Stigma has been described as the most significant obstacle to quality of life for individuals with major psychiatric diagnoses (Sartorious, 1998). Much of the psychological literature on stigma focuses on individual attributes and interactions at the micro level, rather than macro level dynamics. In critiquing this traditional focus, Link and Phelan (2001) present a model in which stigma ensues when labeling, stereotyping, separation, status loss, and discrimination co-occur in a situation of power imbalance. Even as the model fills a gap in conceptualizing stigma, its emphasis on power is unidirectional and fails to account for power as a form of resistance to stigmatization. This study explores the question of how a consumer/survivor activist perspective can inform the Link and Phelan model of stigma. A semi-structured interview methodology was used to gather qualitative data on the perspectives of 10 activists who are both the targets of stigma and active change agents in resisting stigma. The content of the interviews was thematically analyzed based on an iterative coding approach in order to identify the points of overlap with and divergence from the Link and Phelan model. The results of the study support the applicability of the model for psychiatric stigma. The participants' experiences illustrate which aspects of stigmatization take precedence in this context, indicating significant points for intervention. The anti-stigma work discussed by the participants illustrates the power of grassroots resistance, expanding the understanding of power presented in the model. Emergent discursive themes include the importance of similarity, the rejection of negative portrayals of mental illness, and a focus on a shared continuum of human experience. Participants' emphasis on the ii importance of having their voices silenced was a particularly recurring motif. Several respondents challenge the premises of the Link and Phelan model. These participants emphasize the positive aspects of diagnosis and labeling, while several other participants reject the choice of the term stigma because it may obscure the structural aspects of discrimination. These findings can serve as a guideline for designing future interventions, and focusing on strategies for social change.
First and foremost, I would like to thank my major professor, Dr. Cathy Kling, for her valuable feedback, unconditional assistance, guidance, and generous financial support. I would like to thank Dr. Kling for providing me with a wonderful research environment at CARD. I am very grateful for being part of the CARD community and for participating in the weekly donut meetings. I also appreciate the ample opportunities she gave me to improve my communication skills by presenting my research in front of the Environmental Policy group and at conferences.
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