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Coping with stigma and discrimination: evidence from mental health service users in England

Published online by Cambridge University Press:  02 May 2017

A. Isaksson ,
E. Corker ,
J. Cotney ,
S. Hamilton ,
V. Pinfold ,
D. Rose ,
N. Rüsch ,
C. Henderson ,
G. Thornicroft  and
S. Evans-Lacko
A. Isaksson*
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Freiburg, Germany
E. Corker
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Psychology Department, University of East London, London, UK
J. Cotney
Affiliation:
McPin Foundation, London, UK
S. Hamilton
Affiliation:
McPin Foundation, London, UK
V. Pinfold
Affiliation:
McPin Foundation, London, UK
D. Rose
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
N. Rüsch
Affiliation:
Department of Psychiatry and Psychotherapy II, University of Ulm and BKH Günzburg, Germany
C. Henderson
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
G. Thornicroft
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
S. Evans-Lacko
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
*
*Address for correspondence: A. Isaksson, Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany. (Email: [email protected])
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Abstract

Aims.

Mental health stigma and discrimination are significant problems. Common coping orientations include: concealing mental health problems, challenging others and educating others. We describe the use of common stigma coping orientations and explain variations within a sample of English mental health service users.

Methods.

Cross-sectional survey data were collected as part of the Viewpoint survey of mental health service users’ experiences of discrimination (n = 3005). Linear regression analyses were carried out to identify factors associated with the three stigma coping orientations.

Results.

The most common coping orientation was to conceal mental health problems (73%), which was strongly associated with anticipated discrimination. Only 51% ever challenged others because of discriminating behaviour, this being related to experienced discrimination, but also to higher confidence to tackle stigma.

Conclusions.

Although stigma coping orientations vary by context, individuals often choose to conceal problems, which is associated with greater anticipated and experienced discrimination and less confidence to challenge stigma. The direction of this association requires further investigation.

Keywords

Discriminationmental illness stigmastereotypesstress
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 27 , Issue 6 , December 2018 , pp. 577 - 588
Copyright
Copyright © Cambridge University Press 2017 

