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Erschienen in: Social Psychiatry and Psychiatric Epidemiology 4/2017

01.03.2017 | Original Paper

Experience of stigma in the public life of relatives of people diagnosed with schizophrenia in the Republic of Belarus

verfasst von: Dzmitry Krupchanka, Nina Kruk, Norman Sartorius, Silvia Davey, Petr Winkler, Joanna Murray

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 4/2017

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Abstract

Purpose

Mental health-related stigma affects people with mental disorders and their families. We aimed to investigate the experience of stigma among relatives of patients with schizophrenia in Belarus and formulate recommendations for anti-stigma interventions.

Methods

We conducted and thematically analysed 20 interviews with relatives of people diagnosed with schizophrenia. Experience of discrimination, strategies to cope with it, and requests for interventions were examined.

Results

A number of themes related to the experience of stigma in the public life of relatives of people with schizophrenia were elicited in relation to: (1) mental health care (difficulties in contacting mental health professionals; in getting appropriate information; lack of alternatives to hospital treatment; absence of appropriate long-term care services); (2) employment of people living with schizophrenia and (3) contact with the police. Analysis of the strategies used to overcome difficulties revealed resignation and passive acceptance, self-reliance, and emotional containment during crises. Despite the passivity and scepticism in expressing needs, participants suggested a number of interventions that could reduce the burden of stigma.

