Stigma towards people with a diagnosis of severe mental disorder in primary healthcare centers: perspectives of service users and health teams in Chile

Abstract

Background: Stigma towards people diagnosed with a severe mental disorder (SMD) is one of the main obstacles for these service users to receive timely and relevant healthcare. This study was undertaken to understand how stigmatizing attitudes are demonstrated towards people with SMD in primary healthcare centers (PHC) from the perspective of those affected and primary healthcare professionals. Methods: We used a qualitative exploratory research design to contrast the differences and similarities regarding stigmatizing attitudes towards people with SMD in primary healthcare centers (PHC) from the perspective of two groups: (i) people diagnosed with a severe mental disorder, and (ii) healthcare professionals. Data was collected through semi-structured interviews and discussion groups and subsequently analyzed using Atlas.ti software. Results: Our results indicate that both service users and healthcare professionals manifest stereotypes, prejudices, and discriminatory behavior in health care. In addition, structural aspects of the health system and organizational culture appear to contribute to stigmatization. Both groups agreed that there is a need for healthcare professionals to have more education, specialization, and skill development related to mental health issues. Conclusions: Interventions to reduce the stigma towards people with SMD in PHC must consider delivery of information about mental disorders, development of skills in the healthcare professionals, and modifications in the culture of the health centers.

Psychometric properties of the attitudes scale of health care professionals’ toward people with a diagnosis of mental illness (EAPS-TM)

“…Moreover, it was found that secondary care health personnel present a lower level of stigma than do primary care personnel in both dimensions of the EAPS-TM scale. This result is consistent with the research that reports greater stigma in primary care (Mittal et al, 2014) and reinforces the research that shows that in Chile, there are negative attitudes toward mental health users by primary care health personnel (Vaccari et al, 2020;Vistorte et al, 2018). This may be because primary care personnel have less information and contact with people who receive a psychiatric diagnosis.…”

“…However, the exercising of health rights is limited by stigma. In addition, there is little but consistent information showing that health personnel in Chile stigmatize users (Vaccari et al, 2020;Vistorte et al, 2018). These reasons have led the Ministry of Health (MINSAL) to include stigma within the National Mental Health Plan 2017-2025 as a relevant program line (MINSAL, 2017).…”

Efficacy of an Intervention to Reduce Stigma Beliefs and Attitudes among Primary Care and Mental Health Professionals: Two Cluster Randomised-Controlled Trials

“…Therefore, interventions to reduce stigma towards people diagnosed with mental disorders specifically targeted towards health professionals are being promoted [1]. Ingredients such as information about mental disorders, development of specific skills, and modifications in the culture of the health centres have been pointed out as the most effective [18].…”

“…More recently [32] the protocol of an integrative programme to reduce stigma in Chilean healthcare workers from 11 primary care centres has been published. The intervention is based on previous qualitative analyses carried out with service users and health teams [18]. The project consists of education strategies, direct (facilitators will have a diagnosis of mental disorder), and indirect contact (videos and narratives) with people diagnosed with severe mental disorders, and skill development.…”

The factors and outcomes of stigma toward mental disorders among medical and nursing students: a cross-sectional study

“…However, during the past 20 years, public stigma has not improved with the increased knowledge about mental disorders [ 10 ]. Stigma was reported in the healthcare providers even though they may gain more knowledge than the general population [ 11 ]. A previous study pointed out stigma would better be addressed in the early years of professional learning [ 12 ].…”