Academic journal article Health Sociology Review

Understanding and Addressing the Stigma of Mental Illness with Ethnic Minority Communities

Academic journal article Health Sociology Review

Understanding and Addressing the Stigma of Mental Illness with Ethnic Minority Communities

Article excerpt

The way in which we support people with enduring mental health problems in affluent countries is changing. Deinstitutionalisation and recovery-focused models of care are frequently accompanied by rights-based legislation in relation to healthcare treatment, employment and education. Yet in contemporary societies, the intense stigma and discrimination that people with mental health problems continue to face results in a series of 'social injuries' that are profoundly damaging (Rogers & Pilgrim, 2003).

Sociologists Link and Phelan (2001) provide a strong model for understanding mental health stigma. They acknowledge that stigma includes a combination of inaccurate or distorted beliefs, negative attitudes and discriminatory behaviour. They describe stigma as the co-occurrence of labelling of difference, stereotyping, separation of 'us' and 'them', followed by discrimination and status loss. This model acknowledges that it is easier to discriminate against groups who have less power, and that stigma can exist at a number of levels in society: internalised stigma (or anticipated discrimination) for the person affected; social stigma experienced in everyday interactions with friends, family and the wider community; and structural stigma (or institutional discrimination) whereby prejudice is embedded into legal systems, the media, cultural and businesses institutions. Family and friends can also be stigmatised by association with the labelled person or group although this dimension has received less attention (Goffman, 1963).

The impact of stigma is profound. People with mental health problems frequently delay help-seeking for fear of the social consequences (Schomerus & Angermeyer, 2008). Life chances and opportunities are consistently restricted (Rosenfield, 1997). Harassment in the community remains a common phenomenon (Berzins, Petch, & Atkinson, 2003). Employment rates remain at under 20% across Europe compared to over 40% of all people with a disability (Williams, Copestake, Eversley, & Stafford, 2008) and stigma from employers and colleagues is a major cause (Arthur, Knifton, Park, & Doherty, 2008; Faulkner & Layzell, 2000). The cumulative effects of this income and status loss, combined with fear of rejection from friends, families and partners, frequently results in lowered self-esteem (Wright, Gronfein, & Owens, 2000). Enduring stigma can lead to people living in states of constant stress, worsening the initial mental health problem (Link & Phelan, 2006). Under-investment in health services from governmental institutions contributes towards a gap between mental health need, services and support, especially amongst disadvantaged social groups (Patel et al., 2010).

In Scotland, the location of this study, stigma and discrimination against people with mental illness continues to be a major issue. Dangerousness remains a commonly reported belief in public surveys and in the media, along with notions that people are to blame for their condition, are unwilling or unable to work, make little social contribution and are unsuitable as partners (Knifton & Quinn, 2008). Beliefs about danger increased as we moved from institutions to community care, with a shiftfrom 'becoming mad' to 'fear of the other' (Maclean, 1969). Danger and unpredictability remain highly associated with people with severe and enduring mental illnesses including psychoses and schizophrenia. Other conditions, such as depression, attract more subtle forms of stigma related to ability to work and being difficult to talk to (Crisp, Gelder, Rix, Meltzer, & Rowlands, 2000).

This study engages with communities that experience multiple forms of disadvantage and disempowerment, and the case for understanding and addressing mental health stigma in the context of inequalities is compelling. Globally the prevalence of mental health problems is high and increasing (World Health Organization, 2001) and the burden does not fall equally within societies. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.