Prejudice and discrimination from mental health service providers (original) (raw)
Related papers
Perceptions of Discrimination Among Persons With Serious Mental Illness
Psychiatric Services, 2003
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Recent research demonstrated that a stigma reduction intervention based on acceptance and commitment therapy (ACT) may be more effective than one focused on education about mental illness. Studies have often evaluated interventions using tools with weak or unknown psychometric properties. The current project aims to appraise two interventions – education, and acceptance and commitment training – using a new multidimensional measure of Prejudice towards People with Mental Illness (PPMI). We assessed participants (N ¼152) two weeks apart (pre-and post-intervention) using the PPMI scale, comprising dimensions of fear/avoidance, malevolence, authoritarianism, and unpredictability. Both interventions were effective, although the ACT-based intervention was significantly better at reducing overall prejudice. Responses differed across PPMI subscales. Malevolent attitudes worsened slightly following both interventions, suggesting individuals may be less empathetic towards those with mental illness following stigma reduction interventions. We discuss implications for future interventions to reduce prejudice towards people with mental illness.
Perceived and anticipated discrimination in people with mental illness—An interview study
Nordic Journal of Psychiatry, 2013
Background Studies on perceived discrimination of people with mental illness are largely lacking. The purpose of the study was to investigate perceived discrimination in a sample of users in contact with mental health services in Sweden. Methods Interviews were conducted with 156 users, asking for perceived and anticipated discrimination during the last two years. Background characteristics were also collected. Results Perceived discrimination was common. Highest frequencies were reported regarding family (54%), avoidance by people who knew about the mental illness (53%) and in making or keeping friends (50%). A majority of those anticipating discrimination regarding job or education seeking, or starting a close relationship did not report having been discriminated in these areas. Previous hospitalizations were associated with discrimination, and age with anticipated discrimination. Conclusions Public stigma and self-stigma have been reported to have a number of negative consequences for people with mental illness. Discrimination is part of this complex situation and this study showed that this to a large extent affects a number of individual life areas posing an obstacle for social integration. Anticipated discrimination or self-stigma was also prevalent and it is pointed out that this to a great extent is an obstacle on its own without being promoted by actual experiences of discrimination.
Mental Health–Related Discrimination as a Predictor of Low Engagement With Mental Health Services
This study aimed to test the hypothesis that mental health-related discrimination experienced by adults receiving care from community mental health teams is associated with low engagement with services and to explore the pathways between these two variables. Methods: In this cross-sectional study, 202 adults registered with inner-city community mental health teams in the United Kingdom completed interviews assessing their engagement with mental health services (service user-rated version of the Service Engagement Scale), discrimination that they experienced because of mental illness, and other variables. Structural equation modeling was conducted to examine the relationship of experienced discrimination and service engagement with potential mediating and moderating variables, such as anticipated discrimination (Questionnaire on Anticipated Discrimination), internalized stigma (Internalized Stigma of Mental Illness Scale), stigma stress appraisal (Stigma Stress Appraisal), mistrust in services, the therapeutic relationship (Scale to Assess Therapeutic Relationships), difficulty disclosing information about one's mental health, and social support. Analyses controlled for age, race-ethnicity, and symptomatology. Results: No evidence was found for a direct effect between experienced discrimination and service engagement. The total indirect effect of experienced discrimination on service engagement was statistically significant (coefficient=1.055, 95% confidence interval [CI]=.312-2.074, p=.019), mainly via mistrust in mental health services and therapeutic relationships (coefficient=.804, CI=.295-1.558, p=.019). A 1-unit increase in experienced discrimination via this pathway resulted in .804-unit of deterioration in service engagement. Conclusions: Findings indicate the importance of building and maintaining service users' trust in mental health services and in therapeutic relationships with professionals and countering the discrimination that may erode trust.
Reducing stigma and discrimination: Candidate interventions
International Journal of …, 2008
This paper proposes that stigma in relation to people with mental illness can be understood as a combination of problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). From a literature review, a series of candidate interventions are identified which may be effective in reducing stigmatisation and discrimination at the following levels: individuals with mental illness and their family members; the workplace; and local, national and international. The strongest evidence for effective interventions at present is for (i) direct social contact with people with mental illness at the individual level, and (ii) social marketing at the population level.
http://isrctn.com/, 2018
Background: Care assistant workers as a new pattern of care providers in China play an important role in bridging the mental health treatment gap. Stigma and discrimination against people with mental disorders among care assistant workers is a barrier which adversely influences mental health service delivery. However, programs aimed at reducing stigma among care assistant workers are rare in China. Methods: A total of 293 care assistant workers from four districts of Guangzhou, China were randomly divided into an intervention group (n = 139) and a control group (n = 154). The intervention group received anti-stigma training and the control group received traditional mental health training. Both trainings lasted for 3 h. Participants were measured before and after training using Perceived Devaluation and Discrimination Scale (PDD), Mental illness: Clinicians' Attitudes (MICA) and Mental Health Knowledge Schedule (MAKS). Data were analyzed by descriptive statistics, t-test, Chi square test or Fisher's exact test. Multilinear regression models were performed to calculate adjusted regression coefficient of the intervention on PPD, MAKS, and MICA. Results: There were significant lower scores on PDD and MICA in the intervention group after training when compared with the control group (both P < 0.001). No significant difference was found on MAKS total score between the two groups after training (P = 0.118). Both groups had better correct identification of schizophrenia, depression and bipolar disorder before and after training. Conclusions: These findings suggest that anti-stigma training may be effective in reducing the perception of devaluation-discrimination against people with mental illness and decreasing the level of negative stigma-related mental health attitudes among care assistant workers.
Understanding the impact of stigma on people with mental illness
World psychiatry : official journal of the World Psychiatric Association (WPA), 2002
Table 1 Comparing and contrasting the definitions of public stigma and self-stigma Public stigma Stereotype Negative belief about a group (e.g., dangerousness, incompetence, character weakness) Prejudice Agreement with belief and/or negative emotional reaction (e.g., anger, fear) Discrimination Behavior response to prejudice (e.g., avoidance, withhold employment and housing opportunities, withhold help) Self-stigma Stereotype Negative belief about the self (e.g., character weakness, incompetence) Prejudice Agreement with belief, negative emotional reaction (e.g., low self-esteem, low self-efficacy)
Reducing psychiatric stigma and discrimination
Social Psychiatry and Psychiatric Epidemiology, 2003
Background: Across the world there are programmes challenging negative stereotypes of people with mental health problems and associated discriminatory behaviours, but the evidence base describing what works in practice is still underdeveloped. This paper evaluates the effectiveness of a mental health training intervention with the police force in England. Method: A total of 109 police officers attended training workshops and completed pre- and post-questionnaires detailing knowledge, attitudes and behavioural interventions. Results: Mean attitude scores fell from 2.4 at baseline to 2.3 at follow-up (p < 0.0001) using a 5-point Likert scale. Five key message statements were assessed – 70 % of cases successfully reported more messages at follow-up as compared to baseline; however, the stereotype linking people with mental health problems with violent behaviour overall was not successfully challenged. Positive impacts on police work, particularly improvements in communication between officers and subjects, were reported by a third of cases. Conclusions: Short educational interventions can produce changes in participants' reported attitudes towards people with mental health problems, and can leave police officers feeling more informed and more confident to support people in mental distress.