Nicolas Ruesch

The Stigma of Mental Illness

Strategies Against Social Exclusion and Discrimination

• Gebundenes Buch

Produktbeschreibung

People with mental illness are often painfully familiar with overt prejudice or more subtle forms of mistreatment. The stigma and discrimination associated with their disorders can have effects in several areas of life: in social interactions, in work and healthcare settings, in the legal system and the media. Many withdraw due to shame and do not seek help. In turn, stigma can prove to be a more serious problem than the disorder itself. Yet too little is done to reduce stigma and its impact. The Stigma of Mental Illness: Strategies Against Discrimination and Social Exclusion offers up the knowledge necessary to understand and fight against stigma and discrimination. It will be invaluable to all health professionals, social workers, healthcare managers and policy makers with an involvement or interest in mental illness. * Broad coverage of the forms and consequences of stigma * Specific treatment of stigma in relation to diagnoses such as dementia and autism * Perspectives and strategies of a service user and a relative * Up-to-date concepts regarding exclusion and discrimination * Practical strategies for service users, relatives, healthcare professionals and policy makers

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Produktdetails

• Verlag: Elsevier - Health Sciences Division
• Seitenzahl: 292
• Erscheinungstermin: 6. Januar 2023
• Englisch
• Abmessung: 233mm x 156mm x 18mm
• Gewicht: 618g
• ISBN-13: 9780323834292
• ISBN-10: 0323834299
• Artikelnr.: 62213489

Autorenporträt

Nicolas Rüsch has been working in stigma research for 20 years. He has ongoing cooperations of 10+ years with leading international researchers, incl. Prof. P.W. Corrigan, Chicago; Prof. Sir G. Thornicroft, London/UK; Dr. Sara Evans-Lacko, London/UK. He has a background in social psychiatry as well as extensive research experience evidenced by >145 peer-reviewed journal articles and various book chapters and other publications.

