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1 – 10 of over 1000Kristen Marcussen and Christian Ritter
This chapter examines the effects of mental health services and stigma on changes in self-concept and well-being for individuals with SPMI.
Abstract
Purpose
This chapter examines the effects of mental health services and stigma on changes in self-concept and well-being for individuals with SPMI.
Methodology/approach
Data for this chapter come from structured interviews and service data for 140 individuals with severe and persistent mental illnesses. We use structural equation modeling to examine the relationship between perceived and internalized stigma, as well as the relationships among stigma, self-concept (self-esteem and mastery), and well-being (quality of life and functioning).
Findings
We find that case management is negatively related to quality of life and psychiatric services are positively related to functioning. Crisis services and assessment are associated with mastery in opposite directions. Internalized stigma is positively associated with self-esteem and mastery, and negatively associated with functioning. We do not find a relationship between services and stigma.
Research limitations/implications
A limitation to this chapter is the sample size, which prohibits us from examining a full range of services and outcomes. Nonetheless, our findings provide information about how services and stigma impact well-being, and may be used as a starting point for considering strategies for improving services and reducing stigma. Future work should consider pairing outcomes with services to determine their effectiveness.
Originality/value
This chapter builds on previous research that examines the relative effects of services and stigma among individuals in community health care by extending measures of both services and stigma, and by examining the relationship between them, in order to better determine their implications for self-concept and well-being.
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Kayla B. Follmer, Mackenzie J. Miller and Joy E. Beatty
Research related to workplace accommodation requests for employees with mental illness is scarce, though evidence suggests that these individuals often fail to request…
Abstract
Purpose
Research related to workplace accommodation requests for employees with mental illness is scarce, though evidence suggests that these individuals often fail to request accommodations even when needed. The authors' research study aimed to address these shortcomings by (1) assessing employees' knowledge of Americans with Disabilities Act (ADA) laws and how this knowledge influences employees' perceived need for and requests of accommodations; (2) examining the relationship between employees' perceived need for accommodations and employees' workplace outcomes and (3) examining the relationship between perceived need for accommodations and employees' actual accommodation requests, as well as how stigma influences this relationship.
Design/methodology/approach
The authors used two survey studies to investigate their research questions. Study 1 participants were recruited through Amazon's MTurk, and Study 2 participants were recruited through support groups for individuals diagnosed with mood disorders (i.e. depression and bipolar disorder).
Findings
The authors found significant gaps in both subjective and objective ADA-related knowledge among participants in their sample. The authors' Study 1 results also revealed an interaction between the perceived need for accommodations and accommodation requests in predicting job satisfaction and turnover intentions. When employees needed accommodations but did not request them, it resulted in worsened workplace outcomes. In Study 2, the authors aimed to identify barriers to requesting accommodations. The authors found that the relationship between perceived need for accommodations and actual accommodation requests was moderated by both public and self-stigma, thereby showing that stigma can impede individuals from requesting needed accommodations at work.
Originality/value
The authors' study sheds light on a population that has been relatively understudied in the workplace accommodations literature, namely those with mental illness. The authors first identify the perceived need for accommodations as an important factor in making accommodations requests at work, as prior work has failed to differentiate how the need for accommodations can vary across individuals. Next, the authors show how workplace outcomes (i.e. job satisfaction and turnover intentions) are negatively affected when employees need accommodations but do not request them. Finally, the authors demonstrate how both public stigma and self-stigma can reduce the likelihood that individuals request accommodations at work, even when needed.
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Farzin Rasoulyan, Seyed Reza Mirnezami, Arash Khalili Nasr and Bahar Morshed-Behbahani
Experiencing stigma after abortion may decelerate the accumulation of human capital. Despite the importance of studying the relationship between religiosity and abortion stigma…
Abstract
Purpose
Experiencing stigma after abortion may decelerate the accumulation of human capital. Despite the importance of studying the relationship between religiosity and abortion stigma, the topic is understudied, especially in Islamic contexts. Abortion was legalized in Iran in 2005. Under the new law, far more cases are allowed for abortion. This change provided an opportunity to explore the interplay of abortion stigma, legalization and religiosity in Iran.
Design/methodology/approach
Using regression analysis based on 291 completed questionnaires from two cities in Iran, this study analyzes the relation between abortion stigma level and religiosity in Iran, controlling for contextual and individual variables. The time trend is also identified. The authors use different manifestations of abortion stigma as dependent variables.
