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Social Psychiatry and Psychiatric Epidemiology

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01.05.2015 | Original Paper

Stigma experienced by people using mental health services in San Diego County

verfasst von: Andrew Sarkin, Rachel Lale, Marisa Sklar, Kimberly C. Center, Todd Gilmer, Chris Fowler, Richard Heller, Victoria D. Ojeda

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 5/2015

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Abstract

Objective

This paper describes how individuals struggling with severe mental illness experience stigma along multiple dimensions including their experiences of discrimination by others, their unwillingness to disclose information about their mental health, and their internalization or rejection of the negative and positive aspects of having mental health problems.

Methods

This cross-sectional study employs descriptive analyses and linear regression to assess the relationship between demographics, mental health diagnoses and self-reported stigma among people receiving mental health services in a large and ethnically diverse county public mental health system (n = 1,237) in 2009. We used the King Stigma Scale to measure three factors related to stigma: discrimination, disclosure, and positive aspects of mental illness.

Results

Most people (89.7 %) reported experiencing some discrimination from having mental health problems. Regression analyses revealed that younger people in treatment experienced more stigma related to mental health problems. Women reported experiencing more stigma than men, but men were less likely to endorse the potentially positive aspects of facing mental health challenges than women. Although people with mood disorders reported more discomfort with disclosing mental illness than people with schizophrenia, they did not report experiencing more discrimination than people with schizophrenia.

Conclusions

Study findings suggest that the multidimensional experiences of stigma differ as a function of age, gender, and diagnosis. Importantly, these findings should inform anti-stigma efforts by describing different potential treatment barriers due to experiences of stigma among people using mental health services, especially among younger people and women who may be more susceptible to stigma.

Corrigan PW, Edwards AB, Green A, Diwan SL, Penn DL (2001) Prejudice, social distance, and familiarity with mental illness. Schizophr Bull 27(2):219–225CrossRefPubMed

Wahl OF (1995) Media madness: public images of mental illness. Rutgers University Press, New Brunswick

Wahl OF (1999) Mental health consumers’ experience of stigma. Schizophr Bull 25(3):467–478CrossRefPubMed

Jorm AF, Griffiths KM (2008) The public’s stigmatizing attitudes toward people with mental disorders: how important are biomedical conceptualizations? Acta Psychiatr Scand 118:315–321CrossRefPubMed

Link BG, Struening EL, Neese-Todd S, Asmussen S, Phelan JC (2001) Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses. Psychiatr Serv 52(12):1621–1626CrossRefPubMed

West ML, Yanos PT, Smith SM, Roe D, Lysaker PH (2011) Prevalence of internalized stigma among persons with severe mental illness. Stigma Res Action 1(1):3–10CrossRefPubMedCentralPubMed

Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M (2009) Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373(9661):408–415CrossRefPubMed

Fung KM, Tsang HW, Corrigan PW (2008) Self-stigma in people with schizophrenia as a predictor of their adherence to psychosocial treatment. Psychiatr Rehabil J 32(2):95–104CrossRefPubMed

Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS (2001) Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatr Serv 52(12):1615–1620CrossRefPubMed

10.

Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Friedman SJ, Meyers BS (2001) Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. Am J Psychiatry 158(3):479–481CrossRefPubMed

11.

Addis M, Mahalik J (2003) Men, masculinity, and the context of help seeking. Am Psychol 58(1):5–14CrossRefPubMed

12.

Kessler R, Brown R, Broman C (1981) Sex differences in psychiatric help-seeking: evidence from four large-scale surveys. J Health Soc Behav 22:49–64CrossRefPubMed

13.

Interian A, Martinez IE, Guarnaccia PJ, Vega WA, Escobar JI (2007) A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatr Serv 58(12):1591–1594CrossRefPubMedCentralPubMed

14.

Faye GA (2005) Stigma: barrier to mental health care among ethnic minorities. Issues Ment Health Nurs 26:979–999CrossRef

15.

McMiller WP, Weisz JR (1996) Help-seeking preceding mental health clinic intake among African-American, Latino, and Caucasian youths. J Am Acad Child Adolesc Psychiatry 35(8):1086–1094CrossRefPubMed

16.

King M, Dinos S, Shaw J, Watson R, Stevens S, Passetti F, Weich S, Serfaty M (2007) The Stigma scale: development of a standardised measure of the stigma of mental illness. Br J Psychiatry 190:248–254CrossRefPubMed

17.

Livingston JD, Boyd JE (2010) Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med 71(12):2150–2161CrossRefPubMed

18.

Corrigan P, Watson AC (2002) Understanding the impact of stigma on people with mental illness. World J Psychiatry 1(1):16–20

19.

Mann CE, Himelein MJ (2004) Factors associated with stigmatization of persons with mental illness. Psychiatr Serv 55(2):185–187CrossRefPubMed

20.

Corrigan PW, Watson AC (2007) The public stigma of psychiatric and the gender, ethnicity, and education of the perceiver. Community Ment Health J 43(5):439–458CrossRefPubMed

21.

