STIGMA

What is stigma?

‘a mark of difference’

• differences that are socially constructed based on shared assumptions

What are different kinds of interpersonal stigma?

• felt stigma

• self stigma

• stigma by association

• resistance

When a person is aware of boarder labels but doesn’t apply these personally, though they remain aware of the impact this label on how they are viewed by others

Felt sigma

Internalisation of broader negative stereotypes and application of these to yourself/ own identity

Self stigma - process of awareness, agreement and negative self perception

When a family or significant others are impacted by being associated with a person who carries a stigmatised attribute

Stigma by association

What is resistance?

An awareness of perceived stigmatised attribute BUT actively rejects the stereotype associated with the label

What are some of the social impacts of stigma on individuals?

• self stigmatisation

• suicidality

• self isolation

• poorer vocational outcomes of those living with SMI

What are some of the health impacts of stigma on patients?

• poorer treatment adherence

• poorer help seeking behaviour

Which groups are more likely to avoid HS behaviour due to stigma?

• young adults

• males

• military background

• HC professionals

• ethnic minorities

What is the process of stigmatisation (link & phelan 2001)

Labelling > stereotyping > othering > stigmatisation > descrimination

According to Goffman, why does mental illness result in a ‘spoiled identity’ ?

Mental illness is viewed as a discreditable characteristic

What causes characteristics to become discreditable?

Wholly dependant on social interactions

• social groups decide what characteristics become stigmatised ad how people are treated as a result - leading to experiences of shame and exclusion

According to link and phelan, what is stigmatisation entirely reliant on?

• Access to social, economic and political power that allows for the identification of differences

• Then construction of stereotypes, separation of labelled persons into district categories

• This all leads to disapproval, rejection, exclusion and discrimination

What are the 3 different levels of stigma?

• individual

• public

• structural

What can cause variations in public stigma and attitudes?

• by diagnosis - some are more accepted than others

• change over time'

• explanations of illness

• attributable theory

• beliefs about help seeking

• intersectionality

How has the media representation of mental illness changes since the 1980s?

• shift from more structural to biomedical

• journalism focussed on violence has fallen over time

Give an example of the use of media to challenge stereotypes

Get the picture campaign

What was the 1000 bad apples campaign?

Placed outside Scotland yard to highlight the structural sexual violence culture and misogyny towards women and girls in the police force

Examples of structural stigma

• black people are 40% more likely to encounter/enter mental health services via police and criminal justice routes

• Also 4x more likely to be detained under the mental health act

What can HCPs do to challenge stigma?

• Acknowledge bias

• normalisation

• increase stigma literacy

• support families and carers

• challenge organisational practises