Findings
The authors found that abortion stigma and its two manifestations decreased after the new law, suggesting that its legalization might have caused abortion stigma to decrease gradually. Another finding of this study is that the correlations between abortion stigma (internalized stigma) and individual religiosity level are meaningful and positive; religious people feel higher levels of abortion stigma.
Originality/value
The study supports the idea that effective health regulations (in the specific case of abortion) would result in less cost/risk of social issues like stigma. Policymakers in religious societies must pay more attention to the specific case of abortion stigma since it is very important for the mental health of women who think of abortion and/or select it.
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Karin Martin, Andrew Taylor, Benjamin Howell and Aaron Fox
This paper aims to determine whether criminal justice (CJ) stigma affects health outcomes and health care utilization.
Abstract
Purpose
This paper aims to determine whether criminal justice (CJ) stigma affects health outcomes and health care utilization.
Design/methodology/approach
The authors reviewed medical and public health literature through May 2020. Structured terms were used to search four databases identifying articles that related to CJ stigma. Included articles were in English, examined CJ stigma and had people with CJ involvement as subjects. The studies without health outcomes were excluded. Quantitative and qualitative studies were reviewed and assessed for bias. Results were synthesized into a systematic review.
Findings
The search yielded 25 studies relating to CJ stigma and health. Three stigma domains were described in the literature: perceived or enacted, internalized and anticipated stigma. Tenuous evidence linked CJ stigma to health directly (psychological symptoms) and indirectly (social isolation, health care utilization, high-risk behaviors and housing or employment). Multiple stigmatized identities may interact to affect health and health care utilization.
Research limitations/implications
Few studies examined CJ stigma and health. Articles used various measures of CJ stigma, but psychometric properties for instruments were not presented. Prospective studies with standard validated measures are needed.
Practical implications
Understanding whether and how CJ stigma affects health and health care utilization will be critical for developing health-promoting interventions for people with CJ involvement. Practical interventions could target stigma-related psychological distress or reduce health care providers’ stigmatizing behaviors.
Originality/value
This was the first systematic review of CJ stigma and health. By providing a summary of the current evidence and identifying consistent findings and gaps in the literature, this review provides direction for future research and highlights implications for policy and practice.
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Jerome V. Cleofas and Dennis Erasga
Stigma remains to be a major barrier to addressing the sustained rise of human immunodeficiency virus (HIV) infections in the Philippines. Gay, bisexual, and other men who have…
Abstract
Stigma remains to be a major barrier to addressing the sustained rise of human immunodeficiency virus (HIV) infections in the Philippines. Gay, bisexual, and other men who have sex with other men (MSMs) (G/B/MSM) living with HIV experience compounded stigma due to their sexual identity and HIV seropositive status. The family has been identified as one of the main sources of homonegativity and HIV-related discrimination. Drawing from the family life histories of 31 Filipino MSMs living with HIV, the authors demonstrate the concept of compounding stigma, which posits that the extent and nature of gender- and sexuality-based stigma experienced in early life may potentiate or mitigate the experience of HIV stigma in later life in the context of the family. Narrative analysis of the family life histories reveals a central factor that shaped the sexual development and stigma experiences of MSMs living with HIV: sexual identity visibility in the family (SIVF) – the family’s extent of knowledge and/or acceptance of their sexuality. Three core narratives emerged from the data that categorize informants based on the type of SIVF present in their family life viz. full, partial, and invisible. Results also trace the resultant life trajectories for each core narrative and reveal three forms of compounding stigma: low compounding stigma or compounding acceptance, compounding enacted stigma, and compounding internalized stigma.
Beatrice Meda Wendeln and Lindsay Sheehan
The purpose of this study was to evaluate the effects of an online mental health ally program on several measurements of readiness to help and stigma reduction. Allyship is one…
Abstract
Purpose
The purpose of this study was to evaluate the effects of an online mental health ally program on several measurements of readiness to help and stigma reduction. Allyship is one way to support people with mental health challenges beyond traditional care services.