Conclusions

With respect to the public domain of life, substantial stigma and discrimination perceived by families of people living with schizophrenia in Belarus is associated with structural issues of the country’s mental health care system. To reduce the stigma-related burden, action must be taken to: (1) educate and support families and (2) deal with structural issues, by reorganising mental health services to better meet the needs of the families of people diagnosed with schizophrenia, and by including them in decision making at all levels.
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Literatur
1.
Zurück zum Zitat Thornicroft G, Brohan E, Rose D et al (2009) Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373:408–415CrossRefPubMed Thornicroft G, Brohan E, Rose D et al (2009) Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373:408–415CrossRefPubMed
2.
Zurück zum Zitat Thornicroft G (2006) Shunned: discrimination against people with mental illness. Oxford University Press, New York Thornicroft G (2006) Shunned: discrimination against people with mental illness. Oxford University Press, New York
3.
Zurück zum Zitat Corrigan PW, Miller FE (2004) Shame, blame, and contamination: a review of the impact of mental illness stigma on family members. J Ment Heal 13:537–548CrossRef Corrigan PW, Miller FE (2004) Shame, blame, and contamination: a review of the impact of mental illness stigma on family members. J Ment Heal 13:537–548CrossRef
4.
Zurück zum Zitat Angermeyer MC, Schulze B, Dietrich S (2003) Courtesy stigma–a focus group study of relatives of schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 38:593–602CrossRefPubMed Angermeyer MC, Schulze B, Dietrich S (2003) Courtesy stigma–a focus group study of relatives of schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 38:593–602CrossRefPubMed
5.
Zurück zum Zitat Mehta SI, Farina A (1988) Associative stigma: perceptions of the difficulties of college-aged children of stigmatized fathers. J Soc Clin Psychol 7:192–202CrossRef Mehta SI, Farina A (1988) Associative stigma: perceptions of the difficulties of college-aged children of stigmatized fathers. J Soc Clin Psychol 7:192–202CrossRef
6.
Zurück zum Zitat Ostman M (2002) Stigma by association: psychological factors in relatives of people with mental illness. Br J Psychiatry 181:494–498CrossRefPubMed Ostman M (2002) Stigma by association: psychological factors in relatives of people with mental illness. Br J Psychiatry 181:494–498CrossRefPubMed
7.
Zurück zum Zitat Park S, Park KS (2014) Family stigma: a concept analysis. Asian Nurs Res Korean Soc Nurs Sci 8:165–171.CrossRef Park S, Park KS (2014) Family stigma: a concept analysis. Asian Nurs Res Korean Soc Nurs Sci 8:165–171.CrossRef
8.
Zurück zum Zitat Larson JE, Corrigan P (2008) The stigma of families with mental illness. Acad Psychiatry 32:87–91CrossRefPubMed Larson JE, Corrigan P (2008) The stigma of families with mental illness. Acad Psychiatry 32:87–91CrossRefPubMed
9.
Zurück zum Zitat González-Torres MA, Oraa R, Arístegui M et al (2007) Stigma and discrimination towards people with schizophrenia and their family members. A qualitative study with focus groups. Soc Psychiatry Psychiatr Epidemiol 42:14–23CrossRefPubMed González-Torres MA, Oraa R, Arístegui M et al (2007) Stigma and discrimination towards people with schizophrenia and their family members. A qualitative study with focus groups. Soc Psychiatry Psychiatr Epidemiol 42:14–23CrossRefPubMed
10.
Zurück zum Zitat Phelan JC, Bromet EJ, Link BG (1998) Psychiatric illness and family stigma. Schizophr Bull 24:115–126CrossRefPubMed Phelan JC, Bromet EJ, Link BG (1998) Psychiatric illness and family stigma. Schizophr Bull 24:115–126CrossRefPubMed
11.
Zurück zum Zitat Stuart H, Arboleda-Florez J, Sartorius N (2012) Paradigms lost: fighting stigma and the lessons learned. Oxford University Press, New YorkCrossRef Stuart H, Arboleda-Florez J, Sartorius N (2012) Paradigms lost: fighting stigma and the lessons learned. Oxford University Press, New YorkCrossRef
12.
Zurück zum Zitat Evans-Lacko S, Courtin E, Fiorillo A et al (2014) The state of the art in European research on reducing social exclusion and stigma related to mental health: a systematic mapping of the literature. Eur Psychiatry 29:381–389CrossRefPubMed Evans-Lacko S, Courtin E, Fiorillo A et al (2014) The state of the art in European research on reducing social exclusion and stigma related to mental health: a systematic mapping of the literature. Eur Psychiatry 29:381–389CrossRefPubMed
