Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study

Abstract

BackgroundThe unfair treatment of individuals with severe mental illness has been linked to poorer physical and mental health outcomes. Additionally, anticipation of discrimination may lead some individuals to avoid participation in particular life areas, leading to greater isolation and social marginalisation. This study aimed to establish the levels and clinical and socio-demographic associations of anticipated and experienced discrimination amongst those diagnosed with a schizophrenia and comparator severe mental illnesses (bipolar and major depressive disorders).MethodsThis study was a cross-sectional analysis of anticipated and experienced discrimination from 202 individuals in South London (47% with schizophrenia, 32% with depression and 20% with bipolar disorder).Results93% of the sample anticipated discrimination and 87% of participants had experienced discrimination in at least one area of life in the previous year. There was a significant association between the anticipation and the experience of discrimination. Higher levels of experienced discrimination were reported by those of a mixed ethnicity, and those with higher levels of education. Women anticipated more discrimination than men. Neither diagnosis nor levels of functioning were associated with the extent of discrimination. Clinical symptoms of anxiety, depression and suspiciousness were associated with more experienced and anticipated discrimination respectively.ConclusionsThe unfair treatment of individuals with severe mental illnesses remains unacceptably common. Population level interventions are needed to reduce levels of discrimination and to safeguard individuals. Interventions are also required to assist those with severe mental illness to reduce internalised stigma and social avoidance.

Perceived ethnic discrimination and persecutory paranoia in individuals at ultra-high risk for psychosis

“…Perceived ethnic discrimination and paranoid ideation in VR were correlated across the entire sample. The higher rates of exposure to perceived ethnic discrimination in the UHR group are broadly consistent with studies reporting increased prevalence rates of discriminatory experiences in people with psychosis (Corker et al, 2014;Farrelly et al, 2014;Morgan and Fisher, 2007;Saleem et al, 2014;Veling, 2013;Veling et al, 2008), as well as studies showing associations between adversity and psychotic symptoms or disorder in general population samples (Bebbington et al, 2004;Janssen et al, 2004;Spauwen et al, 2006;Whitfield et al, 2005;Wicks et al, 2005).…”

Stigma- and non-stigma-related treatment barriers to mental healthcare reported by service users and caregivers

“…Women are more likely to seek formal mental healthcare than men (Bhui et al, 2014;Fridgen et al, 2013), possibly due to more positive attitudes concerning increased openness to experience (Judd et al, 2008;Mackenzie et al, 2006). However, research also suggests that women anticipate mental health discrimination more than men (for example, see Farrelly et al, 2014). These data suggest a need for future studies to distinguish whether women are more likely to report, or to experience, stigma-related treatment barriers than men.…”

“…This study was undertaken within the wider MIRIAD (Mental Illness-Related Investigations on Discrimination) study (Farrelly et al, 2014). MIRIAD was a large cross-sectional study of 202 individuals using secondary mental health services and 80 caregivers in south London which aimed to increase understanding about the nature and effects of discrimination because of mental health problems.…”

Mental Health–Related Discrimination as a Predictor of Low Engagement With Mental Health Services

“…This research is part of the Mental Illness-Related Investigations on Discrimination (MIRIAD) study, a cross-sectional survey of individuals using secondary mental health services in an inner-city location in England (11). The MIRIAD study had primary aims to investigate anticipated and experienced discrimination based on mental illness (11); multiple discrimination (12); and the impact of discrimination and stigma on economic costs (13), suicidality, hospital admission (14), barriers to care, and service engagement.…”