Work-Related Discrimination and Change in Self-Stigma Among People With Mental Illness During Supported Employment

Rüsch, Nicolas; Nordt, Carlos; Kawohl, Wolfram; Brantschen, Elisabeth; Bärtsch, Bettina; Müller, Mario; Corrigan, Patrick W.; Rössler, Wulf

doi:10.1176/appi.ps.201400073

Cited by 25 publications

(11 citation statements)

References 15 publications

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“…Age of onset did not predict self-stigma, as in the majority of previous studies [5,59,65]. Psychiatric diagnosis did not predict the level of self-stigma, which is consistent with a large number of studies [27,28,58,64]. This contrasts with other studies, which found that self-stigma was higher in SZ [61,69], in MDD compared with BD [3], or in BPD compared with other SMI [20,22,29].…”

Section: European Psychiatrysupporting

confidence: 82%

“…Few studies investigated self-stigma within the context of psychiatric rehabilitation or recovery-oriented practices (7.7% of 220 articles [19]). Recovery-oriented interventions have shown preliminary effectiveness on self-stigma [26][27][28][29]. Self-stigma was associated with worse treatment outcomes during vocational rehabilitation [30].…”

Section: Introductionmentioning

confidence: 99%

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Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

Dubreucq

Plasse²,

Gabayet³

et al. 2020

Eur. Psychiatr.

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Background. Self-stigma is a major issue in serious mental illness (SMI) and is negatively associated with patient outcomes. Most studies have been conducted in schizophrenia (SZ). Less is known about self-stigma in other SMI and autism spectrum disorder (ASD). The objectives of this study are: (i) to assess the frequency of self-stigma in a multicentric nonselected psychiatric rehabilitation SMI and ASD sample; and (ii) to investigate the correlates of elevated self-stigma in different SMI conditions and in ASD. Methods. A total of 738 SMI or ASD outpatients were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluations included sociodemographic data, illness characteristics, and standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, personal recovery, a large cognitive battery, and daily functioning assessment. Results. 31.2% of the total sample had elevated self-stigma. The highest prevalence (43.8%) was found in borderline personality disorder and the lowest (22.2%) in ASD. In the multivariate analysis, elevated self-stigma was best predicted by early stages of personal recovery (moratorium, p = 0.001, OR = 4.0 [1.78–8.98]; awareness, p = 0.011, OR = 2.87 [1.28–6.44]), history of suicide attempt (p = 0.001, OR = 2.27 [1.37–3.76]), insight (p = 0.002, OR = 1.22 [1.08–1.38]), wellbeing (p = 0.037, OR = 0.77 [0.60–0.98]), and satisfaction with interpersonal relationships (p < 0.001, OR = 0.85 [0.78–0.93]). Conclusions. The present study has confirmed the importance of addressing self-stigma in SMI and ASD patients enrolled in psychiatric rehabilitation. The effectiveness of psychiatric rehabilitation on self-stigma and the potential mediating effects of changes in self-stigma on treatment outcomes should be further investigated.

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Section: European Psychiatrysupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

Dubreucq

Plasse²,

Gabayet³

et al. 2020

Eur. Psychiatr.

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“…This may help explain why job tenure in IPS programmes is often low, averaging 12.8 weeks for all study participants, and 20.0 weeks for those who worked, as reported in a synthesis of eight trials with study durations of a year or more . One factor influencing the experience of stress perceived by working IPS clients in our study was if they could socialise with co-workers, and the support they consequently received (Besse et al, 2017): these results reflect the importance of a friendly work environment, confirming Rüsch's conclusion of stigma-related stress in this population (Rüsch et al, 2014).…”

Section: Categories Topics Quotessupporting

confidence: 81%

The meaning and experience of stress among supported employment clients with mental health problems

Besse

Poremski

Laliberté

et al. 2017

Health Soc Care Community

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Many clinicians are concerned that competitive work may cause excessive stress for people with severe mental health problems. Individual Placement and Support (IPS) is acknowledged as the most effective model of supported employment for this population. The manner in which IPS clients define and experience employment-related stress is poorly understood. This qualitative study aims to explore how people with mental health problems receiving IPS services define and experience employment-related stress. We purposively sampled and interviewed 16 clients of an IPS programme, who had been competitively employed for more than 1 month. Data were collected between September 2014 and July 2015 in Montreal, Canada. Transcripts of semi-structured interviews were analysed using grounded theory methodology. IPS clients often defined stress similar to its common understanding: the result of experiencing prolonged or/and cumulative strains, or of an incongruence between efforts and rewards, hopes and reality. Stress experienced in this way could exacerbate psychiatric symptoms, especially depression or psychotic symptoms. However, when maintained at a more manageable level, stress stimulated learning and improved planning of tasks. Participants described different coping mechanisms, such as sharing their experiences and difficulties with others, focusing on problem resolution and avoidance. The first two of these helped IPS clients remain at work and bolstered their confidence. Work-related stress has potentially positive as well as negative consequences for IPS clients. In order to maximise the potential beneficial effects of stress, employment specialists can help clients anticipate potential stressors and plan how they might cope with them. Further research on the most effective ways of helping clients cope with stress is needed.

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“…Many people with mental illnesses experience stigma in the workplace, leading to self-stigma and worsening of selfesteem (Watson et al, 2007). However, an assessment among participants in an employment support programme found that, compared with unemployed participants, those who worked without experiencing discrimination had lower levels of self-stigma and stigma stress (Rüsch et al, 2014). These findings indicate the importance of considering self-stigma and self-esteem in supporting the employment of people with mental illnesses.…”

Section: Introductionmentioning

confidence: 99%

Self-Esteem, Self-Stigma, and Stigmatization among People with Mental Illness in Japan Who Have Work Experience

Yoshii¹,

Akazawa²,

Saito³

2016

PSYCH

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Self-stigma of mental illness hinders work and reduces self-esteem. The aim of the study was to examine self-esteem, self-stigma, and stigmatisation among people with mental illness in Japan who had work experience. Survey respondents were 191 patients with mental illnesses in Japan. Self-esteem and self-stigma were measured, and associations between participants' characteristics and these variables were explored. Most study participants were males (69.1%); 103 participants had schizophrenia (53.9%). Self-esteem differed significantly by type of support facility, age at onset, psychiatric hospitalisation, income, part-time work, treatment at work, consultation, reasons for unemployment and motivations for employment. Significant negative influences on self-stigma were not living alone, not disclosing the illness to colleagues, not citing mental illness as a reason for unemployment and not working for a living. It is necessary to improve working environments to ensure that people with mental illnesses can work by introducing anti-stigma countermeasures.

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Work-Related Discrimination and Change in Self-Stigma Among People With Mental Illness During Supported Employment

Cited by 25 publications

References 15 publications

Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

The meaning and experience of stress among supported employment clients with mental health problems

Self-Esteem, Self-Stigma, and Stigmatization among People with Mental Illness in Japan Who Have Work Experience

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