Mental Health-Related Stigma and Discrimination in Ghana: Experience of Patients and Their Caregivers

Purpose Postgraduate researchers (PGRs) appear to be particularly vulnerable to mental health problems. Mental health-related stigma and discrimination may be endemic within universities, creating a threatening environment that undermines PGRs’ health and well-being. These environmental characteristics may increase PGRs’ absenteeism and presenteeism, attendance behaviours that have great personal and institutional consequences. The study of this issue, however, has been limited to date. Design/methodology/approach This was a mixed methods psychological study using cross-sectional data provided by 3,352 UK-based PGRs. Data were collected in a new national survey (U-DOC) led by a British University in 2018–2019. We used structural equation modelling techniques to test associations between workplace mental health-related stigma and discrimination, presenteeism, absenteeism and demographic characteristics. The authors analysed qualitative survey data with framework analysis to deductively and inductively explore associations between workplace culture, stigma and discrimination, and attendance behaviours. Findings The authors found that some PGRs report positive perceptions and experiences of the academic mental health-related workplace culture. However, experiences of mental health stigma and discrimination appear widespread. Both quantitative and qualitative results show that experiences of mental health-related stigma are associated with greater absenteeism and presenteeism. People with mental health problems appear especially vulnerable to experiencing stigma and its impacts. Practical implications Key implications include recommendations for universities to improve support for PGR mental health, and to encourage taking annual leave and necessary sickness absences, by providing a more inclusive environment with enhanced mental health service provision and training for faculty and administrative staff. Originality/value This study presents the first large-scale survey of PGR experiences of mental health-related stigma and discrimination, and their associations with absenteeism and presenteeism.

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Key lessons learned from the INDIGO global network on mental health related stigma and discrimination

World Psychiatry ◽

10.1002/wps.20628 ◽

2019 ◽

Vol 18 (2) ◽

pp. 229-230 ◽

Cited By ~ 5

Author(s):

Graham Thornicroft ◽

Ioannis Bakolis ◽

Sara Evans‐Lacko ◽

Petra C. Gronholm ◽

Claire Henderson ◽

...

Keyword(s):

Mental Health ◽

Lessons Learned ◽

Global Network ◽

Stigma And Discrimination ◽

Related Stigma ◽

Health Related

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Evidence for effective interventions to reduce mental-health-related stigma and discrimination

The Lancet ◽

10.1016/s0140-6736(15)00298-6 ◽

2016 ◽

Vol 387 (10023) ◽

pp. 1123-1132 ◽

Cited By ~ 322

Author(s):

Graham Thornicroft ◽

Nisha Mehta ◽

Sarah Clement ◽

Sara Evans-Lacko ◽

Mary Doherty ◽

...

Keyword(s):

Mental Health ◽

Stigma And Discrimination ◽

Effective Interventions ◽

Related Stigma ◽

Health Related

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Prescribing stigma in mental disorders: A comparative study of Portuguese psychiatrists and general practitioners

International Journal of Social Psychiatry ◽

10.1177/00207640211002558 ◽

2021 ◽

pp. 002076402110025

Author(s):

Bárbara Almeida ◽

Ana Samouco ◽

Filipe Grilo ◽

Sónia Pimenta ◽

Ana Maria Moreira

Keyword(s):

Mental Health ◽

Mental Disorder ◽

General Practitioners ◽

Psychiatric Patients ◽

Self Report ◽

Cross Sectional ◽

Medical Speciality ◽

Diagnostic Overshadowing ◽

Related Stigma ◽

Health Related

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.

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Long-term effects of filmed social contact or internet-based self-study on mental health-related stigma: a 2-year follow-up of a randomised controlled trial

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-018-1609-8 ◽

2018 ◽

Vol 54 (1) ◽

pp. 33-42 ◽

Cited By ~ 9

Author(s):

Sosei Yamaguchi ◽

Yasutaka Ojio ◽

Shuntaro Ando ◽

Peter Bernick ◽

Kazusa Ohta ◽

...

Keyword(s):

Mental Health ◽

Controlled Trial ◽

Social Contact ◽

Long Term Effects ◽

Self Study ◽

Related Stigma ◽

Health Related ◽

Randomised Controlled

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Anti-stigma interventions

Oxford Textbook of Public Mental Health ◽

10.1093/med/9780198792994.003.0044 ◽

2018 ◽

pp. 411-420

Author(s):

Petra C. Gronholm ◽

Claire Henderson ◽

Tanya Deb ◽

Graham Thornicroft

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Negative Impact ◽

Intervention Development ◽

Outcome Data ◽

Short Term ◽

People With Mental Illness ◽

Related Stigma ◽

Health Related

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.

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Why Mental Health–Related Stigma Matters for Physician Wellbeing, Burnout, and Patient Care

Journal of General Internal Medicine ◽

10.1007/s11606-019-05173-6 ◽

2020 ◽

Vol 35 (5) ◽

pp. 1579-1581 ◽

Cited By ~ 3

Author(s):

Hae Lin Cho ◽

Caroline J. Huang

Keyword(s):

Mental Health ◽

Patient Care ◽

Related Stigma ◽

Health Related

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Effects of education and social contact on mental health-related stigma among high-school students

Psychiatry Research ◽

10.1016/j.psychres.2019.112581 ◽

2019 ◽

Vol 281 ◽

pp. 112581 ◽

Cited By ~ 1

Author(s):

Mariangela Lanfredi ◽

Ambra Macis ◽

Clarissa Ferrari ◽

Luciana Rillosi ◽

Elena Cadone Ughi ◽

...

Keyword(s):

Mental Health ◽

High School ◽

High School Students ◽

Social Contact ◽

School Students ◽

Related Stigma ◽

Health Related

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Stigma and discrimination associated with mental illness and other stigmatizing conditions in China using two cultural-sensitive measures of stigma: interpersonal distance and occupational restrictiveness

Psychological Medicine ◽

10.1017/s0033291720001439 ◽

2020 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Wei Xiong ◽

Michael R. Phillips ◽

Zhizhong Wang ◽

Yuhong Zhang ◽

Hui G. Cheng ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Interpersonal Relationships ◽

Interpersonal Distance ◽

Community Members ◽

Stigma And Discrimination ◽

Different Types ◽

Health Related ◽

Core Components ◽

Selection Of

Abstract Background Reducing stigma is a perennial target of mental health advocates, but effectively addressing stigma relies on the ability to correctly understand and accurately measure culture-specific and location-specific components of stigma and discrimination. Methods We developed two culture-sensitive measures that assess the core components of stigma. The 40-item Interpersonal Distance Scale (IDS) asks respondents about their willingness to establish four different types of relationships with individuals with 10 target conditions, including five mental health-related conditions and five comparison conditions. The 40-item Occupational Restrictiveness Scale (ORS) asks respondents how suitable it is for individuals with the 10 conditions to assume four different types of occupations. The scales – which take 15 min to complete – were administered as part of a 2013 survey in Ningxia Province, China to a representative sample of 2425 adult community members. Results IDS and ORS differentiated the level of stigma between the 10 conditions. Of the total, 81% of respondents were unwilling to have interpersonal relationships with individuals with mental health-related conditions and 91% considered them unsuitable for various occupations. Substantial differences in attitudes about the five mental health-related conditions suggest that there is no community consensus about what constitutes a ‘mental illness’. Conclusions Selection of comparison conditions, types of social relationships, and types of occupations considered by the IDS and ORS make it possible to develop culture-sensitive and cohort-specific measures of interpersonal distance and occupational restrictiveness that can be used to compare the level and type of stigma associated with different conditions and to monitor changes in stigma over time.

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