期刊论文详细信息
International Journal of Mental Health Systems
A qualitative exploration of the perspectives of mental health professionals on stigma and discrimination of mental illness in Malaysia
Tine Van Bortel1  Ainul Nadhirah Hanafiah1 
[1] Cambridge Institute of Public Health, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK
关键词: Discrimination;    Stigma;    Mental illness;    Mental health professionals;    Mental health Malaysia;    Malaysia;    Mental health;   
Others  :  1139233
DOI  :  10.1186/s13033-015-0002-1
 received in 2014-07-17, accepted in 2015-02-11,  发布年份 2015
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【 摘 要 】

Background

Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and ‘stigma’. Numerous researches have been conducted on stigma and discrimination of people with mental disorders. However, most of the literature investigates stigma from a cultural conception point of view, experiences of patients or public attitudes towards mental illness but little to none from the standpoint of mental health professionals. In Malaysia, this research on stigma is particularly limited. Therefore, the state of stigma and discrimination of people with mental illness was investigated from the perspectives of mental health professionals in Malaysia.

Methods

In-depth, face-to-face, semi-structured interviews were conducted with 15 mental health professionals from both government and private sectors including psychiatrists, psychologists and counsellors. The interviews were approximately 45-minutes long. The data was subsequently analysed using the basic thematic approach.

Results

Seven principal themes, each with their own sub-themes, emerged from the analysis of ‘stigma of mental illness’ from mental health professionals’ point of view, including: (1) main perpetrators, (2) types of mental illness carrying stigma, (3) demography and geography of stigma, (4) manifestations of stigma, (5) impacts of stigma, (6) causes of stigma and (7) proposed initiatives to tackle stigma. Stigma of mental illness is widespread in Malaysia. This is most evident amongst people suffering from conditions such as schizophrenia, bipolar disorder and depression. Stigma manifests itself most often in forms of labelling, rejection, social exclusion and in employment. Family, friends and workplace staff are reported to be the main perpetrators of discriminatory conducts.

Conclusion

According to the perspectives of the mental health professionals, implications of stigma include patients being trapped in a vicious cycle of discrimination leading to detrimental consequences for the individual, their families, communities and society as a whole. There is a pressing need to address stigma of mental illness and its consequences, especially through raising awareness of mental health and wellbeing in Malaysia, as reported by the mental health professionals.

