Stigma, discrimination and mental health
The consequences of stigmatisationStigma often leads to discrimination, or the unfair treatment of individuals and can even result in the denial of their rights (Unite for Sight 2015). The World Health Organization (2018) has said that the violation of people with mental and psychosocial disabilities is routinely reported in most countries, by way of physical restraints, seclusion and refusal of basic needs and privacy, for example. Most countries do not adequately protect the rights of people with mental disorders and this is a huge concern.Sometimes individuals can suffer disadvantage from stigmatisation, for instance by being refused employment or housing. Looking at society as a whole, stigmatised people can suffer from intense prejudice which impacts many areas of their lives. Furthermore, stigma and discrimination can prevent mentally ill people and their families from pursuing mental health care (WHO 2018), and from following treatment programmes. In spite of many effective treatments existing there is still an underlying belief that they are untreatable, or that people who have mental health disorders are difficult and incapable of making decisions.In 2001, the World Health Organization (WHO) identified stigma and discrimination towards mentally ill individuals as ‘the single most important barrier to overcome in the community’, and the WHO’s Mental Health Global Action Programme (mhGAP) cited advocacy against stigma and discrimination as one of its four core strategies for improving the state of global mental health.The mhGAP is still working towards its objective and particularly focusing on low and middle income countries. The WHO (2018) has estimated that while 14% of the global burden of disease is thought to be caused by mental health disorders, the majority of affected individuals, approximately 75% in low-income countries, are not able to access the treatment that they need.
Stigma and cultureThe roots of stigmatisation are not constant across communities or cultures, but observed stigma by individuals living with mental illness is reported internationally. For example, the World Mental Health Surveys (Alfonso et al. 2008) revealed that stigma was closely connected with anxiety and mood disorders among adults reporting significant disability.The survey data, which included responses from 16 countries in the Americas, Europe, the Middle East, Africa, Asia, and the South Pacific, showed that 22.1% of participants from developing countries and 11.7% of participants from developed countries experienced embarrassment and discrimination owing to their mental illness. However, the authors stated that these figures likely underestimated the true extent of stigma associated with mental illness since they only evaluated data on anxiety and mood disorders.
The importance of cultural sensitivity
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Defining Mental Health: A Short Introduction
‘Time to Change’In the UK the ‘Time to Change’ campaign is one of the largest programmes that has attempted to address mental health stigma, and has been supported by mental health charities and health service providers.Analysis has shown (Henderson and Thornicroft 2013) that nationally, the public view of mental health issues became slightly more understanding over the first four years of the campaign, while there was also a small decrease in complaints of discrimination on grounds of mental health issues. The first phase of the ‘Time to Change’ campaign seems to have had an appreciable positive effect on the confidence and social mobility of vulnerable people.
- What further steps do you think could be taken to reduce stigma around mental health issues?Post your thoughts in the comments area.
ReferencesAbdullah, T. and Brown, T.L. (2011) ‘Mental Illness Stigma and Ethnocultural Beliefs, Values, and Norms: An Integrative Review’ Clinical Psychology Review 31, 934-948Alonso, J., Buron, A., Bruffaerts, R., He, Y., Posada-Villa, J., Lepine, J-P., Angermeyer, M.C., Levinson, D., Girolamo, G., Tahimori, H., Mneimneh, Z.N., Medina-Mora, M.E., Ormel, J., Scott, K.M., Gureje, O., Haro, J.M., Gluzman, S., Lee, S., Vilagut, G., Kessler, R.C. and Von Korff, M. (2008) ‘Association of Perceived Stigma and Mood and Anxiety Disorders: Results from the World Mental Health Surveys’ Acta Psychiatrica Scandinavica 118, 305-314Davey, G.,C. (2017) Psychopathology 2nd edn. Chichester: WileyHenderson, C. and Thornicroft, G. (2013) ‘Evaluation of the Time to Change Programme in England 2008 -2011’ The British Journal of Psychiatry 202 (5), 45-48Unite for Sight (2015) ‘Module 7: Cultural Perspectives on Mental Health’ [Online]. available from https://www.uniteforsight.org/mental-health/module7#_ftn2 [16th November 2018]WHO (2018) ‘WHO Mental Health Gap Action Programme (mhGAP)’ [Online]. available from http://www.who.int/mental_health/evidence/mhGAP/en/ [16th November 2018]
Defining Mental Health: A Short Introduction
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