Discrimination against people with a mental health diagnosis: qualitative analysis of reported experiences

Hamilton, Sarah; Lewis-Holmes, Elanor; Pinfold, Vanessa; Henderson, Claire; Rose, Diana; Thornicroft, Graham

doi:10.3109/09638237.2014.880408

Cited by 40 publications

(34 citation statements)

References 19 publications

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“…Emotional closeness was important for recovery; much of this resource is provided by family or friends Stigma Families are impacted by public attitudes to mental illness: we found evidence of courtesy stigma 230 in networks. We also found families generate stigma 231 and their lack of understanding can amplify the difficulties people with SMI experience. We also learnt that people often developed effective coping strategies for dealing with 'challenging' family relationships, sometimes aided by practitioners…”

Section: Social Supportmentioning

confidence: 79%

Improving community health networks for people with severe mental illness: a case study investigation

Pinfold

Sweet

Porter³

et al. 2015

Health Services and Delivery Research

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IntroductionPolicy drivers in mental health to address personal recovery, stigma and poor physical health indicate that new service solutions are required. This study aimed to understand how connections to people, places and activities were utilised by individuals with severe mental illness (SMI) to benefit health and wellbeing.MethodsA five-module mixed-methods design was undertaken in two study sites. Data were collected from 150 network-mapping interviews and 41 in-depth follow-up interviews with people with SMI; in-depth interviews with 30 organisation stakeholders and 12 organisation leaders; and 44 telephone interviews with practitioners. We undertook a three-stage synthesis process including independent lived experience feedback, and a patient and public involvement team participated in tool design, data collection, analysis and write-up.ResultsThree personal network types were found in our study using the community health network approach: diverse and active; family and stable; formal and sparse. Controlled for other factors we found only four variables significantly associated with which network type a participant had: living alone or not; housing status; formal education; long-term sickness or disability. Diagnosis was not a factor. These variables are challenging to address but they do point to potential for network change. The qualitative interviews with people with SMI provided further understanding of connection-building and resource utilisation. We explored individual agency across each network type, and identified recognition of the importance and value of social support and active connection management alongside the risks of isolation, even for those most affected by mental illness. We identified tensions in personal networks, be that relationships with practitioners or families, dealing with the impact of stigma, or frustrations of not being in employment, which all impact on network resources and well-being. The value of connectedness within personal networks of people, place and activity for supporting recovery was evident in shaping identity, providing meaning to life and sense of belonging, gaining access to new resources, structuring routines and helping individuals ‘move on’ in their recovery journey.Health-care practitioners recognised that social factors were important in recovery but reported system-level barriers (workload, administrative bureaucracy, limited contact time with clients) in addressing these issues fully. Even practitioners working in third-sector services whose remit involved increasing clients’ social connection faced restrictions due to being evaluated by outcome criteria that limited holistic recovery-focused practices. Service providers were keen to promote recovery-focused approaches. We found contrasts between recovery ideology within mental health policy and recovery practice on the ground. In particular, the social aspects of supporting people with SMI are often underprioritised in the health-care system. In a demanding and changing context, strategic multiagency working was seen as crucial but we found few examples of embedded multisector organisation partnerships.ConclusionWhile our exploratory study has limitations, findings suggest potential for people with SMI to be supported to become more active managers of their personal networks to support well-being regardless of current network type. The health and social care system does not currently deliver multiagency integrated solutions to support SMI and social recovery.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Social Supportmentioning

confidence: 79%

Improving community health networks for people with severe mental illness: a case study investigation

Pinfold

Sweet

Porter³

et al. 2015

Health Services and Delivery Research

Self Cite

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“…These measures were chosen since a previous study found that the common factors effective in a therapeutic relationship (i.e., positive regard, empathy, unconditionality) differentiated peer providers from regular providers at the initial stage of the therapeutic relationship [2]. Given that the general public is known to harbor negative stereotypes of persons with mental illnesses [17][18][19][20][21] and might therefore be afraid to receive care from a person with mental illness while typically having faith in physicians, we predicted that those thought to be psychiatrists would be rated as more likeable, effective, and desirable for returning for care.…”

Section: Introductionmentioning

confidence: 99%

Does Stigma Towards Mental Illness Affect Initial Perceptions of Peer Providers?

2015

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Peers (i.e. people with lived experience of mental illness and/or addictions) are being hired in large numbers to offer support for people with serious mental illnesses, but little is known about how peer providers are viewed. The goal of this study was to measure reactions towards actors posed as peer providers. Half of study participants interacted with an actor portraying a psychiatrist and half interacted with an actor portraying a peer provider. Ratings such as liking, feeling comfortable, as well as time spent talking were measured. Participants did not report preferring actors in either condition and did not talk more or have less silence with actors in either condition. Participants also were equally willing to see actors portraying peer providers again in the future and recommend them to a family member. Among participants who had received mental health services, there was a trend towards viewing actors portraying peer providers as more friendly and effective. These positive initial perceptions suggest that stigma towards people with mental illness does not taint the initial perception of peer providers.

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“…Mental health difficulties affect approximately one third of children, covering emotional, neurodevelopmental and behavioural disorders (Merikangas et al, 2009) and many adults and children diagnosed experience discrimination and stigma (Hamilton et al, 2014). Differentiating developmental norms from mental health difficulties requires mental health services to provide an initial assessment.…”

Section: Introductionmentioning

confidence: 99%

The clinical use of Subjective Units of Distress scales (SUDs) in child mental health assessments: a thematic evaluation

Kiyimba

O’Reilly

2017

Journal of Mental Health

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Word count: 3582 (excluding abstract and references) Word count revised: 3969 (excluding abstract and references) Running head: Subjective Units of Distress in assessments Acknowledgments: The authors would like to thank the other members of the research team; Khalid Karim, Ian Hutchby and Victoria Stafford. They would also like to thank the clinical team and clinical managers for providing access to the service. Equally, they thank all of the participating families, children and other members for providing consent.

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Discrimination against people with a mental health diagnosis: qualitative analysis of reported experiences

Abstract: Discrimination should be understood as occurring within social relationships and influenced by expectations of contact within these relationships. A better understanding of these processes can help target more effective messages in anti-discrimination campaigns.

Cited by 40 publications

References 19 publications

Improving community health networks for people with severe mental illness: a case study investigation

Improving community health networks for people with severe mental illness: a case study investigation

Does Stigma Towards Mental Illness Affect Initial Perceptions of Peer Providers?

The clinical use of Subjective Units of Distress scales (SUDs) in child mental health assessments: a thematic evaluation

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