LAUREN FITZPATRICK // 12048880
After conducting my initial secondary research, I have decided to narrow my focus on the particular issue of mental health related stigma and discrimination. It frustrates me that people continue to disregard mental health compared to more physical illness and how this stigma is engrained in our culture. The first scholarly article I found that articulates and explains this issue further is by Barbara Hocking explaining the impact of stigma on the mentally ill, particularly those suffering with schizophrenia. The second article written by Jing Ye, Timothy F Chen, Diane Paul, Rebecca McCahon, Sumitra Shankar, Alan Rosen and Claire L O’Reilly explains stigma and discrimination more in-depth with scientific research and statistics.
The article from The Medical Journal of Australia, ’Reducing mental illness stigma and discrimination—everybody’s business’ was written by Barbara Hocking who was the Executive Director of the Australian mental health charity SANE from 1995-2012. Her dedicated work at SANE was driven by her passion to work towards a better life for people who are affected by mental health issues. Her efforts include educating communities about mental health and campaigning for improved services and attitudes. Her passion and professionalism is evident throughout this informative article about mental health stigma for people suffering with schizophrenia. Hocking explains this issue clearly and refers to other scholarly writer and professionals such as psychiatrist and university professor Norman Sartorious.
From this article, I learnt that stigma can be as distressing as the symptoms of mental illness themselves. Recovery isn’t simply just “pulling yourself together” (Hocking 2003). It leads to distress, loneliness and discrimination which ultimately leads to people feeling reluctant to seek help which can then result in fatal suicides. Hocking identifies that health professionals have a responsibility to respect their patients and need to improve their attitudes and behaviours. Norman Sartorious believes that medical professionals such as psychiatrists can add to the stigma through careless treatments and diagnostic labels. They can have a tendency to label patients as delusional and attention seeking. Sartorious states that:
“My own view is that overworked, under-resourced healthcare workers are at particular risk of stigmatising people with mental illness.”
There is now a need to improve knowledge and attitudes towards mental health which professionals have labelled “mental health literacy”. The media is in no way helping the current situation of stigma as they play such an essential role in any movement or change. People with schizophrenia for example are always depicted as violent and having split personalities which is inaccurate for many cases. Hocking ends with a sad realisation that for most people living with a mental illness “…living in the community does not mean being part of the community.” This is an issue that I have now become passionate about therefore I would like to find out more about what is being done about mental health stigma.
The article from the International Journal of Social Psychiatry, ’Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings.’ was written by many science and health professionals and corresponding author, Dr Claire L O’Reilly. Dr Claire O’Reilly is a Lecturer at the Faculty of Pharmacy, University of Sydney and is also a practising community pharmacist in Sydney. She is very experienced as a mental health researcher particularly in the experiences of consumers of stigma and discrimination. She was previously National Vice President of the Pharmaceutical Society of Australia (PSA) and has received numerous awards in her field. Along with her co-authors who work in other areas of mental health in Australia, they have written a cohesive report on stigma associated with mental health and the methods of measuring discrimination experienced by mentally ill people. This is a very reliable scholarly source with input from various experienced professionals and is supported with data and statistics.
In the article, they begin by defining stigma as a negative attitude based on prejudice and misinformation and discrimination is the behavioural manifestation of stigma. These two mindsets act as a barrier to receiving care and can result in the deterioration of mentally ill people. Studies have show that health professionals can be agents of stigma in terms of diagnostic overshadowing and under-treatment. This journal article investigates the experiences of stigma and discrimination from mental health consumers perspectives which previously has no data. The Discrimination and Stigma Scale (DISC) was developed to measure both anticipated and experience discrimination, used internationally in many studies showing persistently high levels of stigma. DISC is reliable and asks about personal experiences of discrimination in everyday aspect of life. In this particular study, there were 50 clients with the majority being male (79%), the median age being 52 and 40 patients had experienced negative discrimination. One statistic that shocked me was that one-fifth reported experiences of discrimination from healthcare professionals. Participant 18 (female; 62 years) speaks about her experiences with a healthcare professional:
“As soon as he (the doctor) sees that I’m schizoaffective they immediately start dumbing down to me, they really think that mental illness involves a lack of intelligence … He addressed all the questions to my case manager and I said ‘listen, I’m quite capable of telling you, she (the case manager) doesn’t know, she knows barely anything about it’, I was so insulted.”
This is the kind of stigma and discrimination present in society today from healthcare professionals that makes people suffering from mental illness even more reluctant to seek help which results in more preventable fatalities. It is great that research methods such as DISC are being implemented and explored to identify what the issues are and what can be done to fix them.
From this research, I have further narrowed my focus to stigma and discrimination imposed from healthcare professionals. It is somehow engrained into our nature to question, judge and disregard people who suffer from mental illness. This is something I would like to find more studies on and discover what is being done to rectify this situation, especially in regards to the conduct of healthcare professionals. I would also like to specifically focus on schizophrenia as I don’t have much knowledge on it and it will be interesting to learn more about it in the context of stigma and discrimination.
Hocking, B. 2003, ‘Reducing mental illness stigma and discrimination—everybody’s business’, The Medical Journal of Australia, 9, pp.S47-S48, viewed 3 August 2016, <https://www.mja.com.au/system/files/issues/178_09_050503/hoc10581_fm.pdf>
Ye, Jing, et al. 2016, ‘Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings.’, International Journal of Social Psychiatry, viewed 3 August 2016, <http://isp.sagepub.com.ezproxy.lib.uts.edu.au/content/early/2016/06/21/0020764016651459.full.pdf+html>
Emma, Z. 2016, Puppet Master, Zoe-Emma Illustrations, viewed 11 August 2016, <http://www.zoeemma.co/post/118523229989/title-puppet-master-zoe-emma-2015>