Design/methodology/approach
The efficacy of the program was evaluated in pre and postintervention surveys (n = 26) including measures of self-care, help-seeking intentions, peer-support self-efficacy, advocacy, knowledge of resources and stigma. A within-subject, repeated measures design was conducted analyzing changes at completion. Twenty-six participants who completed the program (either with or without lived experience of mental illness) were included in the study. A subgroup of participants (n = 11) who reported lived experiences of mental illness were assigned additional measures of internalized stigma, stigma stress, stigma resistance and self-esteem.
Findings
Analysis of mean differences indicated a statistically significant change in scores pre and postcompletion. The program increased peer-support, help-seeking intentions and self-esteem, while reducing internalized stigma and stigma stress. Findings provide preliminary support for program effectiveness in training individuals to support others and themselves through mental health challenges.
Research limitations/implications
Trained allies might improve the lives of individuals with mental health challenges by reducing discrimination and improving social support. We discuss the implication of allies to complement the mental health system.
Originality/value
To the best of the authors’ knowledge, this is the first exploratory study on the efficacy of an online ally training program for individuals with mental illness. The NoStigmas Ally Program is a novel and original development in ally training.
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Sarah K. Harkness and Amy Kroska
We examine whether self-stigmatization may affect the everyday social interactions of individuals with a diagnosed, affective mental health disorder. Past research demonstrates…
Abstract
We examine whether self-stigmatization may affect the everyday social interactions of individuals with a diagnosed, affective mental health disorder. Past research demonstrates self-stigmatization lowers self-esteem, efficacy, and personal agency, leading to the likely adoption of role-identities that are at the periphery of major social institutions. We advance research on self-stigma by examining the likely interactional and emotional consequences of enacting either a highly stigmatized self-identity or a weakly stigmatized self-identity.
Using affect control theory (ACT), we form predictions related to the interactional and emotional consequences of self-stigmatization. We use the Indianapolis Mental Health Study and Interact, a computerized instantiation of ACT, to generate empirically based simulation results for patients with an affective disorder (e.g., major depression and bipolar disorder), comparing simulations where the focal actor is a person with a mental illness who exhibits either high or low levels of self-stigma.
Self-stigma is predicted to negatively influence patients’ behavioral expression, leading the highly self-stigmatized to enact behaviors that are lower in goodness, power, and liveliness than the weakly self-stigmatized. Their corresponding emotional expressions during these types of interactions are similarly negatively impacted. Even though these likely interactions are the most confirmatory for people with high levels of self-stigma, they lead to interactions that are behaviorally and emotionally more negative than those who have been better able to resist internalizing stigmatizing beliefs.
This piece has implications for the literature on the interactional and life course challenges faced by psychiatric patients and contributes to the self-stigma literature more broadly. This work will hopefully inform future research involving the collection of non-simulation-based data on the everyday interactional experiences of people with mental health problems.
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Annie Isabel Fukushima, Kwynn Gonzalez-Pons, Lindsay Gezinski and Lauren Clark
The purpose of this study is to contribute to the social understanding of stigma as a societal and cultural barrier in the life of a survivor of human trafficking. The findings…
Abstract
Purpose
The purpose of this study is to contribute to the social understanding of stigma as a societal and cultural barrier in the life of a survivor of human trafficking. The findings illustrate several ways where stigma is internal, interpersonal and societal and impacts survivors’ lives, including the care they receive.
Design/methodology/approach
This study used qualitative methods. Data collection occurred during 2018 with efforts such as an online survey (n = 45), focus groups (two focus groups of seven participants each) and phone interviews (n = 6). This study used thematic analysis of qualitative data.
Findings
The research team found that a multiplicity of stigma occurred for the survivors of human trafficking, where stigma occurred across three levels from micro to meso to macro contexts. Using interpretive analysis, the researchers conceptualized how stigma is not singular; rather, it comprises the following: bias in access to care; barriers of shaming, shunning and othering; misidentification and mislabeling; multiple levels of furthering how survivors are deeply misunderstood and a culture of mistrust.
Research limitations/implications
While this study was conducted in a single US city, it provides an opportunity to create dialogue and appeal for more research that will contend with a lens of seeing a multiplicity of stigma regardless of the political climate of the context. It was a challenge to recruit survivors to participate in the study. However, survivor voices are present in this study and the impetus of the study’s focus was informed by survivors themselves. Finally, this study is informed by the perspectives of researchers who are not survivors; moreover, collaborating with survivor researchers at the local level was impossible because there were no known survivor researchers available to the team.
