Search results

This chapter examines the effects of mental health services and stigma on changes in self-concept and well-being for individuals with SPMI.

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).

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.

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.

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.

This paper aims to determine whether criminal justice (CJ) stigma affects health outcomes and health care utilization.

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.

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.

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.

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.

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.

The purpose of the study is to investigate the perceived stigma among residents of Sanandaj, west of Iran, following COVID-19 pandemic.

This is a cross-sectional study conducted from March to April 2020. The sample consisted of 1,000 participants who live in Sanandaj. The data collection tool was a self-report electronic questionnaire. ANOVA and T-test were used to analyze the data.

The mean perceived stigma for COVID-19 was 5.50±2.24 (IQR: 3.75–6.87) out of 10-point scale. The highest point was seen for perceived external stigma (6.73±2.49, IQR: 5–8.75) followed by disclosure stigma (4.95±3.92, IQR: 0–10). Interestingly, self-employers were more concerned about disclosing their illness than those with governmental jobs (25±3.93 vs. 4.31±4.14, P<0.05), and also had an overall higher stigma score; 5.72±2.23 vs. 5.19±2.37, P<0.05).

COVID-19 stigma is high among Iranians and more common among men, youngsters and self-employers.

This critical review of historical and contemporary literature explores the role of television media in the prevalence of stigma towards persons experiencing a mental health challenge. In addition to this, the purpose of this paper is to examine the notion of perceived dangerousness, which is a concept where persons with mental illness are thought by others to be inherently dangerous.

A vigorous search of databases was undertaken for articles published between 2000 and 2016. Some seminal literature prior to 2000 was used to compare historical data with current literature. In total, 1,037 publications were reviewed against inclusion criteria.

While mental illness stigma has received much attention in the literature, television media and public perceptions of dangerousness have not. While these concepts are complex and multi-factorial, what we do understand is that approaches to address stigma have been largely unsuccessful, and that persons experiencing mental health challenges continue to be significantly disadvantaged.

Implications to practice for clinicians working in mental health on this issue have not been adequately explored within the literature. While media guidelines assist journalists to make informed choices when they portray mental health issues in television news, there are no such guidelines to inform drama television viewing.

Significantly, television’s role in perpetuation of perceptions of dangerousness has not been adequately explored as a combined co-occurring factor associated with the stigmatisation and avoidance of persons experiencing a mental health challenge. In an era when mental health challenges are on the rise, it is of great importance that we collectively seek to minimise negative impacts and improve the experiences of those with a mental health challenge through addressing stigma both individually and in television media.

This chapter reviews qualitative research on parenting children with disabilities published over the last 50 years to explore whether shifts in academic discourse and changes in professional training have affected research on parenting and/or the experiences of parents who are the subject of such research.

An extensive literature search was conducted, and 78 peer-reviewed, qualitative studies on the experience of parenting a child with a disability were included in the sample. Themes were extracted from the reviewed literature and compared across decades.

The findings of the present review suggest that some aspects of the parenting experience have changed very little. In particular, parents continue to experience negative reactions such as stress and anomie, especially early in their children’s lives, and socially imposed barriers such as unhelpful professionals, and a lack of needed services continue to create problems and inspire an entrepreneurial response. In addition, stigmatizing encounters with others continue to be a common occurrence. In contrast to earlier decades, studies conducted in more recent years have begun to use the social model of disability as an analytic frame and also increasingly report that parents are questioning and challenging the concept of “normal” itself.

Additional improvements are needed in professional education and services to reduce the negative reactions experienced by parents of children with disabilities.

The findings of this meta-analysis can serve as a guide to future research on parenting children with disabilities.

The basic family unit is an important institution whose scope and function has changed greatly over the past one hundred years. The contemporary form of the family is understood as “conjugal and nuclear.” This implies a greater emphasis than previously on individual roles and relationships within the private sphere of the contemporary family. Additionally, the family is understood to have lost many of its former functions, further separating itself from the external world. The separation has further stripped the family from many of the roles it once had, with traditional familial functions performed by other institutions.

The purpose of this paper is to investigate whether sexual minority candidates are viewed as less likely to fit-in in their work environments than heterosexual candidates and, hence, to their being evaluated as less promotable.

