PY1507.2 ~ {Stigma}
defining stigma history
a mark of disgrace associated with a particular circumstance, quality, or person. Erving Goffman (1963) attributes which are “deeply discrediting” to the individual.
process of stigma
Link & Phelan (2001)
labelling difference or categorising + stereotyping + separation of ‘them’ and ‘us’ + status loss and discrimination
[this typically occurs in situations where power is exercised]
components of stigma [C&W]
Corrigan and Watson, 2002
Public + self stigma
Stereotypes
Prejudice
Discrimination
stigma
Negative attitudes or discrimination towards an individual based on distinguishing characteristics. [ related to culture, race, age, gender or health]
public vs self stigma
P - involves the negative or discriminatory attitudes that others have about mental illness
S - refers to the negative attitudes, including internalized shame, that people with mental illness have about their own condition
components of stigma [T, R, K & S]
Thornicroft, Rose, Kassam, & Sartorius, 2007
Knowledge (ignorance)
Attitudes (prejudice)
Behaviour (discrimination)
stereotypes [C&W]
especially efficient, social knowledge structures that are learned by most members of a social group
efficency + social
E - quickly generate impressions/expectations of stereotyped individuals
S- collectively agreed upon ideas of groups or communities
can lead to inaccurate knowledge about a particular group or community
prejudice + attitudes
Thornicroft et al (2007)
not just negative thoughts, also emotions - anxiety, anger, resentment, hostility, distaste, disgust, may predict discrimination more than stereotypes
much stigma research just focuses on prejudice
discrimination
unfair treatment of people and groups based on characteristics such as race, gender, age or sexual orientation
treatment
T et al. (2007)
research often focuses on ‘imaginary scenarios’ like "what would you do if a friend said they had a mental illness?"
emphasises what non-mentally ill people think they would do without exploring lived experiences of mentally ill individuals
assumes responses are congruent with actual behaviour
the media + news
might not actually cause the stereotypes + stigma but they definetely perpetuate it
in films mental illnesses are sensationalised + linked with violence
newspaper depictions of mental + physical health [C et al. '02]
analysed the content of the news over a 6 week period in 2002 and found rhat the largest percentage of stories [almost 40%] of newspaper stories focused on topics relating to mental illness being dangerous, things like violent crime + drug & alcohol abuse
newpaper depictions of mental and physical health [2017]
Chen + Lawrie
‘Mental health in print media remains tainted by themes of violence, however some improvement in reporting in recent years is evident, in particular by providing a voice for people with mental illness.’
which groups experience stigma
Any characteristic, visible or otherwise, which marks a person as different from others around them can end up being a stigmatised characteristic [there are different contexts to which society chooses to stigmatise]
"blue eyes - brown eyes" experiment
by Jane Elliot: a social experiment which illustrates how easily stigmatising attitudes develop. she developed experiment in response to the assassination of Martin Luther King Jr. in 1968 to try to get her white students to understand what discrimination might feel like
3 levels of the impact of stigma
individual
family + friends
organisations
individual impact
self esteem
suicide + health
employment
relationships
willingness to seek help
isolation
family + friends impact
loss of status
feelings of shame
isolation + feeling alone
loss of support
organisations impact
policies, procedures, or culture less friendly towards individuals with mental illnesses
lack of funding for mental health organisations
impact on physical health + mortality
in Hong Kong, individuals with schizophrenia die 8-9 years earlier than those in the general population (Yung et al., 2020)
in America, individuals with severe mental illnesses die between 14 to 32 years earlier than the general population (Colton and Mandersheid, 2006)
how can we address stigma
Protest, education and contact (Corrigan et al. 2001)
how to do an intervention
1. find out what we already know
2. go to the source
3. design + pilot [test] your intervention
4. conduct your intervention
5. analyse your results [evaluation]
step 1 [intervention]
find out what we already know
identifying a problem or loop hole that needs to be adressed or solved
step 2 [intervention]
go to the source [this can be done through interviews or surveys; its just a way to obtain raw data about the problem
step 3 [intervention]
design + pilot [test] your intervention
comparison of 2 intervention types + forming a hypothesis
step 4 [intervention]
conduct your intervention
using RCT [participants are assigned to 2 or more groups to test an intervention
step 5 [intervention]
anaylse your results
check your hypothesis + acceptability of those being tested + feasibility [practicality] + analysis
step 1 [cs]
we need to adress stigma in children + adolescents
we need to make sure they feel comfortable help seeking
stigma starts early and is particularly bad in adolescents (Corrigan & Watson, (2007); Flavell, Miller, & Miller, (2001))
[may prevent help-seeking]
mental illness usually starts in childhood and adolescents (Kessler et al., 2007)
step 2 [cs]
one to one interviews with questions like: when you were younger, were your impressions of mental illness mainly positive or negative?
step 2 [cs] 2016
Chisholm et al. (2016) ~ 46 young people age 11-18, thematic analysis, dual perception of mental illness
stereotypes and extreme examples
insight via personal experiences
step 3 [cs]
go to secondary schools
hypothesis': contact is more complicated to organise than education (especially if you use in person contact)
contact has mainly been shown to work in adult populations, not in children or adolescents where there is less evidence
step 4 [cs]
RCT - one topic day per school[wide variety of schools] - NHS staff + young people with experience of mental illness teach pupils
step 5 [cs]: hypothesis
Participants who receive education combined with contact will report more positive attitudes to mental health, increased mental health knowledge and literacy, and improved well-being outcomes at two weeks following the intervention compared to participants who receive the educational component of the intervention alone
step 5 [cs]: acceptability
do the participants like the intervention
did they find it useful
step 5 [cs]: feasibility
how practical was the intervention
was it possible to adapt to different schools
did it work well in diffrent types of school
step 5 [cs]: analysis
we collected measures on stigma, mental health literacy, emotional well-being, resilience, and help seeking attitudes two weeks before and two weeks after the intervention, and conducted focus groups
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