13.
Zurück zum Zitat Semrau M, Evans-Lacko S, Koschorke M et al. (2015) Stigma and discrimination related to mental illness in low- and middle-income countries. Epidemiol Psychiatr Sci 24:382–94.CrossRefPubMed Semrau M, Evans-Lacko S, Koschorke M et al. (2015) Stigma and discrimination related to mental illness in low- and middle-income countries. Epidemiol Psychiatr Sci 24:382–94.CrossRefPubMed
14.
Zurück zum Zitat Sartorius N, Schulze H (2005) Reducing the stigma of mental illness: a report from a Global Association. Cambridge University Press, New YorkCrossRef Sartorius N, Schulze H (2005) Reducing the stigma of mental illness: a report from a Global Association. Cambridge University Press, New YorkCrossRef
15.
Zurück zum Zitat Yang LH, Kleinman A, Link BG et al (2007) Culture and stigma: Adding moral experience to stigma theory. Soc Sci Med 64:1524–1535CrossRefPubMed Yang LH, Kleinman A, Link BG et al (2007) Culture and stigma: Adding moral experience to stigma theory. Soc Sci Med 64:1524–1535CrossRefPubMed
16.
Zurück zum Zitat Yang LH, Chen F, Sia KJ et al (2014) “What matters most”: a cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma. Soc Sci Med 103:84–93CrossRefPubMed Yang LH, Chen F, Sia KJ et al (2014) “What matters most”: a cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma. Soc Sci Med 103:84–93CrossRefPubMed
17.
Zurück zum Zitat Krupchanka D, Winkler P (2016) State of mental healthcare systems in Eastern Europe: do we really understand what is going on? BKPsych Int 13:96–99 Krupchanka D, Winkler P (2016) State of mental healthcare systems in Eastern Europe: do we really understand what is going on? BKPsych Int 13:96–99
18.
Zurück zum Zitat Krupchanka D, Kruk N, Murray J et al. (2016) Experience of stigma in private life of relatives of people diagnosed with schizophrenia in the Republic of Belarus. Soc Psychiatry Psychiatr Epidemiol Krupchanka D, Kruk N, Murray J et al. (2016) Experience of stigma in private life of relatives of people diagnosed with schizophrenia in the Republic of Belarus. Soc Psychiatry Psychiatr Epidemiol
19.
Zurück zum Zitat Link BG, Phelan JC (2001) Conceptualizing stigma. Annu Rev Sociol 27:363–385.CrossRef Link BG, Phelan JC (2001) Conceptualizing stigma. Annu Rev Sociol 27:363–385.CrossRef
20.
Zurück zum Zitat Schulze B (2007) Stigma and mental health professionals: a review of the evidence on an intricate relationship. Int Rev Psychiatry 19:137–155CrossRefPubMed Schulze B (2007) Stigma and mental health professionals: a review of the evidence on an intricate relationship. Int Rev Psychiatry 19:137–155CrossRefPubMed
21.
Zurück zum Zitat Henderson C, Noblett J, Parke H et al (2014) Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry 1:467–482 Henderson C, Noblett J, Parke H et al (2014) Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry 1:467–482
22.
Zurück zum Zitat Corrigan PW, Markowitz FE, Watson AC (2004) Structural levels of mental illness stigma and discrimination. Schizophr Bull 30:481–491CrossRefPubMed Corrigan PW, Markowitz FE, Watson AC (2004) Structural levels of mental illness stigma and discrimination. Schizophr Bull 30:481–491CrossRefPubMed
24.
Zurück zum Zitat Schulze B, Angermeyer MC (2003) Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med 56:299–312CrossRefPubMed Schulze B, Angermeyer MC (2003) Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med 56:299–312CrossRefPubMed
25.
Zurück zum Zitat Brown C (2001) Qualitative methods in psychiatric research. Adv Psychiatr Treat 7:350–356.CrossRef Brown C (2001) Qualitative methods in psychiatric research. Adv Psychiatr Treat 7:350–356.CrossRef
26.
Zurück zum Zitat Hudelson PM (1994) Qualitative research for health programmes. World Health Organization, Geneva Hudelson PM (1994) Qualitative research for health programmes. World Health Organization, Geneva
27.
Zurück zum Zitat Krupchanka D, Katliar M (2016) The role of insight in moderating the association between depressive symptoms in people with schizophrenia and stigma among their nearest relatives: a pilot study. Schizophr Bull 42:600–607. doi:10.1093/schbul/sbw024 CrossRefPubMed Krupchanka D, Katliar M (2016) The role of insight in moderating the association between depressive symptoms in people with schizophrenia and stigma among their nearest relatives: a pilot study. Schizophr Bull 42:600–607. doi:10.​1093/​schbul/​sbw024 CrossRefPubMed
28.