【 授权许可】

   
2015 Hanafiah and Van Bortel; licensee BioMed Central.

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【 参考文献 】
  • [1]Corrigan PW, Watson AC: Understanding the impact of stigma on people with mental illness. World Psychiatr 2002, 1:16-20.
  • [2]Rusch N, Angermeyer MC, Corrigan PW: Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 2005, 20:529-39.
  • [3]Thornicroft G, Brohan E, Kassam A, Lewis-Holmes E: Reducing stigma and discrimination: candidate interventions. Int J Ment Health Syst 2008, 2:3. BioMed Central Full Text
  • [4]Corrigan PW, Wassel A: Understanding and influencing the stigma of mental illness. J Psychosoc Nurs Ment Health Serv 2008, 46:42-8.
  • [5]Overton SL, Medina SL: The stigma of mental illness. J Counsel Dev 2008, 86:143-51.
  • [6]Silton NR, Flannelly KJ, Milstein G, Vaaler ML: Stigma in America: Has anything changed? impact of perceptions of mental illness and dangerousness on the desire for social distance: 1996 and 2006. J Nerv Ment Dis 2011, 199:361.
  • [7]Thornicroft G: Shunned: Discrimination against People with Mental Illness. Oxford University Press, Oxford; 2006.
  • [8]Castro A, Farmer P: Understanding and addressing AIDS-related stigma: from anthropological theory to clinical practice in Haiti. Am J Public Health 2005, 95:53-9.
  • [9]Herek GM: AIDS and stigma. Am Behav Sci 1999, 42:1106-16.
  • [10]Puhl RM, Heuer CA: The stigma of obesity: a review and update. Obesity 2009, 17:941-64.
  • [11]Dovidio JF, Pagotto L, Hebl MR: Implicit Attitudes and Discrimination Against People With Physical Disabilities. In Disability and Aging Discrimination. Springer, New York; 2011:157-83.
  • [12]Corrigan PW, River LP, Lundin RK, Wasowski KU, Campion J, Mathisen J, et al.: Stigmatizing attributions about mental illness. J Community Psychol 2000, 28:91-102.
  • [13]Corrigan P: How stigma interferes with mental health care. Am Psychologist 2004, 59:614.
  • [14]Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA: Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Public Health 1999, 89:1328-33.
  • [15]Link BG: Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. Am Sociol Rev 1987, 52:96-112.
  • [16]Phelan JC, Link BG, Stueve A, Pescosolido BA: Public conceptions of mental illness in 1950 and 1996: what is mental illness and is it to be feared? J Health Soc Behav 2000, 41:188-207.
  • [17]WHO: Mental Health-Facing the Challenges, Building Solutions: Report from the WHO European Ministerial Conference. World Health Organization; 2005.
  • [18]Fabrega H: Psychiatric stigma in non-Western societies. Compr Psychiatry 1991, 32:534-51.
  • [19]Lauber C, Rossler W: Stigma towards people with mental illness in developing countries in Asia. Int Rev Psychiatry 2007, 19:157-78.
  • [20]Ng CH: The stigma of mental illness in Asian cultures. Aust New Zeal J Psychiatr 1997, 31:382-90.
  • [21]Chang KH, Horrocks S: Lived experiences of family caregivers of mentally ill relatives. J Adv Nurs 2006, 53:435-43.
  • [22]Khan T, Hassali M, Tahir H, Khan A: A pilot study evaluating the stigma and public perception about the causes of depression and schizophrenia. Iranian J Public Health 2011, 40:50-6.
  • [23]Minas H, Zamzam R, Midin M, Cohen A: Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes. BMC Public Health 2011, 11:317. BioMed Central Full Text
  • [24]Mubarak A, Baba I, Chin LH, Hoe QS: Quality of life of community-based chronic schizophrenia patients in Penang, Malaysia. Aust N Z J Psychiatry 2003, 37:577-85.
  • [25]Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M: Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. The Lancet 2009, 373:408-15.
  • [26]Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, et al.: Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 2013, 381:55-62.
  • [27]Lasalvia A, Van Bortel T, Bonetto C, Jayaram G, Weegel Jv, Zoppei S et al. Cross-national variations in reported discrimination among people with major depression worldwide: the ASPEN/INDIGO international study. Br J Psychiatry(in press).
  • [28]Rose D, Willis R, Brohan E, Sartorius N, Villares C, Wahlbeck K, et al.: Reported stigma and discrimination by people with a diagnosis of schizophrenia. Epidemiol Psychiatr Sci 2011, 20:193-204.
  • [29]Biegel DE, Milligan SE, Putnam PL, Song LY: Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness. Community Ment Health J 1994, 30:473-94.
  • [30]Sales E: Family burden and quality of life. Qual Life Res 2003, 12:33-41.
  • [31]Jamaiyah H. Community mental health in Malaysia: Marriage of psychiatry and public health. Buletin Kesihatan Masyarakat Isu Khas 2000:155–166.
  • [32]Mubarak A: Malaysia’s social policies on mental health: a critical theory. J Health Soc Policy 2003, 17:55.
  • [33]Haque A: Mental health concepts and program development in Malaysia. J Ment Health 2005, 14:183-95.
  • [34]Merriam SB: Qualitative Research in Practice: Examples for Discussions & Analysis. John Wiley & Sons, San Francisco; 2002.
  • [35]Mays N, Pope C: Qualitative Research in Health Care. Blackwell Pub./BMJ Books, Oxford; 2006.
  • [36]Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol 2006, 3:77-101.
  • [37]Myers MD, Avison D: Qualitative research in information systems. Manag Inf Syst Q 1997, 21:241-2.
  • [38]Penn DL, Kohlmaier JR, Corrigan PW: Interpersonal factors contributing to the stigma of schizophrenia: social skills, perceived attractiveness, and symptoms. Schizophr Res 2000, 45:37-45.
  • [39]Knifton L, Gervais M, Newbigging K, Mirza N, Quinn N, Wilson N, et al.: Community conversation: addressing mental health stigma with ethnic minority communities. Soc Psychiatry Psychiatr Epidemiol 2010, 45:497-504.
  • [40]Zoppei S, Lasalvia A, Bonetto C, Van Bortel T, Nyqvist F, Webber M, et al.: Social capital and reported discrimination among people with depression in 15 European countries. Soc Psychiatr Psychiatr Epidemiol 2014, 49:1-10.
  • [41]Deva MP: Bringing changes to Asian mental health. Int Rev Psychiatry 2008, 20:484-7.
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