Stigma in Consultation Liaison Psychiatry: A Qualitative Study of Trainee Psychiatrists

Abstract

Objective Stigma related to mental illness can impact service-user care and clinician wellbeing. The aim of this study was to explore experiences of stigma in consultation-liaison psychiatry from the perspectives of trainee psychiatrists and suggest interventions to tackle stigma within a hospital environment. Method Ethics approval and consent were obtained for the study. In-depth interviews were conducted by telephone with six participants in four New Zealand district health boards. De-identified data was analysed using thematic analysis. An independent co-coder was employed to enhance analytic rigour. Results Participants experienced stigma during their consultation-liaison rotations. Some felt isolated and undervalued. Education, intergration and role clarification within the hospital environment were identified as ways to reduce stigma. Conclusions Stigma experienced by trainee psychiatrists completing consultation-liaison rotations may lead to them feeling devalued and perceiving service-users to experience poorer care. Multidisciplinary education may potentially combat stigma and contribute to improved integration of services.

Psychiatrists’ occupational stigma conceptualization, measurement, and intervention: A literature review

“…That public stigma can reduce patient compliance and help-seeking behavior, thereby impeding treatment[ 32 , 35 ]. For another, psychiatrists’ self-stigma may result in an increase in defensive medical behavior[ 36 ], such as little communication with patients, unnecessary testing, excessive medication, refusal, or referral[ 37 - 39 ], leading to not only health-care costs rise and poor medical relationship but also the potential negative impact on patient health and treatment effect[ 40 ].…”