Misdiagnosis of BPD: The stigmatization on mental illness and its effects on treatment on its patients in the metropolitan Puerto Rico (original) (raw)
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Stigmatization Experiences among People Living with Borderline Personality Disorder in Puerto Rico
The experiences of stigmatization among people living with specific Serious Mental Illnesses (SMI), such as Borderline Personality Disorder (BPD) has not been addressed by the scientific literature. In this study we wanted to explore how people living with BPD experience stigmatization. We examine the experiences of 8 people (7 women and 1 man) living and receiving treatment for BPD in Puerto Rico. We used an exploratory qualitative design with semi-structured interviews. To interpret our data, we conducted a thematic analysis. We discuss three categories that focus on one identified theme: the interpersonal dimension of the stigmatization process. These categories are (a) society's views of people living with BPD, (b) family relationships, and (c) partner relationships. Our findings show that people with BPD experience a high attributed personal responsibility, discrimination, social exclusion, and lack of social support. In addition, our findings suggest that the stigmatization of BPD might be more complex than other mental illnesses as it shares characteristics of both SMI and less severe forms of mental illness. We also discuss the importance for practitioners to address stigmatization in therapy and the importance for research to address other aspects of the stigmatization process such as its structural dimension.
Perceptions of mental health and utilization of mental health services in Puerto Rico
Social Work in Mental Health, 2019
This article contributes to the literature on mental health in Puerto Rico based on a focus group study with bilingual mental health service providers. The study explored perceptions of mental health and mental health services and the factors that influenced utilization of mental health services. According to participants, having a mental health condition in Puerto Rico is associated with "being crazy," a concept that carries the attitude that something wrong is going on inside the person. Stigma was identified as a powerful force influencing the perceptions of mental illness, the support of the family and community to people with mental health conditions as well as the use of mental health services. Findings suggested that the structural changes in mental health services delivery from a public to a mostly privatized system has limited quality, access and utilization of mental health services. A trend highlighted by participants was that some people seek mental health services because of socioeconomic factors. They create a factitious disorder based on economic insecurity. Mental health remains a public health concern. Suggestions included advocacy to change stigmatized perceptions, a reform that included mental health as a human right and an educational campaign that addresses prevention, early detection and treatment.
1998
OBJECTIVE: This study sets forth the premises of psychosomatic and sociosomatic approaches in medicine and psychiatry and considers how these approaches differentiate or complement one another. The course of persistent mental illness is examined in sociosomatic terms by considering a life defined by a cycle of expectation, violation, illness, and recovery. METHOD: A case study of a Puerto Rican woman is drawn from a larger study of the course of depression and schizophrenia among 80 Latinos and Euro-Americans. RESULTS: Analysis of the patient's narrative reveals a set of interrelated themes in terms of which this cycle is structured. CONCLUSION: The study concludes by offering a structural model of the sociosomatic reticulum that define the interaction between bodily experience and social relationships or conditions.
A critical review of epidemiological studies of Puerto Rican mental health
American Journal of Psychiatry, 1990
Through a review of the epidemiological literature on the mental health of Puerto Ricans and other Hispanics, to Rican mental health. It is a review of the epidemiological studies of Puerto Rican mental health on the mainland United States and in Puerto Rico, from the perspective of a growing literature in medical anthropology on cultural dimensions of illness experience
Stigma and psychiatric care in Latin America: its inclusion on the universal health coverage agenda
BJPsych international, 2015
In 2014, the Pan American Health Organization (PAHO) approved Resolution CP53.R14, which aimed to provide a framework for universal access to health and universal health coverage. It sets the stage for the inclusion of psychiatric practice within the provision of universal healthcare and highlights the fight against stigma. We propose to concentrate our efforts on changing the model of medical management. To that end, we are promoting the inclusion of mental health patients within the daily routine of primary care centres, thus allowing them to interact with other users of health services on a regular basis.
60 Years of Clinical Psychology in Puerto Rico
This article examines the history of clinical psychology in Puerto Rico since its beginnings in 1946, summarizing the events that led to the field's emergence and looking closely at the sixty years of its subsequent development. The information presented is based on a review of publications, theses and dissertations, and interviews with professionals working in the field. The objective of this article is to raise awareness and interest in the many chapters that make up the history of psychology. Clinical psychology in Puerto Rico can reach new heights if its practitioners are aware of its history. Such awareness enables the creation of a socially informed discipline, firmly and conscientiously placed within the rich contexts of Puerto Rico.
