Stigma Flashcards
Stigma
- an attribute, trait or behaviour that is considered shameful; that symbolically marks the possessor as unacceptable and inferior or dangerous
- Goffman
Enacted stigma
-refers to a patient’s actual experience of discrimination
Felt stigma
-refers to a patient’s fear of experiencing a discriminated act; it is more prevalent and more disabling than enacted stigma
Public stigma
-the reaction that the general population has to people with mental illness
Self-stigma
-the prejudice which people with mental illness hold against themselves; this internalised stigma develops from the prolonged societal response
Courtesy stigma
-refers to the stigmatisation an unaffected person experiences due to his or her relationship with a person who bears a stigma e.g parents of children with psychiatric conditions
Hayward and Bright
- 4 recurring themes of beliefs behind the stigma against mental illness
1. dangerousness
2. attribution of responsibility
3. poor prognosis
4. disruption of social interaction - 60% thought that addicts only have themselves to blame
Jorm et al
- professionals think antidepressants etc are more helpful than the public do
- publlic think that self help and vitamins are more favourable
- health practicioners and public have very different views re. mental health
Hagighat Unifying theory of stigma
stigma serves the self interest of the stigmatisers
- constitutional orgins: quick and easy stereotypes at the expense of sophistication and depth
- psychological origins: people use the example of ‘unfortunate other’ to feel better about themselves
- economic origins: to increase one’s access to resources by stigmatising others
- evolutionary origins: stigmatisation may have an evolutionary advantage
Evolution of stigma- Link and Phelan
- Labelling- people distinguish and label human differences
- Stereotyping: dominant cultural beliefs are used to group and categorise labelled persons into undesirable characteristics
- Separation: labelled persons are placed in distinct categories with an observable degree of separation of us’ from ‘them’
- Status loss and discrimination follow
Corrigan components of stigma
- stereotypes e.g schizophrenics are violent
- prejudice- endorse negative stereotypes
- social discrimination-result in behavioural reaction
Dimensions of stigma
Jones et al
- concealability- less concelable problems are more stigmatised
- course- whether stigmatizing condition is revversible over time. Irreversible conditions tend to elivit more negative remarks
- disruptiveness- the extent to which a mark strains or obstructs interpersonal interactions
- aesthetics- disorder that elicits a reaction of disgust will be more stigmatised
- origin: self inflicted conditions are more stigmatised
- peril- threatening problems are stigmatised
3 types of anti-stigma interventions
Rights based- legal methods
Normalising approach- popularising how common mental illnesses are
Educational media-based approach- highlighting the role of balanced reporting by media
Legislative intervention
- reduces discriminatory acts but not prejudice or stereotypes
- does not suppress or eliminate stigma
Affective intervention
increasing contacts between local neighbourhood and mentally ill patients living in a hostel
Public education
-can help with response around stigma but no improvement in behaviour
Brain disease model
- Liz Sayce
- model for addressing stigma
- ‘it’s an illness like any other’, but may lack credibility and be seen as paternalistic
Individual growth model
- Liz Sayce
- model for addressing stigma
- considers a continuum or spectrum of mental health
- mental health is related to experiences
- may encourage status quo rather than attitude shifts
LIbertarian model
- Liz Sayce
- model for addressing stigma
- advocates equal rights and equal criminal responsibility for mental health service users.
- concerning as mentally ill people may stand to lose more rather than gain more
Disability inclusion model
- Liz Sayce
- model for addressing stigma
- favoured approach, which promotes the concept of social inclusion in civil rights grounds and not just paternalistic ‘help’
Changing minds
- 5 year campaign
- Kendell and co at RCPsych
- 1 in 4= short film
- ‘Every family in the land’- book on stigma
Normalization
- concept that emerged in the context of deinstitutionalisation of people with developmental disabilities
- tries to provide people with culturally normative means to maintain personal behaviours and characteristics that are culturally normative
Social role valorisation
- Wolfensberger
- SRV aims to create social roles for devalued people to enhance their competencies
