Reported stigma and discrimination by people with a diagnosis of schizophrenia

Abstract

Aims. This article examines the extent of stigma and discrimination as reported by people with a diagnosis of schizophrenia. The hypothesis is that when people express in their own words the discrimination they experience such discrimination will be found to be widespread.Methods. Seventy-five people with a diagnosis of schizophrenia from 15 different countries were interviewed with a mixed methods instrument to assess reported discrimination. The data were analysed for frequency counts and then a thematic analysis was performed. A conceptual map is provided.Results. The study was a cross-cultural one but, contrary to expectations, few transnational differences were found. The main hypothesis was supported. Conversely, we found that when participants reported 'positive discrimination', this could as easily be conceptualised as being treated similarly to how others in society would expect to be treated. Conclusion.Negative discrimination is ubiquitous and sometimes connotatively very strong, with reports of humiliation and abuse. 'Positive discrimination' conversely indicates that people with a mental illness diagnosis expect discrimination and are grateful when it does not occur. The literature on self-stigma is discussed and found wanting. Similarly, the theory that contact with mentally ill people reduces stigma and discrimination is not fully supported by our results.

Stigma and discrimination related to mental illness in low- and middle-income countries

“…Significant between-country variations were found for experienced discrimination, but not anticipated discrimination reported by people with schizophrenia (Thornicroft et al 2009). A report on the qualitative experiences of stigma and discrimination, however, found few transnational differences (Rose et al 2011). …”

Mistrust of mental health services: ethnicity, hospital admission and unfair treatment

“…Rather, 'unfair treatment' most often related to interactional issues such as not feeling listened to (Rose et al 2011).…”

Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking

“…Stigma and discrimination associated with mental illness are common (Angermeyer & Dietrich, 2006;Rose et al 2011;Schomerus et al 2012b;Lasalvia et al 2013) and can act as barriers to helpseeking and prevention in different ways (Corrigan & Rüsch, 2002;Phelan et al 2006;Schomerus & Angermeyer, 2008;Clement et al 2012;Lanfredi et al 2013). People with mental illness may avoid helpseeking due to fear of being discriminated against by others (public stigma) or because they agree with negative stereotypes and turn them against themselves (self-stigma) (Vogel et al 2006;Rüsch et al 2009a;Evans-Lacko et al 2012).…”