People with a diagnosis of borderline personality disorder are relatively high users of inpatient and community services. There is concern, however, that mental health nurses feel negative about working with this group of people, are often socially distancing and feel under-skilled. The purpose of this research was to explore the experiences of good practice among mental health professionals working in a service that provided specialist treatment for this group of service users. The research was undertaken through semi-structured interviews and identified four key themes: shared decision making, social roles, peer support and open communication. These themes are discussed in the context of research in this field, the need for recovery-focused services, and through drawing on the Winnicotian notions of disillusionment and mirroring as key developmental processes.
The provision of better care for this client group will rely on appropriate training for nurses. This research highlights the need for training that supports the development of engagement skills, communication skills and an ability to use reflection in action as a means of providing therapeutic care. It also highlights the different emphasis on the use of these skills by forensic and non-forensic nurses.
Aims: Media representations of mental health problems may influence readers’ understanding of, and attitude towards, people who have received psychiatric diagnoses. Negative beliefs and attitudes may then lead to discriminatory behaviour, which is understood as stigma. This study explored the language used in popular national newspapers when writing about schizophrenia and considered how this may have contributed to the processes of stigmatisation towards people with this diagnosis. Methods: Using corpus linguistic methods, a sample of newspaper articles over a 24-month period that mentioned the word ‘schizophrenia’ was compared with a similar sample of articles about diabetes. This enabled a theory-driven exploration of linguistic characteristics to explore stigmatising messages, while supported by statistical tests (log-likelihood) to compare the data sets and identify words with a high relative frequency. Results: Analysis of the ‘schizophrenia’ data set identified that overtly stigmatising language (e.g. ‘schizo’) was relatively infrequent, but that there was frequent use of linguistic signatures of violence. Articles frequently used graphic language referring to acts of violence, descriptions of violent acts, implements used in violence, identity labels and exemplars of well-known individuals who had committed violent acts. The word ‘schizophrenic’ was used with a high frequency ( n = 108) and most commonly to name individuals who had committed acts of violence. Discussion: The study suggests that while the press has largely avoided the use of words that press guidance has steered them away from (e.g. ‘schizo’ and ‘psycho’), they still use a range of graphic language to present people with a diagnosis of schizophrenia as frighteningly ‘other’ and as prone to violence. This repetition of negative stereotypical messages may well contribute to the processes of stigmatisation many people who experience psychosis have to contend with.
This article reviews research findings into the portrayal of mental health disorders in print media, with particular attention to research that uses content analysis. The findings indicate that there is diversity in the representations of mental health disorders, and that in the UK the proportion of ‘good news’ stories increased between 1992 and 2008. However, there remains an over-association of mental health disorders with dangerousness, and this is emphasised through the use of sensationalistic language and highlighting violence in newspaper headlines. These results are explored as part of the process of stigmatisation and the impact that it has on the knowledge, attitudes and behaviours of the general public; and on the lives of service users.
There is evidence that people with personality disorder are stigmatized within healthcare settings; however, little is known about the role that the media has played in the wider processes of stigmatization. This research examines the degree to which the popular press in the UK have established a link between personality disorder and homicide, and the impact this may have had on the processes of stigmatization. Using a content analysis approach, it was identified that there were 552 articles in the popular press, between 2001 and 2012, that made reference to personality disorder and 42% of those articles established a link with homicide. Comparison between two time periods, 2001-2006 and 2007-2012, identified that there was a significant reduction in the proportion of homicide articles (Pearson χ (5, n = 552) = 5.64, P > .05), however, the effect size of this change was only small. These findings suggest that the press may have contributed to the processes of stigmatization, and may have encouraged the general public to hold prejudicial attitudes towards people with a diagnosis of personality disorder.
Accessible Summary What is known on the subject? People with a diagnosis of personality disorder often experience stigma both outside of, and within, mental health services. The media contribute to people's understanding of mental health issues, and negative portrayals appear to lead to increased negative attitudes in readers. Relatively little is known about how the press represent personality disorder, and the types of messages that people with this disorder may be receiving, which may impact on their understanding of themselves and emotional well‐being. What the paper adds to existing knowledge? The key findings indicate that in a 10‐year period, the representation of personality disorder in the popular tabloid press in the UK was characterized by the frequent use of language of violence. The research approach enabled the study to identify significant patterns in the language used, rather than only using a checklist of words that the press are directed to avoid. This adds to our understanding about the images repeatedly presented that may affect how readers treat people with a diagnosis of personality disorder and affect the self‐esteem of those with the diagnosis. What are the implications for practice? Mental health nurses are well placed to address issues of stigma both in terms of the general public's beliefs and the impact it has on those who use mental health services. A greater understanding of the messages in the press can help nurses to support service users who are vulnerable to believing that their lives will start to reflect the negative messages they have read. Abstract IntroductionMany people with a diagnosis of personality disorder experience stigma, and the press’ representations may contribute to those processes. To date, little is known about how the press write about people with personality disorder and analysis of language used is often limited to checklists of words to avoid.AimThe aim of the study was to explore the linguistic characteristics of press articles about personality disorder in popular tabloids in the UK and consider the implications for stigmatization.MethodCorpus linguistics was used to examine a 50% sample of all articles published by the popular press in the UK, from 2008 to 2017, that referred to personality disorder (n = 260).ResultsThe findings identified a range of words that constructed narratives of violence.DiscussionThe method enabled the findings to expand the current level of knowledge in the field, identifying patterns in the use of the language of violence, which may contribute to the processes of self‐stigma.Implications for practiceGreater understanding of the messages in the press can sensitize nurses to common misconceptions about the disorder, how these may have become internalised and the need for psycho‐social interventions to address the impact of self‐stigma on self‐esteem.
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