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
2The issue of stigma against mental
illness sometimes feels like the worst part about
it.Tom
3Sources
- 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)
4What is Stigma?
- Problem of knowledge Ignorance
- Problem of attitudes Prejudice
- Problem of behaviour Discrimination
5Words 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.
6Key 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
71. 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
92. 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
134. 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
14UK 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)
16INDIGO 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
17Discrimination 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
18Anticipated 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
19Anticipated Experienced Discrimination
Empowerment resilience
Anti-discrimination law
Person with mental illness
Anticipated Discrimination
Experienced Discrimination
20Evidence of How to Reduce Discrimination
21Local Level Interventions
22Social Contact Theory
- Bogardus 1924
- Direct, personal contact with individual(s) of
stigmatised group - Equal status (eg co-facilitator)
23Kent 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
25Feedback from Police
26National Level Interventions
27National Campaigns
- Australia
- Scotland
- New Zealand
- England
28New Campaign in England against Stigma
Discrimination 2008-2011
29Thornicroft G 2006 Shunned discrimination
against people with mental illness Oxford
University Press Oxford
30Major global conference on stigma and
discrimination on January 21-23 2009 in
LondonContactann.law_at_iop.kcl.ac.uk