised in the social sciences by Erving Goffman, 1 who used it to refer to 'an attribute that is deeply discrediting'. The author noticed, however, that 'a language of relationships, not attributes is really needed' and he emphasised the dynamic process of the social construction of stigma. Strictly speaking, in Goffman's formulation, stigma 'is really a special kind of relationship between attribute and stereotype'. For practical reasons, however, Goffman often spoke about stigma as if it were an attribute, because there are important attributes that are discrediting in all contexts. One typical example is mental illness. Although societal reactions to some attributes, such as obesity, show substantial variability across time and across cultures, mental illness seems to be associated with a stigma that is universal and less dependent on historical or cultural contingencies. 2 The review of the studies conducted in recent years confirms unequivocally that stigmatisation of people receiving psychiatric treatment is a common, transcultural phenomenon, and mental illness is still a strong socially excluding condition. 3-5 A large body of research indicates that stigma may exert numerous detrimental effects on people with mental disorders, limiting their life opportunities and leading to diminished self-esteem and self-efficacy, compromised quality of life and non-adherence to treatment. 3,6 ORIGINAL PAPERS Świtaj et al Stigma among people with schizophrenia, depression and malignancies
Experiences of Stigma Among Outpatients With Schizophrenia
Schizophrenia …, 2002
Many individuals with schizophrenia are devalued and discriminated against because of their mental illness. There has been only limited study of how individuals with schizophrenia experience mental illness stigma. We evaluated 74 stable outpatients with schizophrenia receiving community care. Study participants were interviewed with the Consumer Experiences of Stigma Questionnaire (CESQ), the Positive and Negative Syndrome Scale, and several social functioning measures. On the CESQ, all but one respondent indicated having at least one stigma experience. The most frequently reported CESQ items were respondents' worry about being viewed unfavorably because of their psychiatric illness (70%) and avoidance of telling others about it (58%). Many respondents also indicated having heard offensive statements (55%) and media accounts (43%) about persons with psychiatric disorders. Socioeconomic variables, but not symptoms or social functioning measures, were related to the extent of stigma and discrimination experiences. These results document the extent to which persons with mental illness experience negative reactions from others. Strategies are needed to enhance how persons with schizophrenia cope with stigma.
Stigma, agency and recovery amongst people with severe mental illness
Social Science & Medicine, 2014
Evidence suggests that people with a severe mental illness still suffer high levels of stigma and discrimination. However little is known about how people with a severe mental illness manage such stigma. As such, the overall aim of this study is to document and analyze behavioral and psychological strategies of stigma management and control in a sample of people in recovery from a severe mental illness. To meet this aim, we conducted a five-year (2008e2012) qualitative longitudinal study in Washington D.C. Participants were recruited from small-scale congregate housing units ('recovery communities') for people in recovery, provided by a public mental health agency. We conducted regular focus groups at these communities, augmented by in-depth participant observation. Analysis was propelled by the grounded theory approach. A key finding of this study is that stigma and discrimination were not perceived as commonly experienced problems by participants. Instead, stigma and discrimination were perceived as omnipresent potential problems to which participants remained eternally vigilant, taking various preventive measures. Most notable among these measures was a concerted and self-conscious effort to behave and look 'normal'; through dress, appearance, conduct and demeanor. In this endeavor, participants possessed and deployed a considered degree of agency to prevent, avoid or preempt stigma and discrimination. These efforts appeared to have a strong semiotic dimension, as participants reported their developing 'normality' (and increased agentic power) was tangible proof of their ongoing recovery. Participants also routinely discussed severe mental illness in normative terms, noting its similarity to physical illnesses such as diabetes, or to generic mental health problems experienced by all. These behavioral and psychological strategies of normalization appeared to be consolidated within the recovery communities, which provided physical shelter and highly-valued peer support. This fostered participants' ability to face and embrace the outside world with confidence, pride and dignity.
The Israel journal of psychiatry and related sciences, 2017
Stigma and discrimination are major difficulties for people with psychosis. However, despite the dominance of biomedical ideology in public education and de-stigmatization efforts, there is substantial evidence that campaigns based on the "medical model" (such as the "mental illness is an illness like any other" approach) are not only ineffective, but can actually compound the problem. This paper considers the alternative role of psychosocial explanatory frameworks in promoting more tolerant and enlightened approaches to, and attitudes about, psychosis. A summary of theoretical and empirical research on the effectiveness of mental health anti-stigma campaigns is presented. There is a reasonably substantial evidencebase supporting the hypothesis that anti-stigma campaigns which frame psychosis as a meaningful response to adversity are effective. They are a more promising approach to "humanizing" people with complex mental health problems than strategies ...