Practical 1 - Exploring Stigma in Mental Health

Question 1

What is Goffman’s definition of stigma?

Answer 1

Stigma is a mark of disgrace associated with a particular condition, quality or person

Question 2

What are the three kinds of stigma?

Answer 2

Public, structural, and self

Question 3

What is public stigma?

Answer 3

Societal attitudes

Question 4

What is structural stigma?

Answer 4

Policies or systems reinforcing stigma

Question 5

What is self-stigma?

Answer 5

Internalisation of stigma by individuals

Question 6

What is neutral language?

Answer 6

• Emphasises agency, functional capacity, suppot, and a sense of recovery
• Acknowledging difficulties but focuses on empowering an individual to take an active role in their lives

Question 7

What is stigmatising language?

Answer 7

• Focuses more on helplessness, limitations, and pathology, being dominated by their condition
• Minimises or disregards agency and a passivity to the condition
• Emphasises struggle, barriers, and a lack of progress

Question 8

What are the three theories relating to stigma?

Answer 8

Labelling theory, Attribution theory, and social identity theory

Question 9

Who suggested labelling theory?

Answer 9

Becker 1963

Question 10

What does the labelling theory suggest?

Answer 10

suggests that the act of labelling someone with. a mental illness can lead to stereotyping, social exclusion, and marginalisation

Question 11

How do labels influence identity?

Answer 11

• create a sense of ‘otherness’ where they are viewed as different from society
• often reduced to their condition rather than seen as a whole (could be in recovery etc)
• can lead to self-fulfilling prophecy - internalising negative labels, shaping their identity and reinforcing stigma

Question 12

Who proposed the attribution theory?

Answer 12

Weiner 1986

Question 13

What is attribution theory?

Answer 13

How we perceive the cause of someones mental illness after the degree of stigma

Question 14

What is controllability and stigma?

Answer 14

• people tend to assign more stigma conditions that are seen as controllable (e.g. addiction) assuming that the person could have avoided the condition or could stop it
• if it is viewed as a personal failing, stigma is typically stronger
• Less stigma for uncontrollable conditions: conditions perceived as uncontrollable may receive less moral judgement but can still be subject to fear-based stigma

Question 15

Who proposed the social identity theory?

Answer 15

Tajafel and Turner 1979

Question 16

What are in groups vs out groups?

Answer 16

• Individuals with mental illness are placed into the ‘out-group’ creating an ‘us and them’ mentality
• Stigma acts as a mechanism to maintain boundaries between these groups, preserving a sense of superiority in the in-group
• Group hierarchies: This separation reinforces hierarchy

Question 17

What is the social identity theory?

Answer 17

How group memberships can influence attitudes. People with mental illness are often seen as part of the ‘out-group’ reinforcing negative stereotypes and maintaining social hierarchies

Question 18

What are the barriers to seeking treatment?

Answer 18

Prevent and delay individuals from seeking support

Question 19

What are poor treatment adherence?

Answer 19

Avoiding prescribed medication and therapeutic support due to feelings of shame or the belief that the condition is not ‘real’.

Question 20

What is the impact on providers and systems?

Answer 20

• Structural stigma – biased attitudes and suboptimal and inequitable care
• Wider implications in terms of healthcare costs, employability, systemic impacts.