Zurück zum Zitat Dicicco-Bloom B, Crabtree BF (2006) The qualitative research interview. Med Educ 40:314–321CrossRefPubMed Dicicco-Bloom B, Crabtree BF (2006) The qualitative research interview. Med Educ 40:314–321CrossRefPubMed
29.
Zurück zum Zitat Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101CrossRef Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101CrossRef
30.
Zurück zum Zitat Modgill G, Patten SB, Knaak S et al (2014) Opening minds stigma scale for health care providers (OMS-HC): examination of psychometric properties and responsiveness. BMC Psychiatry 14:120CrossRefPubMedPubMedCentral Modgill G, Patten SB, Knaak S et al (2014) Opening minds stigma scale for health care providers (OMS-HC): examination of psychometric properties and responsiveness. BMC Psychiatry 14:120CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Corrigan PW, Morris SB, Michaels PJ et al (2012) Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 63:963–973CrossRefPubMed Corrigan PW, Morris SB, Michaels PJ et al (2012) Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 63:963–973CrossRefPubMed
32.
Zurück zum Zitat Knaak S, Modgill G, Patten SB (2014) Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies. Can J Psychiatry 59:S19–S26PubMedPubMedCentral Knaak S, Modgill G, Patten SB (2014) Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies. Can J Psychiatry 59:S19–S26PubMedPubMedCentral
33.
Zurück zum Zitat Stuart H, Chen S-P, Christie R et al (2014) Opening minds in Canada: targeting change. Can J Psychiatry 59:S13–S18PubMedPubMedCentral Stuart H, Chen S-P, Christie R et al (2014) Opening minds in Canada: targeting change. Can J Psychiatry 59:S13–S18PubMedPubMedCentral
34.
Zurück zum Zitat Mundt AP, Frančišković T, Gurovich I et al (2012) Changes in the provision of institutionalized mental health care in post-communist countries. PLoS One 7:e38490CrossRefPubMedPubMedCentral Mundt AP, Frančišković T, Gurovich I et al (2012) Changes in the provision of institutionalized mental health care in post-communist countries. PLoS One 7:e38490CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Golubeva N, Naudts K, Gibbs A, et al. (2006) Psychiatry in the Republic of Belarus. Int Psychiatry 3(3):11–13 Golubeva N, Naudts K, Gibbs A, et al. (2006) Psychiatry in the Republic of Belarus. Int Psychiatry 3(3):11–13
36.
Zurück zum Zitat Thompson JW (1994) Trends in the development of psychiatric services, 1844–1994. Hosp Community. Psychiatry 45:987–992 Thompson JW (1994) Trends in the development of psychiatric services, 1844–1994. Hosp Community. Psychiatry 45:987–992
37.
Zurück zum Zitat Accordino MP, Porter DF, Morse T (2001) Deinstitutionalization of persons with Severe mental illness: context and consequences. J Rehabil 67:16 Accordino MP, Porter DF, Morse T (2001) Deinstitutionalization of persons with Severe mental illness: context and consequences. J Rehabil 67:16
38.
Zurück zum Zitat Curson DA, Pantelis C, Ward J, Barnes TR (1992) Institutionalism and schizophrenia 30 years on. Clinical poverty and the social environment in three British mental hospitals in 1960 compared with a fourth in 1990. Br J Psychiatry 160:230–241 (discussion 241–3)CrossRefPubMed Curson DA, Pantelis C, Ward J, Barnes TR (1992) Institutionalism and schizophrenia 30 years on. Clinical poverty and the social environment in three British mental hospitals in 1960 compared with a fourth in 1990. Br J Psychiatry 160:230–241 (discussion 241–3)CrossRefPubMed
39.
Zurück zum Zitat Leff J (1998) Care in the community: illusion or reality? Wiley & Sons, Chichester Leff J (1998) Care in the community: illusion or reality? Wiley & Sons, Chichester
40.
Zurück zum Zitat Saxena S, Funk M, Chisholm D (2013) World health assembly adopts comprehensive mental health action plan 2013–2020. Lancet 381:1970–1971CrossRefPubMed Saxena S, Funk M, Chisholm D (2013) World health assembly adopts comprehensive mental health action plan 2013–2020. Lancet 381:1970–1971CrossRefPubMed
42.
44.
Zurück zum Zitat Lokshina T, Sergeeva I, Moskovskaîa khelʹsinkskaîa gruppa., Nezavisimaîa psikhiatricheskaîa assoťŝiaťŝîîa (Russia) (2004) Human rights and psychiatry in the Russian Federation: report based on monitoring findings and thematic articles. Moscow Helsinki Group, Moscow Lokshina T, Sergeeva I, Moskovskaîa khelʹsinkskaîa gruppa., Nezavisimaîa psikhiatricheskaîa assoťŝiaťŝîîa (Russia) (2004) Human rights and psychiatry in the Russian Federation: report based on monitoring findings and thematic articles. Moscow Helsinki Group, Moscow
