Introduction
The stigma suffered by people identified as experiencing psychiatric problems is often described as more disabling than the actual 'mental disorder'. This article will first offer a definition of stigma and list the specific negative consequences of being identified as a psychiatric patient. The ways that professional psychiatric services inadvertently promote stigma in the patients they serve will then be described.
What is stigma?
A concise definition of stigma is, ‘A sign of disgrace or discredit which sets a person apart from others’ (1). A helpful distinction can be made between two types of stigma, Firstly, the ‘public stigma’ associated with the way that lay people perceive, and react towards, those individuals identified as displaying psychiatric difficulties. Secondly, ‘self stigma’ whereby people suffering mental health problems develop awareness of the way they are perceived and begin to concur with these negative evaluations (2), a process that may contribute to the low self-esteem that is prevalent among psychiatric patients.
A more detailed exploration of stigma has proposed a four stage process (3), all elements of which need to be present for someone to be stigmatised:
1. Labelling: the person is put into a category (e.g. ‘mental patient’ or ‘psychotic’) on the basis of a distinguishing characteristic.
2. Stereotyping: an automatic (some might say lazy) process whereby the label is instantly assumed to signify negative attributes.
3. Separation: the emergence of an ‘us and them’ attitude leading to the labelled person being viewed as an outsider.
4. Loss of status/discrimination: the labelled person is denied rights and opportunities within society.
Source
The consequences of stigma
There is abundant evidence that stigma blights the lives of people with mental health problems, impacting negatively on their self-concept, relationships and work opportunities. Specifically, these negative consequences include:
1. Perceived as a danger to others
Those people unfortunate enough to acquire the label of ‘schizophrenia’ are commonly perceived as dangerous and unpredictable, despite the fact that this group of patients are 14 times more likely to be the victims of violent crime than to commit one (4). The media is guilty of promoting this psychosis stereotype via their propensity to over report stories linking psychosis with violence, both newspapers (5)(6) and television (7) being culpable of these distortions
2. Limited social networks
Partly as a consequence of the psychosis stereotype, people with mental health problems are inclined to have smaller social networks as compared to the general population (8). Around three-quarters of those experiencing psychoses state that they conceal their diagnosis from others and about half report that they struggle to make and keep friends (9).
3. Harassment from others
Surveys by mental health charities suggest that psychiatric patients disproportionately suffer verbal and physical assaults from members of the public (10).
4. Loss of valued roles
Being labelled with a psychiatric 'disorder' appears to negatively impact on success in the work environment. Anticipation of rejection at interview discourages many sufferers from applying for jobs (11), illustrating the perniciousness of self-stigma (see above). A recent international study concluded that 29% of people labelled with a 'schizophrenia' diagnosis were discriminated against in regards to both finding and keeping a job (9). Furthermore, there are reports that a mental health problem might lead to parenting ability being unfairly questioned (11).
Comments
Post a Comment