Background: Latin America is characterized by a high prevalence of public stigma toward those with mental illness, and significant self-stigma among labeled individuals, leading to social exclusion, low treatment adherence, and diminished quality of life. However , there is no published evidence of an intervention designed to address stigma in the region. In light of this, a psychosocial intervention to reduce self-stigma among users with severe mental illness was developed and tested through an RCT in two regions of Chile. Objectives: To describe the development of the psychosocial intervention, assess its feasibility and acceptability , and evaluate its preliminary impact. Methods: An intervention was designed and is being tested, with 80 users with severe mental illness attending two community mental health outpatient centers. To prepare the intervention, pertinent literature was reviewed, and experts and mental health services users were consulted. Feasibility and acceptability were assessed, and impact was analyzed, based on follow-up qualitative reports by the participants. Results: The recovery-oriented, ten-session group intervention incorporates the Tree of Life narrative approach, along with other narrative practices, to promote a positive identity change in users, and constructivist psychoeducation, based on case studies and group discussions, to gather tools to confront self-stigma. The intervention was feasible to implement and well evaluated by participants, family members, and center professionals. Participants reported increased self-confidence, and the active use of anti-stigma strategies developed during the workshop. Conclusions: This group intervention promises an effective means to reduce stigma of mental illness within Chile and other Latin American countries and feasibility to scale up within mental health services. Resumen: Antecedentes: Latinoamérica se ha caracterizado por ser una región que presenta una alta prevalencia de estigma público hacia la enfermedad mental, y niveles significativos de auto-estigma entre las personas con diagnóstico psiquiátrico, conduciendo a un alto nivel de exclusión social, baja adherencia al tratamiento y una disminución de la calidad de vida. Sin embargo, no se dispone de evidencia científica sobre alguna intervención diseñada para abordar el estigma a nivel local o regional. Considerando lo anterior, se ha desarrollado y evaluado a través de una ensayo clínico aleatorizado una interven-ción psicosocial para reducir el auto-estigma entre usuarios de servicios de salud mental en dos regiones de Chile.Objetivos: Describir el desarrollo de una intervención psicosocial anti-estigma y evaluar su confiabilidad, aceptabilidad e impacto inicial entre un grupo de usuarios.Métodos: La intervención fue diseñada y evaluada en 80 usuarios con diagnóstico de trastorno mental severo que estuvieron asistiendo a dos centros ambulatorios de salud mental comunitaria. Para elaborar la interven-ción, se revisó literatura científica pertinente y se conformaron paneles de discusión con expertos y usuarios de servicios de salud mental. La factibilidad y la aceptabilidad fueron evaluadas y se analizó su impacto inicial entre los participantes, en base a una serie de evaluaciones cualitativas.Resultados: Se generó una intervención orientada a la recuperación, que considera 10 sesiones grupales e incorpora el abordaje del 'Árbol de la Vida', además de otras prácticas narrativas, para promover un cambio positivo en la identidad de los usuarios; adicionalmente, se incluyen elementos de psicología constructivista, basada en estudio de casos y grupos de discusión, para que los usuarios adquieran herramientas para afrontar el estigma. La inter-vención fue implementada apropiadamente y bien evaluada por participantes, familiares y profesionales de los centros de salud mental. Los participantes reportaron un incremento de la autoconfianza y un activo uso de las estrategias anti-estigma desarrolladas durante las sesiones de trabajo. Conclusiones: La presente intervención grupal demostró un promisorio efecto en la reducción del estigma hacia la enfermedad mental en Chile, y cuenta con el potencial para ser implementado en otros servicios de salud mental de Latinoamérica.
“The Problem Will Pass:” Attitudes of Latinx Adults Toward Mental Illness and Help Seeking
International Journal for the Advancement of Counselling
Globally, mental illness is still stigmatized by many. The following qualitative study explored beliefs about mental illness and help seeking among Latinx participants in the United States. Themes included mental illness suggesting inferiority and weakness, mental illness stereotypes such as crazy and dangerous, and mental illness does not exist and/or should be ignored. Implications include the importance of culturally competent clinicians being particularly warm and caring. Counselors should also consider using psychoeducation and anti-stigma efforts and interventions when practicing within the Latinx community.
Stigma toward mental illness in Latin America and the Caribbean: a systematic review
2020
Objective: Stigma toward individuals with mental disorders has been studied extensively. In the case of Latin America and the Caribbean, the past decade has been marked by a significant increase in information on stigma toward mental illness, but these findings have yet to be applied to mental health services in Latin America. The objective of this study was to conduct a systematic review of studies relating to stigma toward mental illness in Latin America and the Caribbean. The authors specifically considered differences in this region as compared with manifestations reported in Western European countries. Methods: A systematic search of scientific papers was conducted in the PubMed, MEDLINE, EBSCO, SciELO, LILACS, Imbiomed, and Bireme databases. The search included articles published from 2002 to 2014. Results: Twenty-six studies from seven countries in Latin America and the Caribbean were evaluated and arranged into the following categories: public stigma, consumer stigma, family stigma, and multiple stigmas. Conclusion: We identified some results similar to those reported in high-income settings. However, some noteworthy findings concerning public and family stigma differed from those reported in Western European countries. Interventions designed to reduce mental illness-related stigma in this region may benefit from considering cultural dynamics exhibited by the Latino population.