Inhaltsangabe

¿1. Introduction 1.1. Aims and content of the book (i) To clarify forms and
consequences of stigma and (ii) to outline anti-stigma programs, including
evidence on their efficacy
1.2. Language Person-first language, thought police as distraction from
anti-stigma work
1.3. Types of anti-stigma agendas Services agenda, rights agenda,
self-worth agenda
1.4. Should we sugarcoat stigma by downplaying the challenges of mental
illness? Impairments due to mental illness, disability and label
1.5. Studies and evidence Types of available evidence, research synthesis,
pros and cons of meta-analyses; this will inform readers about types of
evidence that are referred to throughout this book
1.6. Diagnosis and mental health continuum Pros and cons of psychiatric
diagnoses, their limited validity, continuum model
1.7. Stigma in a time of rapid societal change Increased difficulty for
disadvantaged individuals with mental illness in a world in crisis (Social
inequality, migration etc.)
1.8. What is not covered in this book Special topics and populations, e.g.
people in forensic psychiatry; mental illness stigma in low and
middle-income countries
1.9. Perspective of this book Written by the author in his roles as
researcher, clinician, peer and anti-stigma worker; voices of service users
and relatives are present throughout the book with quotes from qualitative
research as well as by the contributions of JBP and MHG (see above)
2. Historical and social aspects of mental illness and social exclusion The
aim of this chapter is to contextualize mental illness stigma in terms of
its historical and social aspects - both of which are crucial to understand
current stigma and ways to address it. 2.1. Historical aspects Madness in
ancient Greece, Greek tragedy and concept of melancholia; forced
sterilization and "euthanasia" in Nazi Germany; psychiatric reform movement
and anti-psychiatry of the 1960ies
2.2. Prevalence and burden of mental disorders Prevalence, burden,
disability-adjusted life years, costs of mental disorder in- and outside
the mental healthcare system, lack of adequate policy response, key
populations (e.g. youth), health economy perspective, "mental health in all
policies" approach
2.3. Mental health as a task for society Social determinants of mental
health, "deaths of despair", need for a social model of mental health,
social solutions
3. What is stigma? This chapter introduces basic concepts of stigma as it
applies to people with mental illness and also to other stigmatized
conditions; the aim is to clarify the concepts and their implications for
interventions based on sociological and social psychological literature
(prior to discussing stigma as it specifically applies to people with
mental illness in Chapters 5 ff.). 3.1. Terminology, models and forms of
stigma 3.1.1. Origin of the word stigma 3.1.2. Stigma as umbrella term
3.1.3. Social cognitive model Stereotypes, prejudice, discrimination
(Corrigan) 3.1.4. Sociological model Difference, labeling, separation,
status loss, discrimination, power (Link & Phelan) 3.1.5. Forms of stigma:
Public, self, structural 3.1.6. Levels of stigma Matter of degree
(subtle/blatant), explicit vs. implicit, open vs. indirect, microaggression
3.1.7. Stigma and knowledge - mental health literacy 3.1.8.
Intersectionality Double stigma, origin of concept
3.2. Categorization and stereotypes as basic elements of stigma 3.2.1. What
is categorization? 3.2.2. Categorization and prejudice reduction
De-categorization, group differentiation, re-categorization 3.2.3. What are
stereotypes? 3.2.4. Stereotype content Fiske's stereotype content model:
warmth and competence; stereotypes and kernel of truth discussion;
stereotypes as normal perception of bizarre behavior? 3.2.5. Development of
stereotypes Unconscious association, outgroup homogeneity effect, illusory
correlation 3.2.6. Maintenance of stereotypes Biased processing, linguistic
intergroup bias etc. 3.2.7. Application of stereotypes 3.2.8. Changing
stereotypes
3.3. Functions of stigma 3.3.1. Functions for individuals Downward
comparisons, self-esteem, terror management 3.3.2. Functions for own group
Social cooperation, dilemma of trust, social identity 3.3.3. Comprehensive
models Social dominance, just world beliefs, system justification, "to keep
people down, in or away" (Jo Phelan) 3.3.4. Evolutionary perspective
Avoidance of illness risk, smoke detector principle and false
positives/overreactions; avoidance of poor cooperation partners
4. Consequences of stigma 4.1. Consequences for the non-stigmatized Common
stereotypes, ambivalence, anxiety/insecurity, discrepancy between
self-reported attitudes and behavior
4.2. Consequences for the stigmatized Experiences of discrimination, stigma
consciousness, stereotype threat, stigma stress, attributional ambiguity,
stigma and poor health
4.3. How can stigmatized individuals cope with stigma? Blame
discrimination, ingroup comparisons, secrecy, social withdrawal, challenge
stigma
4.4. Interaction between the stigmatized and the non-stigmatized From the
perspective of the non-stigmatized, and of the non-stigmatized
5. People with mental illness and their relatives 5.1. People with mental
illness 5.1.1. Public stigma Public attitudes, change over time, experience
and anticipation of discrimination, public stigma and self-stigma 5.1.2.
Role of biological models of mental illness Attribution theory, genetic
essentialism, consequences of biological models 5.1.3. Self-stigma, shame,
why try What is self-stigma, predictors of self-stigma, empowerment and
