Schizophrenia Stigma: Challenges and Solutions

Introduction

Numerous individuals with genuine psychological diseases are facing one problem over the other due to the associated stigmas with the disease. On one hand, they battle with the clinical manifestations of the disorders and on the other side they also suffer from the misapprehensions of the common people about psychological sickness specifically schizophrenia which is a serious mental health disorder. In the present assignment it will be discussed that how patients of schizophrenia are often devoid of all the opportunities that characterize a quality life and about the major strategies to encounter the stigmatizing attitudes against for instance the innovation models and policies initiated by the government of the UK. The varied forms of stigma associated with the mental health problems and the Goffman's hypothesis are also discussed in brief.

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Key Theory/Concepts

According to Goffman's hypothesis for social stigma, a disgrace is a characteristic which is socially undermining: it makes an individual be classified based on mental issues by others in an inappropriate way as opposed to in an acknowledged, typical one. Anticipated and enacted disgrace reflects shame coordinated at the self from the perspectives of others, on the other hand internalized stigma reflects shame coordinated at the self from self source only (Abdullah, et al, 2011). In case of internalized stigma an individual with dysfunctional behaviour subjectively or sincerely assimilates negative messages or generalizations about psychological instability and comes to trust them and apply them to him/herself. Moreover, the discredited are those people who have a stigma that is transcendently noticeable, for example, sex, race or ethnicity and physical incapacity whereas, the discreditable are those people who suffers from a stigma that is prevalently concealable, for example, psychological sickness (Muñoz, et al, 2011; Abdullah, et al, 2011).

Stigma related to mental health and mental health inequalities

The concept of “public stigma” is the response that the common individuals have towards individuals with psychological disorders. On the other hand the perception of self-stigma is the feeling which individuals with psychological issues applies and torments themselves. Therefore, both the concept might be comprehended on the basis of three parts: prejudice, stereotypes, and segregation. The application of prejudice prompts separation, because of the social response of hostile behaviour by the individuals suffering with mental health issues (Harrison, and Gill, 2010). Partiality that yields outrage can prompt unfriendly behaviour. For the patient with psychological problems, the furious behaviour may prompt supplanting of human services with administrations form the criminal equity framework. Therefore, the concept of dread prompts aversion; for example the organisations do not want people with psychological instability close by so they do not recruit them within their sector. Alternatively, when any prejudice works within themselves of the patients eventually results in self-separation. Several researchers have demonstrated that self-disgrace and dread of dismissal by others lead numerous people to not seek any opportunities of life for themselves (Henderson, 2013). Moreover, in the most progressed form of associated stigmas it prompts prohibition of the individual from a few circles of social working and it causes sentiments of blame, disgrace, inadequacy, and a desire for disguise. However, the lack of enthusiasm for the individual's background history and the demand of avoidance of family members from treatment arrangements of the organisations have likewise been referenced as experts' perspectives of stigmatization toward individuals suffering from psychological disorders (Henderson, 2013). It has additionally been stated that professional experts of mental health problems also often hold a similar open criticizing perspectives toward psychologically sick people just as exceptionally sceptical perspectives on their odds of recuperation (Harrison, and Gill, 2010).

Stigma associated with Schizophrenia patients

A study conducted by authors Singh, et al, 2016 highlighted about the varied forms of stigma associated with patients of mental health condition schizophrenia namely the stigma associated social participation, internalized stigma and perceived forms of stigma and also about their relationship with the medical and demographic parameters. For this study randomly selected 100 patients of schizophrenia who were in the phase of remission were screened and analyzed using the internalized stigma of mental illness scale (ISMIS), participation scale (P-scale), positive and negative syndrome scale, explanatory model interview catalog stigma scale, global assessment of functioning scale and the scale to evaluate the ignorance of mental disorders and the scale to assess the information about mental problems. The findings highlighted that 85 of the patients was facing hostility whereas 45 patients of them demonstrated resistance to stigma. Support to stereotypes was observed among 26 patients, 21 patients faced discrimination and 16 of them revealed withdrawal from society. Nearly 29 patients of total sample were suffering from internalised stigma and 67 patients faced major restriction measured on P-scale. When the correlation between the sociodemographic and stigma were investigated no such significant measures were observed apart from those individuals who were involved in salaried occupations. For the clinical variables, the functioning level was the persistent stigma factor and higher education about the disease was correlated with reduced stigma (Singh, et al, 2016).