Farina A (1981) Are women nicer people than men? Sex and the stigma of mental disorders. Clin Psychol Rev 1:223–243CrossRef

22.

Munoz M, Sanz M, Perez-Santos E, de los Angeles Quiroga M (2011) Proposal of a socio-cognitive-behavioral structural equation model of internalized stigma in people with severe and persistent mental illness. Psychiatry Res 186:402–408

23.

Gary FA (2005) Stigma: barrier to mental health care among ethnic minorities. Issues Ment Health Nurs 26:979–999CrossRefPubMed

24.

Perlick DA, Rosenheck RA, Clarkin JF, Sirey JA, Salahi J, Struening EL, Link BG (2001) Stigma as a barrier to recovery: adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiat Serv 52(12):1627–1632CrossRef

25.

Angermeyer MC, Matschinger H (2003) Public beliefs about schizophrenia and depression: similarities and differences. Soc Psychiatry Psychiatr Epidemiol 38:526–534CrossRefPubMed

26.

Norman RM, Windell D, Manchanda R (2012) Examining the differences in the stigma of depression and schizophrenia. Int J Soc Psychiatry 58(1):69–78CrossRefPubMed

27.

Lysaker PH, Roe D, Yanos PT (2007) Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophr Bull 33(1):192–199CrossRefPubMedCentralPubMed

28.

Lazowski L, Koller M, Stuart H, Milev R (2012) Stigma and discrimination in people suffering with a mood disorder: a cross-sectional study. Depress Res Treat 2012:724848PubMedCentralPubMed

29.

Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K et al (2013) Global patterns of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381(9860):55–62CrossRefPubMed

30.

Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62(6):593–602CrossRefPubMed

31.

Griffiths KM, Batterham PJ, Barney L, Parsons A (2011) The generalised anxiety stigma scale (GASS): psychometric properties in a community sample. BMC Psychiatry 22(11):184CrossRef

32.

Hinshaw SP, Stier A (2008) Stigma as related to mental disorders. Annu Rev Clin Psychol 4:367–393CrossRefPubMed

33.

Dinos S, Stevens S, Serfaty M, Weich S, King M (2004) Stigma: the feelings and experiences of 46 people with mental illness: qualitative study. Br J Psychiatry 184(2):176–181CrossRefPubMed

34.

Hinshaw SP, Cicchetti D (2000) Stigma and mental disorder: conceptions of illness, public attitudes, personal disclosure, and social policy. Dev Psychopathol 12(4):555–598CrossRefPubMed

35.

Census (2009) Resident population estimates for the 100 largest US counties based on July 1, 2009 population estimates: April 1, 2000 to July 1, 2009 (CO-EST2009-07)

36.

Gilmer TP, Stefancic A, Ettner SL, Manning WG, Tsemberis S (2010) Effect of full-service partnerships on homelessness, use and costs of mental health services, and quality of life among adults with serious mental illness. Arch Gen Psychiatry 67(6):645–652CrossRefPubMed

37.

Folsom DP, Lindamer L, Montross LP, Hawthorne W, Golshan S, Hough R, Shale J, Jeste DV (2006) Diagnostic variability for schizophrenia and major depression in a large public mental health care system dataset. Psychiatry Res 144(2–3):167–175CrossRefPubMed

38.

Marquez JA, Ramirez-Garcia JI (2013) Family caregivers’ narratives of mental health treatment usage processes by their Latino adult relatives with serious and persistent mental illness. J Fam Psychol 27(3):398–408CrossRefPubMed

39.

Stewart SM, Simmons A, Habibpour E (2012) Treatment of culturally diverse children and adolescents with depression. J Child Adolesc Psychopharmacol 22(1):72–79CrossRefPubMed

40.

Beeber LS, Cooper C, Van Noy BE, Schwartz TA, Blanchard HC, Canuso R, Robb K, Laudenbacher C, Emory SL (2007) Flying under the radar: engagement and retention of depressed low-income mothers in a mental health intervention. Adv Nurs Sci 30(3):221–234CrossRef

41.

Chandra A, Minkovitz CS (2006) Stigma starts early: gender differences in teen willingness to use mental health services. J Adolesc Health 38(6):754e1–8

42.

Wang J, Fick G, Adair C, Lai D (2007) Gender specific correlates of stigma toward depression in a Canadian general population sample. J Affect Disord 103(1–3):91–97CrossRefPubMed

43.

Jorm AF, Oh E (2009) Desire for social distance from people with mental health disorders: a review. Aust N Z J Psychiatry 43:183–200CrossRefPubMed

44.

Lale R, Sklar M, Wooldridge J, Sarkin A (2014) Gender congruence moderates beliefs about the causes of alcohol dependence and major depression. Int J Ment Health Addict 12:395–405CrossRef

45.

Wirth JH, Bodenhausen GV (2009) The role of gender in mental-illness stigma: a national experiment. Psychol Sci 20(2):169–173CrossRefPubMed

46.

