scholarly journals Experience of stigmatization in children receiving inpatient and outpatient mental health treatment: a longitudinal study

Author(s):  
Anya Kaushik ◽  
Efstathios Papachristou ◽  
Laurence Telesia ◽  
Danai Dima ◽  
Sandra Fewings ◽  
...  

AbstractMental health-related stigma is poorly understood, and minimal research has focused on the experience of stigma from children’s perspectives. We sought to investigate whether children treated as inpatients and outpatients had different experiences of stigma over time and whether stigma is linked to global functioning cross-sectionally and longitudinally. Children, aged 8–12 years, receiving treatment within a national specialist mental health inpatient unit were matched for age, gender and diagnosis with children receiving outpatient treatment (N = 64). Validated measures of stigma, global functioning and symptom severity were collected at the start of treatment and upon discharge from the ward for inpatients, and a similar timeframe for their individually matched outpatients. Latent change score models and partial correlation coefficients were employed to test our hypotheses. No differences in most aspects of stigma between children treated as inpatients and outpatients were observed, except for personal rejection at baseline and self-stigma at follow-up favouring outpatients. A reduction in stigma was observed in societal devaluation, personal rejection and secrecy for inpatients, and self-stigma and secrecy for outpatients between the two assessments. Societal devaluation declined at a higher rate among inpatients compared to outpatients, albeit reductions in stigma were comparable for all remaining measures. No association was found between the change in stigma and change in global functioning. Future research may offer further insights into the development and maintenance of stigma and identify key targets for anti-stigma interventions to reduce its long-term impact.

2021 ◽  
pp. 002076402110025
Author(s):  
Bárbara Almeida ◽  
Ana Samouco ◽  
Filipe Grilo ◽  
Sónia Pimenta ◽  
Ana Maria Moreira

Background: Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. Aims: This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. Method: A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions ( Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. Results: GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician’s interest in mental health topics. Conclusions: Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.


Author(s):  
Adina S Kazan ◽  
Laura M Perry ◽  
Wasef F Atiya ◽  
Hallie M Voss ◽  
Seowoo Kim ◽  
...  

Abstract Tobacco use is a leading preventable cause of early mortality and is prevalent among adults with mental health diagnoses, especially in the southern USA. Increasing cessation resources in outpatient mental health care and targeting individuals most receptive to changing their behavior may improve cessation. Drawing on the transtheoretical model, our goals were to develop an educational video about the Louisiana Tobacco Quitline and evaluate its acceptability. We designed the video with knowledge derived from Louisiana-specific data (2016 Louisiana Adult Tobacco Survey, N = 6,469) and stakeholder feedback. Bivariate associations between demographic/tobacco-use characteristics and participants’ stage of quitting (preparation phase vs. nonpreparation phase) were conducted, which informed design elements of the video. Four stakeholder advisory board meetings involving current smokers, mental health clinicians, and public health advocates convened to provide iterative feedback on the intervention. Our stakeholder advisory board (n = 10) and external stakeholders (n = 20) evaluated intervention acceptability. We found that 17.9% of Louisiana adults were current smokers, with 46.9% of them in the preparation phase of quitting. Using insights from data and stakeholders, we succeeded in producing a 2-min video about the Louisiana Tobacco Quitline which incorporated three themes identified as important by stakeholders: positivity, relatability, and approachability. Supporting acceptability, 96.7% of stakeholders rated the video as helpful and engaging. This study demonstrates the acceptability of combining theory, existing data, and iterative stakeholder feedback to develop a quitline educational video. Future research should examine whether the video can be used to reduce tobacco use.


Author(s):  
Elizabeth M. Waldron ◽  
Inger Burnett-Zeigler ◽  
Victoria Wee ◽  
Yiukee Warren Ng ◽  
Linda J. Koenig ◽  
...  

