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Reported stigma and discrimination by people with a diagnosis of schizophrenia

Published online by Cambridge University Press:  21 March 2011

D. Rose ,
R. Willis ,
E. Brohan ,
N. Sartorius ,
C. Villares ,
K. Wahlbeck  and
G. Thornicroft
D. Rose*
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
R. Willis
Affiliation:
Institute of Gerontology, Room 6.27, Strand Building, King's College London, Strand, London WC2R 2LS, UK
E. Brohan
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
N. Sartorius
Affiliation:
14 Chemin Colladon, 1209 Geneva, Switzerland
C. Villares
Affiliation:
Department of Psychiatry, UNIFESP – São Paulo Federal University, R. Borges Lagoa, 570, 04038–020, Sao Paulo – SP, Brazil
K. Wahlbeck
Affiliation:
National Institute for Health and Welfare, Mental Health and Vaasa, Central Hospital, 65320 Vaasa, Finland
G. Thornicroft
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
*
*Address for correspondence: Dr Diana Rose, Institute of Psychiatry, King's College London, PO Box 34, De Crespigny Park, London SE5 8AF, UK. (E-mail: [email protected])
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Abstract

Aims.

This article examines the extent of stigma and discrimination as reported by people with a diagnosis of schizophrenia. The hypothesis is that when people express in their own words the discrimination they experience such discrimination will be found to be widespread.

Methods.

Seventy-five people with a diagnosis of schizophrenia from 15 different countries were interviewed with a mixed methods instrument to assess reported discrimination. The data were analysed for frequency counts and then a thematic analysis was performed. A conceptual map is provided.

Results.

The study was a cross-cultural one but, contrary to expectations, few transnational differences were found. The main hypothesis was supported. Conversely, we found that when participants reported ‘positive discrimination’, this could as easily be conceptualised as being treated similarly to how others in society would expect to be treated.

Conclusion.

Negative discrimination is ubiquitous and sometimes connotatively very strong, with reports of humiliation and abuse. ‘Positive discrimination’ conversely indicates that people with a mental illness diagnosis expect discrimination and are grateful when it does not occur. The literature on self-stigma is discussed and found wanting. Similarly, the theory that contact with mentally ill people reduces stigma and discrimination is not fully supported by our results.

Keywords

Behaviourconsumers'viewsdiscriminationschizophreniastigma
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 20 , Issue 2 , June 2011 , pp. 193 - 204
Copyright
Copyright © Cambridge University Press 2011

