Experience of stigma in the public life of relatives of people diagnosed with schizophrenia in the Republic of Belarus

Abstract

With respect to the public domain of life, substantial stigma and discrimination perceived by families of people living with schizophrenia in Belarus is associated with structural issues of the country's mental health care system. To reduce the stigma-related burden, action must be taken to: (1) educate and support families and (2) deal with structural issues, by reorganising mental health services to better meet the needs of the families of people diagnosed with schizophrenia, and by including them in decision making at all levels.

Experience of stigma among family members of people with severe mental illness: A qualitative systematic review

“…The majority of the studies (researches from USA, Germany, Canada, Spain, Italy, Iran, Dutch, Belarus, and Czech Republic) in this review showed that in addition to the inadequacy of mental health care, participants reported experiencing negative attitudes or discriminatory responses in their contacts with mental health professionals (Angermeyer et al ; Atine ; Buizza et al ; Gonzalez‐Torres et al ; Krupchanka et al, ; Krupchanka et al, ; Krupchanka et al ; O'Grady ; van der Sanden et al ; Shamsaei et al ), and one study from Israel even made this the main topic of its research (Amsalem et al ).…”

“…Several studies (researches from USA, Germany, Italy, Belarus, India, and Czech Republic) discussed structural discrimination due to a perceived inadequacy of medical support, information (regarding illness, treatment, and service), and the lack of legislation applicable to people with mental illness and their family members (Angermeyer et al ; Atine ; Buizza et al ; Koschorke et al, ; Krupchanka et al, ; Krupchanka et al, ; Krupchanka et al ; Muhlbauer ).…”

“…Family members perceived the poor quality of mental health care (including the lack of mental healthcare facilities, insufficient crisis support facilities, inadequate long‐term care programmes, and the lack of self‐help groups for families in communities) as the strongest form of structural discrimination (Angermeyer et al ; Atine ; Buizza et al ; Krupchanka et al, ; Krupchanka et al ). Participants complained that public mental health services were not well equipped to provide adequate care, and compulsory hospitalization was perceived as the worst service because of its highly stigmatizing effects (Buizza et al ; Krupchanka et al ). At the same time, relatives believed that involuntary commitment was often an unavoidable last resort as there is usually no intervention until the illness becomes aggravated to a dangerous point (Buizza et al ).

I don’t want to hospitalize her, but what else can I do – it is the only option.

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“…An additional form of structural discrimination mentioned was the lack of legislation and institutional policies protecting the rights of people with mental illness and their relatives. Family members stated that mental illness was hardly considered by the political and legislative world, which did not take into account the daily problems faced by the families of patients with mental illness, such as the financial burden on the family and the employment problems faced by their mentally ill relatives; additionally, they felt alone in managing patients and reported experiences of legal discrimination (Angermeyer et al ; Gonzalez‐Torres et al ; Krupchanka et al, ; Krupchanka et al ; Muhlbauer ). Participants reported limitations or denials of mental healthcare insurance for their relatives experiencing severe and persistent mental illnesses (Angermeyer et al ; Krupchanka et al, ; Muhlbauer ).…”

“…Participants reported limitations or denials of mental healthcare insurance for their relatives experiencing severe and persistent mental illnesses (Angermeyer et al ; Krupchanka et al, ; Muhlbauer ). Respondents also mentioned discrimination related to work and hiring possibilities and a lack of assistance with employment for patients (Gonzalez‐Torres et al ; Krupchanka et al, ; Krupchanka et al ).

Parents and patients have to bear most of the expenses themselves’, ‘For the health insurance, the situation of patients and their relatives has to get worse and worse, otherwise they don’t pay. (Angermeyer et al .

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