Service improvement in the UK

The media interventions were considered to be the key role utilized by the government of the United Kingdom to encounter the stigma associated with mental health disorders namely the Time To Change anti-stigma program. The objective of the programme was to bring a positive attitude at least of 5% among the people towards psychological disorders along with a decrease of 5% in the attitude of discrimination among people for a total period of five years (Stuart, 2016). The programme was financed by the Comic Relief and Big Lottery Fund with 18 million pounds. The study conducted by authors Gaske et al 2012 highlighted about three interventions adopted as a model to access care service for instance: 1) engagement at the community level; 2) monitoring the quality of the correspondence that happens at the community centres and 3) the formulation and execution of the customary mental health interventions. In this regard the population based model developed by Katon and their fellow members aimed to improve the quality of life of patients by augmenting the utilization to antidepressants. The government of the UK had developed two priority policies in this regard to provide better access such as 1) enhanced payment was provided to the GPs for screening the patients of psychological disorders for prolonged period using mechanical tool; 2) the innovation of ‘Improving Access to Psychological Therapies’ strategy to augment the recruitment of psychological therapist so that patients can access the model of ‘pathways to care’. The agencies like NICE are trying to develop innovative models to give patient focused consideration but a lot research is still required in this field (Gaske, et al, 2012; Corbiere, et al, 2012).

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Conclusion

The patients with schizophrenia suffer from the varied types of stigma associated with mental health problems which significantly affects their quality of life. The present study had briefly highlighted the impact of stigma in their life and also about the interventions taken by the government of the UK to encounter this problem such as the Time To Change anti-stigma program, innovation of population based model, screening the patients of mental disorders such as schizophrenia with tool by the GPs and the innovation of ‘Improving Access to Psychological Therapies’ strategies. Till today most of the research studies conducted lacks a systemic approach or model to address the issues and the existing interventions and policies have very limited access to the care services. The innovation of multi faceted models demands huge cost which also becomes a crucial factor so further research is demanded in this field.

Reference

Gask, L., Bower, P., Lamb, J., Burroughs, H., Chew-Graham, C., Edwards, S., Hibbert, D., Kovandžić, M., Lovell, K., Rogers, A. and Waheed, W., 2012. Improving access to psychosocial interventions for common mental health problems in the United Kingdom: narrative review and development of a conceptual model for complex interventions. BMC health services research, 12(1), p.249.

Singh, A., Mattoo, S.K. and Grover, S., 2016. Stigma and its correlates in patients with schizophrenia attending a general hospital psychiatric unit. Indian journal of psychiatry, 58(3), p.291.

Stuart, H., 2016. Reducing the stigma of mental illness. Global Mental Health, 3.

Corbiere, M., Samson, E., Villotti, P. and Pelletier, J.F., 2012. Strategies to fight stigma toward people with mental disorders: perspectives from different stakeholders. The Scientific World Journal, 2012.

Harrison, J. and Gill, A., 2010. The experience and consequences of people with mental health problems, the impact of stigma upon people with schizophrenia: a way forward. Journal of Psychiatric and Mental Health Nursing, 17(3), pp.242-250.

Henderson, C., Evans-Lacko, S. and Thornicroft, G., 2013. Mental illness stigma, help seeking, and public health programs. American journal of public health, 103(5), pp.777-780.

Muñoz, M., Sanz, M., Pérez-Santos, E. and de los Ángeles Quiroga, M., 2011. Proposal of a socio–cognitive–behavioral structural equation model of internalized stigma in people with severe and persistent mental illness. Psychiatry Research, 186(2-3), pp.402-408.

Abdullah, T. and Brown, T.L., 2011. Mental illness stigma and ethnocultural beliefs, values, and norms: An integrative review. Clinical psychology review, 31(6), pp.934-948.


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