Practical implications
There are clinical responses to the narratives of stigma that impact survivors’ lives, but anti-trafficking response must move beyond individualized expectations to include macro responses that diminish multiple stigmas. The multiplicity in stigmas has meant that, in practice, survivors are invisible at all levels of response from micro, meso to macro contexts. Therefore, this study offers recommendations for how anti-trafficking responders may move beyond a culture of stigma towards a response that addresses how stigma occurs in micro, meso and macro contexts.
Social implications
The social implications of examining stigma as a multiplicity is central to addressing how stigma continues to be an unresolved issue in anti-trafficking response. Advancing the dynamic needs of survivors both in policy and practice necessitates responding to the multiple and overlapping forms of stigma they face in enduring and exiting exploitative conditions, accessing services and integrating back into the community.
Originality/value
This study offers original analysis of how stigma manifested for the survivors of human trafficking. Building on this dynamic genealogy of scholarship on stigma, this study offers a theory to conceptualize how survivors of human trafficking experience stigma: a multiplicity of stigma. A multiplicity of stigma extends existing research on stigma and human trafficking as occurring across three levels from micro, meso to macro contexts and creating a system of oppression. Stigma cannot be reduced to a singular form; therefore, this study argues that survivors cannot be understood as experiencing a singular form of stigma.
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Jeffrey D. MacCharles and E. Nicole Melton
The purpose of this study was to examine how identity covering techniques can influence raters' perceptions of job candidates who have a socially stigmatized identity…
Abstract
Purpose
The purpose of this study was to examine how identity covering techniques can influence raters' perceptions of job candidates who have a socially stigmatized identity. Specifically, the authors explore how raters respond to two types of candidates: one who does not mention his gay identity during the interview process, and one who openly discusses their gay identity during the interview process. The authors also investigate whether job type (sport operations vs business operations) and the rater's views toward social equality influence perceptions of job fit and subsequent hiring recommendations.
Design/methodology/approach
The authors conducted an experiment to examine whether an applicant's level of stigma covering, type of job posting and rater's views toward social equality influenced perceptions of job fit. The authors then tested whether perceptions of job fit mediated hiring recommendations. Adults in the USA (n = 237) who were employed and had served on a hiring committees participated in the survey.
Findings
When applying for sport operations jobs, as opposed to business operations jobs, gay male applicants are viewed more favorably if they engage in high levels of identity covering. Further, the applicant's level of stigma covering influenced raters who reported high or moderate social dominance orientation but did not impact raters with low social dominance orientation. Overall, the findings reveal that identity covering techniques do have relevance for studying the dynamics of hiring gay men who apply for jobs in the sport industry.
Originality/value
The study advances the understanding of identity management techniques by examining the nuances of how applicants can choose to disclose their stigmatized identity, and how those decision influence the hiring process.
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Akm Ahsan Ullah and Ahmed Shafiqul Huque
HIV or AIDS remains invisible and dismissed by most South Asians living in Canada as HIV or AIDS issues are perceived as an offshoot of Western lifestyle linked with drug use and…
Abstract
Purpose
HIV or AIDS remains invisible and dismissed by most South Asians living in Canada as HIV or AIDS issues are perceived as an offshoot of Western lifestyle linked with drug use and promiscuity. This paper aims to look into how people living with HIV or AIDS (PLWHA) cope with prejudice and stigma.
Design/methodology/approach
To guide this research, a constructivist grounded theory approach was adopted as the theoretical and methodological framework. The authors reached the participants through a Toronto-based group that works with PLWHA. The authors chose their respondents in a snowball method and interviewed them both in person and online.
Findings
This paper identifies how South Asian immigrants and refugees/refugees with HIV or AIDS claimants are vulnerable to discrimination in Canada due to the following factors, which include but are not limited to: a lack of information about HIV and AIDS incidence in the community; and the Canadian health system's inability to respond appropriately to the lack of information.
Practical implications
HIV service engagements should take place within the context of a constellation of local traditions, or standardized expectations of patient engagement with HIV services can be counterproductive.
Originality/value
It is critical that governmental action prioritizes increasing public understanding of stigma. To minimize the consequences of HIV-related discrimination and stigma, misconceptions about HIV transmission must be debunked.
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