45.
Zurück zum Zitat Saraceno B, van Ommeren M, Batniji R et al (2007) Barriers to improvement of mental health services in low-income and middle-income countries. Lancet 370:1164–1174CrossRefPubMed Saraceno B, van Ommeren M, Batniji R et al (2007) Barriers to improvement of mental health services in low-income and middle-income countries. Lancet 370:1164–1174CrossRefPubMed
46.
Zurück zum Zitat Vogel DL, Bitman RL, Hammer JH, Wade NG (2013) Is stigma internalized? The longitudinal impact of public stigma on self-stigma. J Couns Psychol 60:311–316CrossRefPubMed Vogel DL, Bitman RL, Hammer JH, Wade NG (2013) Is stigma internalized? The longitudinal impact of public stigma on self-stigma. J Couns Psychol 60:311–316CrossRefPubMed
47.
Zurück zum Zitat Świtaj P, Grygiel P, Anczewska M, Wciórka J (2014) Loneliness mediates the relationship between internalised stigma and depression among patients with psychotic disorders. Int J Soc Psychiatry 60:733–740CrossRefPubMed Świtaj P, Grygiel P, Anczewska M, Wciórka J (2014) Loneliness mediates the relationship between internalised stigma and depression among patients with psychotic disorders. Int J Soc Psychiatry 60:733–740CrossRefPubMed
48.
Zurück zum Zitat Ritsher JB, Phelan JC (2004) Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Res 129:257–265CrossRefPubMed Ritsher JB, Phelan JC (2004) Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Res 129:257–265CrossRefPubMed
49.
Zurück zum Zitat Vogel DL, Wade NG, Hackler AH (2007) Perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling. J Couns Psychol 54:40–50CrossRef Vogel DL, Wade NG, Hackler AH (2007) Perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling. J Couns Psychol 54:40–50CrossRef
50.
Zurück zum Zitat Williams SL, Mickelson KD (2008) A paradox of support seeking and rejection among the stigmatized. Pers Relatsh 15:493–509.CrossRef Williams SL, Mickelson KD (2008) A paradox of support seeking and rejection among the stigmatized. Pers Relatsh 15:493–509.CrossRef
51.
Zurück zum Zitat WHO (2014) Mental health atlas 2014. World Health Organization, Geneva WHO (2014) Mental health atlas 2014. World Health Organization, Geneva
52.
Zurück zum Zitat McCann TV, Lubman DI, Clark E (2011) First-time primary caregivers’ experience of caring for young adults with first-episode psychosis. Schizophr Bull 37:381–388CrossRefPubMed McCann TV, Lubman DI, Clark E (2011) First-time primary caregivers’ experience of caring for young adults with first-episode psychosis. Schizophr Bull 37:381–388CrossRefPubMed
53.
Zurück zum Zitat Yanos PT, Roe D, Lysaker PH (2011) Narrative enhancement and cognitive therapy: a new group-based treatment for internalized stigma among persons with severe mental illness. Int J Group Psychother 61:577–595CrossRefPubMed Yanos PT, Roe D, Lysaker PH (2011) Narrative enhancement and cognitive therapy: a new group-based treatment for internalized stigma among persons with severe mental illness. Int J Group Psychother 61:577–595CrossRefPubMed
54.
Zurück zum Zitat 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 42:1741–1752CrossRefPubMed 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 42:1741–1752CrossRefPubMed
55.
Zurück zum Zitat Vázquez-Barquero JL, García J, Torres-González F (2001) Spanish psychiatric reform: what can be learned from two decades of experience? Acta Psychiatr Scand Suppl 104(s410):89–95CrossRef Vázquez-Barquero JL, García J, Torres-González F (2001) Spanish psychiatric reform: what can be learned from two decades of experience? Acta Psychiatr Scand Suppl 104(s410):89–95CrossRef
56.
Zurück zum Zitat Verhaeghe M, Bracke P, Bruynooghe K (2007) Stigmatization in different mental health services: a comparison of psychiatric and general hospitals. J Behav Health Serv Res 34:186–197CrossRefPubMed Verhaeghe M, Bracke P, Bruynooghe K (2007) Stigmatization in different mental health services: a comparison of psychiatric and general hospitals. J Behav Health Serv Res 34:186–197CrossRefPubMed
Metadaten
Titel
Experience of stigma in the public life of relatives of people diagnosed with schizophrenia in the Republic of Belarus
verfasst von
Dzmitry Krupchanka
Nina Kruk
Norman Sartorius
Silvia Davey
Petr Winkler
Joanna Murray
Publikationsdatum
01.03.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 4/2017
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-017-1365-1

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