Brohan E, Elgie R, Sartorius N, Thornicroft G (2010) Self-stigma, empowerment and perceived discrimination among people with schizophrenia in 14 European countries: the GAMIAN-Europe study. Schizophr Res 122(1–3):232–238CrossRefPubMed

47.

Phelan JC, Lucas JW, Ridgeway CL, Taylor CJ (2014) Stigma, status, and population health. Soc Sci Med 103:15–23CrossRefPubMedCentralPubMed

48.

Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rüsch N, Brown JS, Thornicroft G (2014) What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med 26:1–17CrossRef

49.

Corrigan PW, Kosyluk KA, Rüsch N (2013) Reducing self-stigma by coming out proud. Am J Public Health 103(5):794–800CrossRefPubMed

50.

Ojeda VD, Bergstresser SM (2008) Gender, race-ethnicity, and psychosocial barriers to mental health care: an examination of perceptions and attitudes among adults reporting unmet need. J Health Soc Behav 49(3):317–334CrossRefPubMed

51.

Robillos E, Sarkin AJ, Gilmer T, Levack A, Tally S, Heller R, Rodriguez B. Gender differences in mental health utilization, satisfaction, and treatment preferences. In: Poster presented at the 29th Annual Meeting of the Society of Behavioral Medicine; April 2008, San Diego, California

52.

Hatzenbuehler ML, Phelan JC, Link BG (2013) Stigma as a fundamental cause of population health inequalities. Am J Public Health 103(5):813–821CrossRefPubMedCentralPubMed

53.

Kanter JW, Rüsch LC, Brondino MJ (2008) Depression self-stigma: a new measure and preliminary findings. J Nerv Ment Dis 196(9):663–670CrossRefPubMed

54.

Link BG, Yang LH, Phelan JC, Collins PY (2004) Measuring mental illness stigma. Schizophr Bull 30(3):511–541CrossRefPubMed

55.

Brohan E, Slade M, Clement S, Thornicroft G (2010) Experiences of mental illness stigma, prejudice and discrimination: a review of measures. BMC Health Serv Res 10:80CrossRefPubMedCentralPubMed

56.

Rüsch N, Brohan E, Gabbidon J, Thornicroft G, Clement S (2014) Stigma and disclosing one’s mental illness to family and friends. Soc Psychiatry Psychiatr Epidemiol 49(7):1157–1160CrossRefPubMed

57.

Bushnell J, McLeod D, Dowell A, Salmond C, Ramage S, Collings S, Ellis P, Kljakovic M, McBain L (2005) Do patients want to disclose psychological problems to GPs? Fam Pract 22(6):631–637CrossRefPubMed

58.

Evans-Lacko S, Brohan E, Mojtabai R, Thornicroft G (2012) Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med 42(8):1741–1752CrossRefPubMed

59.

Brohan E, Clement S, Rose D, Sartorius N, Slade M, Thornicroft G (2013) Development and psychometric evaluation of the Discrimination and Stigma Scale (DISC). Psychiatry Res 208(1):33–40CrossRefPubMed

60.

Flores Reynoso S, Medina Dávalos R, Medina Dávalos R, Robles García R (2011) Study of the Spanish translation and psychometric assessment of a scale to measure internalized stigma in patients with severe mental disorders. Salud Ment 34:331–336

61.

Silverman MJ (2013) Effects of music therapy on self- and experienced stigma in patients on an acute care psychiatric unit: a randomized three group effectiveness study. Arch Psychiatr Nurs 27(5):223–230CrossRefPubMed

62.

Arboleda-Flórez J, Stuart H (2012) From sin to science: fighting the stigmatization of mental illnesses. Can J Psychiatry 57(8):457–463PubMed

63.

Carlson JA, Sarkin AJ, Levack AE, Sklar M, Tally SR, Gilmer TP, Groessl EJ (2011) Evaluating a measure of social health derived from two mental health recovery measures: the California Quality of Life (CA-QOL) and Mental Health Statistics Improvement Program Consumer Survey (MHSIP). Community Ment Health J 47(4):454–462CrossRefPubMedCentralPubMed

64.

Sczersputowski J, Smith S, Guard A, Rodig L, Goode M, Sarkin A (2013) A countywide public awareness campaign to reduce mental illness stigma: Research, approaches, and outcomes. Cases Public Health Commun Mark 7:35–59

65.

Robillos E, Lale R, Wooldridge J, Heller R, Sarkin A (2013) Gender differences in the relative importance of mental health satisfaction domains. Eval Program Plann 24(43C):9–15

66.

Long CG, Fulton B, Dolley O (2013) Using psychoeducation to motivate engagement for women with personality disorder in secure settings. J Psychiatr Intensive Care 00(1):1–9

Titel: Stigma experienced by people using mental health services in San Diego County
verfasst von: Andrew Sarkin
Rachel Lale
Marisa Sklar
Kimberly C. Center
Todd Gilmer
Chris Fowler
Richard Heller
Victoria D. Ojeda
Publikationsdatum: 01.05.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 5/2015
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-014-0979-9

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Objective

Methods

Results

Conclusions

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