Women living with HIV (WLWH) experience depression, anxiety, and posttraumatic stress symptoms at higher rates than their male counterparts and more often than HIV-unaffected women. These mental health issues affect not only the well-being and quality of life of WLWH, but have implications for HIV management and transmission prevention. Despite these ramifications, WLWH are under-treated for mental health concerns and they are underrepresented in the mental health treatment literature. In this review, we illustrate the unique mental health issues faced by WLWH such as a high prevalence of physical and sexual abuse histories, caregiving stress, and elevated internalized stigma as well as myriad barriers to care. We examine the feasibility and outcomes of mental health interventions that have been tested in WLWH including cognitive behavioral therapy, mindfulness-based interventions, and supportive counseling. Future research is required to address individual and systemic barriers to mental health care for WLWH.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 358-358
Author(s):  
Hyojin Choi ◽  
Kristin Litzelman ◽  
Molly Maher ◽  
Autumn Harnish

Abstract Spouses of cancer survivors are 33% less likely to receive guideline-concordant depression treatment than other married adults. However, depression is only one of many manifestations of psychological distress for caregivers. This exploratory study sought to assess the paths by which caregivers access mental health-related treatment. Using nationally representative data from the Medical Expenditures Panel Survey, we assessed the proportion of caregivers who received a mental health-related prescription or psychotherapy visit across care settings (office based versus outpatient hospital, emergency room, or inpatient visit), provider type (psychiatric, primary care, other specialty, or other), and visit purpose (regular checkup, diagnosis and treatment, follow-up, psychotherapy, other). In addition, we assessed the health condition(s) associated with the treatment. The findings indicate that a plurality of caregivers accessed mental health-related treatment through an office-based visit (90%) with a primary care provider (47%). A minority accessed this care through a psychologist or psychiatrist (11%) or a physician with another specialty (12%) or other provider types. Nearly a third accessed treatment as part of a regular check-up (32%). These patterns did not differ from the general population after controlling for sociodemographic characteristics. Interestingly, mental health-related treatments were associated with a mental health diagnosis in only a minority of caregivers. The findings confirm the importance of regular primary care as a door way to mental healthcare, and highlight the range of potential paths to care. Future research will examine the correlates of accessing care across path types.


Author(s):  
Petra C. Gronholm ◽  
Claire Henderson ◽  
Tanya Deb ◽  
Graham Thornicroft

There is a rich literature on the nature of mental health-related stigma and the processes by which it severely affects the life chances of people with mental health problems. Applying this knowledge to deliver and evaluate interventions to reduce stigma in a lasting way is, however, a complex and long-term challenge. This chapter outlines how mental health-related stigma and discrimination have been defined; describes the negative impact they have on people with mental illness; summarizes anti-stigma strategies and the evidence regarding their effectiveness; and makes suggestions for future intervention development and evaluation. It seems likely that short-term interventions may only have a short-term impact, with the implication being the need to study longer-term interventions and to use interim process and outcome data to improve interventions along the way.


2020 ◽  
pp. 088626052091258
Author(s):  
Douglas A. Brownridge ◽  
Tamara Taillieu ◽  
Marcelo L. Urquia ◽  
Alexandra Lysova ◽  
Ko Ling Chan ◽  
...  

This study examined the elevated risk of intimate partner violence (IPV) among persons with mental health-related disabilities (MH-RD) and the extent to which known risk factors accounted for this phenomenon. Data were drawn from a nationally representative sample of 33,127 Canadians collected in 2014 as part of Statistics Canada’s General Social Survey. Results showed that respondents with MH-RD had more than three-fold increased odds of both overall and severe IPV victimization. Although females were more likely to possess a MH-RD, males and females with MH-RD reported similarly elevated odds of IPV victimization. Risk factors that contributed to a significant reduction in elevated odds of IPV for respondents with MH-RD were child maltreatment (CM), respondents’ nonprescription drug abuse, and perpetrators’ jealous, monitoring, and socially isolating behaviors. The inability to test additional risk factors and bidirectionality in the relationship between MH-RD and IPV may have contributed to the failure to fully account for these respondents’ elevated odds of IPV. Future research is needed to understand the complex mechanisms contributing to the elevated risk of IPV and enhance prevention and intervention strategies for this underresearched and underserved vulnerable population.


Author(s):  
Kathleen M. Chard ◽  
Jennifer Schuster Wachen ◽  
Patricia A. Resick

Cognitive Processing Therapy (CPT) has been recognized by the Institute of Medicine (2007) as one of the most effective treatments for PTSD. This chapter provides a brief overview of the CPT session content, the underlying mechanisms of the therapy, a review of the empirically based literature outlining the treatment effectiveness, limitations of the therapy, and areas of future research. In addition, the authors discuss the utility of the various versions of CPT, including cognitive only (CPT-C), group, individual, and combination. Further the research supporting the effectiveness of CPT for treating PTSD related to a variety of traumas, (e.g., combat, child abuse, and rape) and the significant impact CPT can have in areas of mental health related to PTSD (e.g., anger, guilt, social functioning) are described.


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