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The Stigma of Mental Illness:

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World Health Organisation Collaborating Centre The Stigma of Mental Illness: Inevitable or Unjustifiable? Professor Graham Thornicroft g.thornicroft_at_iop.kcl.ac.uk – PowerPoint PPT presentation

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Title: The Stigma of Mental Illness:


1
  • The Stigma of Mental Illness
  • Inevitable or Unjustifiable?
  • Professor Graham Thornicroft
  • g.thornicroft_at_iop.kcl.ac.uk

World Health Organisation Collaborating Centre
2
The issue of stigma against mental
illness sometimes feels like the worst part about
it.Tom
3
Sources
  • Review 1615 international stigma published
    sources
  • Detailed statements / testimonies from people
    with severe mental illness in South London (n40)
  • Statements about discrimination from INDIGO Study
    (729 people with a diagnosis of schizophrenia in
    28 countries)

4
What is Stigma?
  • Problem of knowledge Ignorance
  • Problem of attitudes Prejudice
  • Problem of behaviour Discrimination

5
Words used by 14 year old Students in Kent,
England
Term Frequency
Disturbed 11
Nuts 11
Confused 10
Psycho 10
Spastic 10
Crazy 9
Depression 7
Disabled 7
Mad 7
Unpredictable 7
Insane 6
Loony 6
Mental 6
Schizophrenia 6
Thicko 6
Weird 6
Depressed 5
Different 5
Freak 5
Odd 5
Problem 5
Retard 5
Rose D, Thornicroft G, Pinfold V, Kassam A.
250 labels used to stigmatise people with mental
illness. BMC Health Serv Res 2007 797.
6
Key Features of Stigma Research
  • Focus on violence media
  • Mostly only address schizophrenia
  • Little attention to emotions
  • Little information on actual discrimination
  • Few reports from service users
  • Few intervention studies

7
1. Discrimination at Home
  • Adverse reactions by family eg lazy / weak
  • Negative reactions to family members
  • High rates of homelessness
  • Neighbourhood reactions to residential care

8
  • At 16, in 1996, I suffered a bad mental
    breakdown where I was hospitalised for 5 years.
    It was very traumatic. There I was, the eldest
    son, suffering a sudden deep depression, crying
    and unable to work, often threatened by my
    confused Dad as being weak.
  • Robert

9
2. Discrimination in Friendships, Intimate
Relationships and Childcare
  • Loss of husband/wife/partner
  • Disappearance of friends
  • Impaired long-term sexual relationships

10
  • When I got sick for the first time I was
    seventeen and I was at high school. My behavior
    was awkward and my friends and classmates were
    making fun of me. I was feeling really bad about
    this. Then I was hospitalised. When they found
    out about this, they all abandoned me. I lost my
    friends.
  • Paul

11
3. Discrimination at Work
  • Lower rates of short-listing and hiring
  • More often sacked
  • Lower rates of pay
  • Poorer promotion prospects
  • Dilemma conceal or disclose

12
  • Unfortunately I have never suffered from such
    cruelty because, when applying for jobs, I never
    admitted to my own depression.
  • If I had, I would never have stood a chance.
  • People are frightened about anything to do
    with mental illness, they just do not understand
    the malady.
  • Anna

13
4. Discrimination in the Media
  • Newspapers 40-70 of items violence
  • 85 of children's animations show characters with
    mental illness
  • Few direct accounts from consumers
  • Clear negative effects on popular views

14
UK Newspaper content analysis for mental illness
related items in 2005
15
  • indigo study
  • International Study of Stigma and
  • Discrimination Outcomes
  • Graham Thornicroft, Diana Rose,
  • Norman Sartorius, Elaine Brohan, Ann Law
  • and the INDIGO Study Group
  • The Lancet (in press)

16
INDIGO Aims
  • develop and validate a scale to measure service
    users experiences of discrimination (anticipated
    and experienced)
  • called Discrimination and Stigma Scale (DISC)
  • collect international data on the nature and
    severity of discrimination

17
Discrimination Stigma Scale (DISC) Reported by
service users about experiences of
discrimination
  • financial affairs
  • community life
  • health social services
  • privacy and safety
  • children
  • avoidance
  • 27 countries
  • personal relationships
  • housing
  • education
  • family life
  • work
  • transport and travel
  • 732 people interviewed

18
Anticipated Discrimination
  • Similar ideas self-stigma, self-discrimination
  • Avoidance of important actions eg
  • applying for a job
  • seeking a close relationship
  • because of previous failure or
  • in anticipation of failure

19
Anticipated Experienced Discrimination
Empowerment resilience
Anti-discrimination law
Person with mental illness
Anticipated Discrimination
Experienced Discrimination
20
Evidence of How to Reduce Discrimination
21
Local Level Interventions
22
Social Contact Theory
  • Bogardus 1924
  • Direct, personal contact with individual(s) of
    stigmatised group
  • Equal status (eg co-facilitator)

23
Kent Awareness in Action Aims
To develop
deliver
and evaluate ...
... intervention packages to reduce psychiatric
stigma and discrimination
24
Target Groups
  • Police officers
  • Young people
  • Medical students

25
Feedback from Police
26
National Level Interventions
27
National Campaigns
  • Australia
  • Scotland
  • New Zealand
  • England

28
New Campaign in England against Stigma
Discrimination 2008-2011
29
Thornicroft G 2006 Shunned discrimination
against people with mental illness Oxford
University Press Oxford
30
Major global conference on stigma and
discrimination on January 21-23 2009 in
LondonContactann.law_at_iop.kcl.ac.uk
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