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References

Ahuvia, A (2001). Traditional, interpretive and reception based content analysis: improving the ability of content analysis to address issues of pragmatic and theoretical concern. Social Indicators Research 54, 139–172.CrossRefGoogle Scholar
Angermeyer, MC, Beck, M, Matschinger, H (2006). Determinants of the public's preference for social distance from people with schizophrenia. Canadian Journal of Psychiatry 48, 663–668.Google Scholar
Angermeyer, M, Beck, M, Deitriech, S, Holzinger, A (2004). The Stigma of Mental Illness: Patients' Anticipations and Experiences. International Journal of Social Psychiatry 50, 153–162.CrossRefGoogle ScholarPubMed
Barbour, R (2001). Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? BMJ 322, 1115–1117.Google Scholar
Boyatzis, RE (1998). Transforming Qualitative Information: Thematic Analysis and Code Development. Sage: Thousand Oaks, California, London.Google Scholar
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.Google Scholar
Brohan, E, Slade, M, Clement, S, Thornicroft, G (2010). Experiences of mental illness stigma, prejudice and discrimination: a review of measures. BMC Health Services Research 10, 80.CrossRefGoogle ScholarPubMed
Buizza, C, Schulze, B, Rossi, B, Ghilardi, and Pioli, (2007). The stigma of schizophrenia from patients' and relatives' view: A pilot study in an Italian rehabilitation residential care unit. Clinical Practice and Epidemiology in Mental Health doi:10.1186/1745-0179-3-Google Scholar
Cechnicki, , Angermeyer, MC, Bielańska, A (2010). Anticipated and experienced stigma among people with schizophrenia: its nature and correlates. Social Psychiatry and Psychiatric Epidemiology, doi: 10.1007/s00127-010-0230-2Google Scholar
Corrigan, PW, Markowitz, FE, Watson, A, Rowan, D, Kubiak, MA (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behaviour 44, 162–179.CrossRefGoogle ScholarPubMed
Cumming, E, Cumming, J (1957). Closed Ranks: An Experiment in Mental Health Education. Harvard University Press: Cambridge, MA.Google Scholar
Department of Health, England (2003). Attitudes to Mental Illness. Taylor Nelson Sofres: London.Google Scholar
Falk, G (2001). Stigma: How We Treat Outsider's. Prometheus Books, New York.Google Scholar
González-Torres, Rodrigo Oraa Maialen Arístegui Aranzazu Fernández-Rivas Jose Guimon, (2006). Social Psychiatry and Psychiatric Epidemiology, 42, 14–23.Google Scholar
Hayward, P, Bright, JA (1997). Stigma and mental illness: A review and critique. Journal of Mental Health 6, 345–354.CrossRefGoogle Scholar
Jenkins, JH, Carpenter-Song, E (2005). The new paradigm of recovery from schizophrenia: cultural conundrums of improvement without cure. Culture Medicine and Psychiatry 29, 379–413.Google Scholar
Kolodziej, M, Johnson, B (1996). Interpersonal contact and acceptance of persons with psychiatric disorders: a research synthesis. Journal of Consulting and Clinical Psychology 64, 1387–1396.CrossRefGoogle ScholarPubMed
Kurihara, T, Kato, M, Sakamoto, S, Reverger, R, Kitamura, T (2000). Public attitudes towards the mentally ill: a cross-cultural study between Bali and Tokyo. Psychiatry and Clinical Neuroscience 54, 547–52.Google Scholar
Link, BG, Cullen, FT (1986). Contact with the mentally ill and perceptions of how dangerous they are. Journal of Health and Social Behaviour 27, 289–303.Google Scholar
Link, BG, Phelan, JC (2001). Conceptualizing stigma. Annual Review of Sociology 27, 363–385.CrossRefGoogle Scholar
Link, BG, Struening, EL, Neese-Todd, S, Asmussen, S, Phelan, M (2001). Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services 52, 1621–1626.Google Scholar
Markowitz, FE (1998). The effects of stigma on the psychological well-being and life satisfaction of persons with mental illness. Journal of Health and Social Behaviour 39, 335–347.CrossRefGoogle ScholarPubMed
QSR (2002). NVivo 2. QSR International Pty Ltd: Victoria, Australia.Google Scholar
Rose, D, Sweeney, A, Leese, M, Burns, T, Catty, J, Wykes, T (2009). Developing a user-generated measure of continuity of care: brief report. Acta Psychiatrica Scandinavica 119, 320–324.Google Scholar
Rose, D, Thornicroft, G (2010). Service user perspectives on the impact of a mental illness diagnosis. Epidemiologia e Psichiatria Sociale 19, 140–47.Google Scholar
Rose, DS, Knight, M, Fleischmann, P, Thornicroft, G, Sidhu, R, Kassam, A, Bhugra, B, Pinfold, V. (2007). Public and Media Perceptions of Risk and Violence from People with Mental Ill Health. Commission for Services Improvement: London.Google Scholar
Sartorius, N, Kuyken, W (1994). Translation of Health Status Instruments. In Quality of Life Assessment in Health Care Settings (ed. Orley, J and Kuyken, J), pp. 97–112, Springer-Verlag: Berlin.Google Scholar
Scheff, TJ (1966). Being Mentally Ill: A Sociological Theory. Aldine: Chicago, IL.Google Scholar
Schomerus, G, Matschinger, H, Kenzin, D, Breier, P, Angermeyer, MC (2006). Public attitudes towards mental patients: a omparison between Novosibirsk, Bratislava and German Cities. European Psychiatry 2, 436–441.Google Scholar
Slade, M (2009). Personal Recovery and Mental Illness. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Slade, M, Amering, M, Oakes, L (2008). Recovery; an international perspective. Epidemiologia e Psichiatria Sociale 17, 128–137.Google Scholar
Star, SA (1955). The Public's Ideas about Mental Illness. National Opinion Research Centre, University of Chicago (unpublished monograph).Google Scholar
Strauss, AL, Corbin, JM (1990). Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Sage: Newbury Park, California.Google Scholar
Thornicroft, G (2006). Shunned: Discrimination against People with Mental Illness. Oxford University Press: Oxford.Google Scholar
Thornicroft, G, Brohan, E, Rose, DS, Sartorius, N, Leese, M, the INDIGO Study Group (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia. Lancet 373, 408–415.Google Scholar