stigma resistance, awareness of illness/insight 5.1.4. Secrecy and
disclosure Pros and cons of disclosure, conditions of disclosure 5.1.5.
Stigma stress 5.1.6. Recovery and stigma 5.1.7. Stigma as a barrier to
service use 5.1.8. Structural discrimination Legal aspects, funding for
health services and research; other aspects of structural discrimination
are discussed in the respective societal domains in Chapter 7
5.2. People with a history of suicidality Suicide stigma, stigma and
suicide prevention
5.3. Young people with psychosis risk or first episode of psychosis
5.4. People with specific diagnoses Aim of this subchapter is to cover a
number of diagnoses for which the content of stigma and its consequences
differ from other mental disorders: Autism, bipolar disorder, borderline
personality disorder, dementia, eating disorders, intellectual disability,
substance use disorders
5.5. People with mental illness and other stigmatized characteristics
(intersectionality)
5.6. Families and relatives
5.7. Children and adolescents
5.8. Migrants and refugees with mental illness
6. First-person accounts 6.1. Martina Heland-Graef: My experience of stigma
and psychosis The author is a leading German peer advocate who fights,
e.g., for mental health service reform and human rights for people with
severe mental illness.
6.2. Janine Berg-Peer: My life and my daughter with severe mental illness
The author is board member of the German National Alliance of Relatives of
People with Mental Illness and has published several books on this topic.
7. Stigma in different societal domains (incl. anti-stigma interventions)
7.1. Employment 7.1.1. People with mental illness who work Public
attitudes, employer attitudes, experiences of discrimination, disclosure,
role of clinicians, structural barriers in the healthcare system, role of
companies, anti-stigma interventions in the workplace 7.1.2. People with
mental illness who are unemployed Disclosure during job search,
interventions, supported employment, supported education, structural
discrimination and barriers to finding work
7.2. Housing and Homelessness Homelessness and poor health, media and
public attitudes, experiences of discrimination, structural problems in the
social and healthcare sectors, Housing First
7.3. Healthcare 7.3.1. and 7.3.2. Individual level discrimination and
interventions Attitudes of service providers, experiences of service users,
interactions of service providers and service users, service providers with
own experience of mental illness, "stigmatization of psychiatrists",
anti-stigma interventions for service providers 7.3.3. and 7.3.4.
Structural level discrimination and interventions Fragmentation of the
healthcare service system, lack of implementation of psychosocial
interventions, poor somatic care, architecture of mental healthcare,
structural interventions, strengthening outpatient care, integrated care,
prevention, peer support, avoiding coercion
7.4. Media Stereotypes, types of media (film, TV, newspaper, social media,
video games), information and disinformation, relevance of media, media and
suicide, origins of stigma in media, anti-stigma interventions for media
professionals and media guidelines, role of peers and citizen journalism
7.5. Legal system Stigma and social justice; UN-convention on rights of
persons with disabilities; new German legislation on social participation
of persons with disabilities; voting rights; new Bavarian law on acute
admissions to psychiatric hospital and protest against this law
8. Programs to reduce public stigma 8.1. Education Approach, problems,
content, program types, evidence of efficacy
8.2. Name change Approach, side effects, evidence of efficacy
8.3. Protest Approach, examples, evidence of efficacy
8.4. Contact Approach, evidence of efficacy, contact and self-stigma,
contact and social change, types of interventions, key ingredients, TLC3
(targeted, local, continuous, credible change; Corrigan), examples of
contact-based programs
9. Programs to reduce self-stigma 9.1. Strategies to reduce self-stigma and
to increase empowerment Psychoeducation, cognitive therapy, narrative
approaches (Narrative Enhancement and Cognitive Therapy), photovoice,
self-help and peer support
9.2. Honest, Open, Proud Honest, Open, Proud as a peer-led program to
support people with mental illness in their decision whether and how to
disclose their illness; program rationale and content; data on efficacy,
program versions and issues of implementation
10. Programs to address treatment-related stigma and to facilitate
help-seeking 10.1. General population and healthcare
10.2. Self-stigma, shame and relatives/carers
10.3. Evidence
11. Programs to reduce structural discrimination Summary of key approaches
(specific interventions to reduce structural discrimination are discussed
in Chapter 7 for the respective contexts: legal system etc.)
12. National anti-stigma campaigns - examples and challenges 12.1. Examples
in English speaking countries Time to Change, UK; See Me, Scotland; Opening
Minds, Canada
12.2. The situation in German speaking countries Lack of comparable
national anti-stigma campaigns in German speaking countries
12.3. Funding for anti-stigma programs
12.4. Leadership of antistigma programs Peers/service users should lead
programs
13. Summary and outlook Factors that facilitate social change; future
developments (machine learning; social media and real-time interventions;
biogenetic research, biomarkers of mental illness, risks of labeling and
discrimination; embracing diversity as a value that counters stigma