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References

Bos, AER, Kanner, D, Muris, P, Janssen, B, Mayer, B (2009). Mental illness stigma and disclosure: consequences of coming out of the closet. Issues in Mental Health Nursing 30, 509–513.Google Scholar
Brohan, E, Gauci, D, Sartorius, N, Thornicroft, G (2011). Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: the GAMIAN-Europe study. Journal of Affective Disorders 129, 56–63.Google Scholar
Brohan, E, Clement, S, Rose, D, Sartorius, N, Slade, M, Thornicroft, G (2013). Development and psychometric evaluation of the Discrimination and Stigma Scale (DISC). Psychiatry Research 208, 33–40.Google Scholar
Corker, E, Hamilton, S, Henderson, C, Weeks, C, Pinfold, V, Rose, D, Williams, P, Flach, C, Gill, V, Lewis-Holmes, E, Thornicroft, G (2013). Experiences of discrimination among people using mental health services in England 2008–2011. British Journal of Psychiatry 202 (Suppl. 55), s58–s63.Google Scholar
Corker, E, Hamilton, S, Robinson, E, Cotney, J, Pinfold, V, Rose, D, Thornicroft, G, Henderson, C (2016). Viewpoint survey of mental health service users’ experiences of discrimination in England 2008–2014. Acta Psychiatrica Scandinavica 134 (Suppl. 446), 6–13.Google Scholar
Corrigan, PW, Rao, D (2012). On the self-stigma of mental illness: stages, disclosure, and strategies for change. Canadian Journal of Psychiatry 57, 464–469.Google Scholar
Corrigan, PW, Kosyluk, KA, Rüsch, N (2013). Reducing self-stigma by coming out proud. American Journal of Public Health 103, 794–800.Google Scholar
Evans-Lacko, S, Malcolm, E, West, K, Rose, D, London, J, Rusch, N, Little, K, Henderson, C, Thornicroft, G (2013). Influence of Time to Change's social marketing interventions on stigma in England 2009–2011. British Journal of Psychiatry 202 (Suppl. 55), s77–s88.Google Scholar
Henderson, C, Brohan, E, Clement, S, Williams, P, Lassman, F, Schauman, O, Dockery, L, Farrelly, S, Murray, J, Murphy, C, Slade, M, Thornicroft, G (2013). Decision aid on disclosure of mental health status to an employer: feasibility and outcomes of a randomised controlled trial. British Journal of Psychiatry 203, 350–357.Google Scholar
Henderson, RC, Corker, E, Hamilton, S, Williams, P, Pinfold, V, Rose, D, Webber, M, Evans-Lacko, S, Thornicroft, G (2014). Viewpoint survey of mental health service users’ experiences of discrimination in England 2008–2012. Social Psychiatry and Psychiatric Epidemiology 49, 1599–1608.Google Scholar
Holmes, EP, River, LP (1998). Individual strategies for coping with the stigma for severe mental illness. Cognitive and Behavioral Practice 5, 231–239.Google Scholar
Holzinger, A, Floris, F, Schomerus, G, Carta, MG, Angermeyer, MC (2012). Gender differences in public beliefs and attitudes about mental disorder in western countries: a systematic review of population studies. Epidemiology and Psychiatric Sciences 21, 73–85.Google Scholar
Ilic, M, Reinecke, J, Bohner, G, Hans-Onno, R, Beblo, T, Driessen, M, Frommberger, U, Corrigan, PW (2011). Protecting self-esteem from stigma: a test of different strategies for coping with the stigma of mental illness. International Journal of Social Psychiatry 58, 246–257.Google Scholar
Lasalvia, A, Zoppei, S, Van Bortel, T, Bonetto, C, Cristofalo, D, Wahlbeck, K, Bacle, SV, Van Audenhove, C, van Weeghel, J, Reneses, B, Germanavicius, A, Economou, M, Lanfredi, M, Ando, S, Sartorius, N, Lopez-Ibor, JJ, Thornicroft, G (2013). Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381, 55–62.Google Scholar
Lasalvia, A, Van Bortel, T, Bonetto, C, Jayaram, G, van Weeghel, J, Zoppei, S, Knifton, L, Quinn, N, Wahlbeck, K, Cristofalo, D, Lanfredi, M, Sartorius, N, Thornicroft, G (2015). Cross-national variations in reported discrimination among people treated for major depression worldwide: the ASPEN/INDIGO international study. British Journal of Psychiatry 207, 507–514.Google Scholar
Lewer, D, O'Reilly, C, Mojtabai, R, Evans-Lacko, S (2015). Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors. British Journal of Psychiatry 207, 221–226.Google Scholar
Link, B (1989). A modified labeling theory approach to mental disorders: an empirical assessment. American Sociological Review 54, 400–423.Google Scholar
Link, BG, Mirotznik, J, Cullen, FT (1991). The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided? Journal of Health and Social Behavior 32, 302–320.Google Scholar
Link, BG, Struening, EL, Neese-todd, S, Asmussen, S, Phelan, JC (2002). On describing and seeking to change the experience of stigma. American Journal of Psychiatric Rehabilitation 6, 201–231.Google Scholar
Link, BG, Yang, LH, Phelan, JC, Collins, PY (2004). Measuring mental illness stigma. Schizophrenia Bulletin 30, 511–541.Google Scholar
Livingston, JD, Boyd, JE (2010). Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Social Science and Medicine 71, 2150–2161.Google Scholar
Major, B, O'Brien, LT (2005). The social psychology of stigma. Annual Review of Psychology 56, 393–421.Google Scholar
Miller, CT, Kaiser, CR (2001). A theoretical perspective on coping with stigma. Journal of Social Issues 57, 73–92.Google Scholar
Moses, T (2014). Coping strategies and self-stigma among adolescents discharged from psychiatric hospitalization: a 6-month follow-up study. International Journal of Social Psychiatry, 1–10.Google Scholar
Rüsch, N, Evans-Lacko, SE, Henderson, C, Flach, C, Thornicroft, G (2011). Knowledge and attitudes as predictors of intentions to seek help for and disclose a mental illness. Psychiatric Services 62, 675–678.Google Scholar
Rüsch, N, Abbruzzese, E, Hagedorn, E, Hartenhauer, D, Kaufmann, I, Curschellas, J, Ventling, S, Zuaboni, G, Bridler, R, Olschewski, M, Kawohl, W, Rossler, W, Kleim, B, Corrigan, PW (2014). Efficacy of coming out proud to reduce stigma's impact among people with mental illness: pilot randomised controlled trial. British Journal of Psychiatry 204, 391–397.Google Scholar
Sarkin, A, Lale, R, Sklar, M, Center, KC, Gilmer, T, Fowler, C, Heller, R, Ojeda, VD (2015). Stigma experienced by people using mental health services in San Diego County. Social Psychiatry and Psychiatric Epidemiology 50, 747–756.Google Scholar
Schibalski, JV, Müller, M, Ajdacic-Gross, V, Vetter, S, Rodgers, S, Oexle, N, Corrigan, PW, Rössler, W, Rüsch, N (2017). Stigma-related stress, shame and avoidant coping reactions among members of the general population with elevated symptom levels. Comprehensive Psychiatry 74, 224–230.Google Scholar
Sterne, JA, White, IR, Carlin, JB, Spratt, M, Royston, P, Kenward, MG, Wood, AM, Carpenter, JR (2009). Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. British Medical Journal 338, b2393.Google Scholar
Thornicroft, G, Brohan, E, Rose, D, Sartorius, N, Leese, M (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373, 408–415.Google Scholar
Vauth, R, Kleim, B, Wirtz, M, Corrigan, PW (2007). Self-efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia. Psychiatry Research 150, 71–80.Google Scholar
Webber, M, Corker, E, Hamilton, S, Weeks, C, Pinfold, V, Rose, D, Thornicroft, G, Henderson, C (2014). Discrimination against people with severe mental illness and their access to social capital: findings from the Viewpoint survey. Epidemiology and Psychiatric Sciences 23, 155–165.Google Scholar
Webber, MP, Huxley, PJ (2007). Measuring access to social capital: the validity and reliability of the Resource Generator-UK and its association with common mental disorder. Social Science and Medicine 65, 481–492.Google Scholar
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