Consistent with previous research, the authors used a hiring scenario where evaluators saw one of four different resumes, which varied based on candidate sexual orientation and gender, yet were equal on all factors, including candidate qualifications. The research included a pre-test and manipulation check to ensure the validity of the authors’ research design.

As the authors expected based on stigma theory, gay and lesbian candidates were more likely to be perceived as unable to fit-in than heterosexual candidates. Perceptions of a lack of fitting-in were negatively related to promotability ratings, as were beliefs about the controllability of sexual orientation. However, counter to the authors’ expectations, gay and lesbian candidates were rated more promotable than heterosexual candidates. This presents a more nuanced picture of sexual orientation discrimination than has been offered heretofore.

Previous research has suggested that gay men and lesbians may be trapped in “gay ghettos,” yet there is little if any research on evaluations of sexual minority candidates in employment decisions beyond hiring. The present study extends research on sexual orientation discrimination by investigating whether decision makers are biased against gay and lesbian candidates in promotion decisions, and the factors that are related to promotability ratings.

The purpose of this paper is to explore how injecting opiate users on a methadone treatment programme experience stigma as drug addicts, and as service users in health care and pharmacy settings. In particular the paper explores the rationale for injecting drugs, which the paper is argued to create the conditions for experiencing shame at the micro interactional level, influenced by macro institutional factors. The paper links this issue of being an injecting drug user in treatment to question whether the definition of recovery as “drug free” in the Scottish drug policy document The Road to Recovery (2008) creates the potential for stigma of service users receiving methadone maintenance treatment.

In all, 14 participants, all of whom identified themselves as problem intravenous users of drugs, were recruited from three voluntary sector (third sector) treatment agencies in Scotland. Participants took part in semi-structured interviews; these were recorded, transcribed and qualitatively analysed thematically.

Participants describe feelings of stigma in relation to their drug taking as problem users. Their experiences as recovering opiate injectors raises further challenges in distancing themselves from stigmatised addict identities.

Reasons for injecting rather than smoking heroin were principally financially challenging a widely held belief that users inject primarily for pleasure, which is argued as increasing the potential for stigma. Shame and perceived discrimination was documented before and during drug treatment.

We argue that self-stigma places patients on a path of marginalization throughout their life course leading to a negative cycle of opportunity and advancement. Mental health patients with higher levels of self-stigma tend to have much lower self-esteem, efficacy, and personal agency; therefore, they will be more inclined to adopt role-identities at the periphery of major social institutions, like those of work, family, and academia. Similarly, the emotions felt when enacting such roles may be similarly dampened.

Utilizing principles from affect control theory (ACT) and the affect control theory of selves (ACTS), we generate predictions related to self-stigmatized patients’ role-identity adoption and emotions. We use the Indianapolis Mental Health Study and Interact, a computerized version of ACT and ACTS, to generate empirically based simulation results for patients with an affective disorder (e.g., major depression and bipolar disorder) with comparably high or low levels of self-stigmatization.

Self-stigma among affective patients reduces the tendency to adopt major life course identities. Self-stigma also affects patients’ emotional expression by compelling patients to seek out interactions that make them feel anxious or affectively neutral.

This piece has implications for the self-stigma and stigma literatures. It is also one of the first pieces to utilize ACTS, thereby offering a new framework for understanding the self-stigma process. We offer new hypotheses for future research to test with non-simulation-based data and suggest some policy implications.

Many people delay or never seek professional help for stress and depression. There is limited research on this topic using qualitative methodologies, but even less exploring the attitudes of the general population.This study explores the attitudes and preferences of the general population about when and where help is sought for stress and depression through the Somerset Health Panels. These comprised 12 two‐hour panels held across Somerset, England, involving a total of 96 people. This study reveals that a positive and non‐judgemental view of depression and stress exists within the general population. The response and support from friends and family is critical in seeking other sources of help, for which the GP is perceived as a gatekeeper. A preferred hierarchy of professional and nonprofessional sources of help exists, which is not entirely consistent with the arrangement of current services. This research adds to our understanding of how to engage with communities more generally and helps understand a general population perspective on mental health issues ‐ in particular, the way services are currently arranged does not always reflect the hierarchy in which people would prefer to seek help, and that stigma is evident but does not always act as a barrier to eventual help‐seeking.