Stigma and higher rates of psychiatric re-hospitalization: São Paulo public mental health system

Abstract

Family's stigma towards mental illness might contribute to the increase in readmission rates of their relatives with psychiatric disorders. More studies should be conducted to depict mechanisms by which stigma increases re-hospitalization rates.

Discharged from a mental health admission ward: is it safe to go home? A review on the negative outcomes of psychiatric hospitalization

“…Recent studies observed that early readmission rates, usually defined as occurring within 90 days of discharge, can be as high as 13% 11. Several factors were associated with readmission, but number of previous admissions seemed to be one of the most important predictors of readmission 7. This would fit with the theory of “revolving-door” patients 12.…”

“…A Brazilian study, conducted in São Paulo, the most populous metropolis of the country, also assessed rehospitalization rates among patients with psychotic and bipolar disorders. After 1 year of follow-up, the readmission rate of the sample was 43% 7. In the US 150 patients discharged from a psychiatric ward were also followed up for 1 year.…”

“…For example, Loch7 studied 169 patients with bipolar or psychotic disorder after their discharge from an acute psychiatric facility in Brazil. One-year rehospitalization rate was as high as 43%.…”

“…It has already been observed that former inpatients are at special risk for discrimination 27. Furthermore, stigma has already been implicated in higher rates of rehospitalization,7 along with patients’ failure to seek adequate treatment,53 low self-esteem,54 and lack of social adaptation 55. Consequently, fighting against society’s stigma toward mental illness is central in reducing negative outcomes after discharge.…”

Atitudes dos trabalhadores de saúde mental em relação aos pacientes psiquiátricos em uma cidade do interior do Estado do Rio de Janeiro

“…No Brasil, há poucos estudos que avaliam as atitudes de profissionais de saúde mental com relação aos indivíduos com transtornos mentais. Loch 12 pesquisaram as atitudes dos psiquiatras para com esquizofrênicos no Congresso Brasileiro de Psiquiatria (2009) em São Paulo. Para tanto, utilizaram um questionário que avaliava estereótipos negativos, opinião sobre psicotrópicos e tolerância aos efeitos colaterais.…”