Stigma and psychiatry


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Stigma and psychiatry

  1. 1. Presented by: Dr.S.M. Shazzadul karim FCPS trainee , Department of Psychiatry, BSMMU.
  2. 2.  Friends They don’t call me sad They don’t call me bad They don’t call me mad They don’t call me. @ William Mcknight.
  3. 3. What is STIGMA?  The word stigma refers originally to a mark or brand on Greek slaves , clearly separating them from freeman.  Dictionary definition, `a mark of disgrace or infamy’  Goff man(1963) `an attribute that is deeply discrediting’  Jones et al(1984) `A mark that sets a person apart & links the marked person to undesirable characteristics.’
  4. 4. Component of STIGMA  Labeling  Stereotyping  Devaluing  Ignorance  Prejudice.
  5. 5. Origin of STIGMA  Problem of knowledge=Ignorance  Problem of attitude=Prejudice  Problem of behavior=Discrimination
  6. 6. Types of STIGMA  Mental health stigma can be divided into two types- 1.Social stigma: characterized by prejudicial & discriminating behavior directed towards individual with mental illness. 2.Perceived stigma or self stigma: is the internalizing by the mental health sufferer of their perception of discrimination & perceived stigma can significantly affect feelings of shame & lead to poorer treatment outcome.
  7. 7. Why do people Stigmatize?  Keeping people down  -exploitation & domination.  Keeping people in  -enforcement of social norms.  Keeping people away  -avoidance of disease.
  8. 8. People’s reaction  Bullying  Harassment.  Violence.  Avoidance.  Fear. NAME CALLING:  Crazy  Waived.  Psycho.  Insane.  Loony.  Maniac.
  9. 9. STIGMA CAN-  Cause feelings of - isolation - hopelessness - shame - blame - low self esteem - distress  Creates problem with employment.  Negatively impact housing.
  10. 10. STIGMA CAN…  cause harassment. cause physical violence. Negatively impact community participation. Cause a person to deny the illness. Cause a person not to seek help due to fear of rejection, discrimination ,ridicule. Cause a person to refuse treatment.
  11. 11.  Families are also affected by stigma, leading to a lack of support. For mental health professionals stigma means that they themselves are seen as abnormal, corrupt or evil& psychiatric treatment are often viewed with suspicion & horror.
  12. 12. ATTITUDE OF HEALTH PROFE SSIONALS  Medical students & doctors agree that psychiatric patients are “not easy to like” but the more they learn of the subject the less they stigmatize. Overall the result suggest that medical practitioner hold a range of attitude towards individuals with a psychiatric diagnosis similar to those held by the general public. Practitioners with the most knowledge about mental illness are generally least stigmatizing.
  13. 13.  A 2006 Australian study found that: -nearly one in four people felt depression was sign of personal weakness& would not employ a person with depression. -around a third would not vote for politician with depression. -42%thought people with depression are unpredictable.
  14. 14. -One in five said that if they had depression they would not tell anyone. -Nearly 2 in 3 people surveyed thought people with schizophrenia were unpredictable & a quarter felt that they are dangerous. Some groups are subjected to multiple types of stigma & discrimination at the same time; such as people with intellectual disability or those from a cultural or ethnic minority.
  15. 15. To cope with stigma:  There are ways to cope with stigma related to mental illness: -Surround yourself with supportive people. -Remember-you are NOT your illness. -Remember-treatment works. -Remember you are not alone. -Be hopeful. -Be active. -Remember you & your loved one have choices. -Make sure people know your expectation.
  16. 16. How can we challenge stigma?  Learn & share the facts about mental health & illness.  Get to know people with personal experiences of mental illness.  Speak up in protest when friends,family,colleague or media display false beliefs & negative stereo types.  Offer the same support to people when they are physically or mentally unwell.
  17. 17. How can we challenge stigma…  Don’t label or judge people with a mental illness ; treat them with respect & dignity as you would anyone else.  Don’t discriminate when it comes to participation housing & employment.  Talk openly of your own experience of mental illness The more hidden mental illness remains , the more people continue to believe that it is shameful & need to be concealed.
  18. 18.  Last of all , we want to conclude after mentioning one verse from Holy Quran which is related to stigma, “O you who believe! Let not a group scoff at another group, it may be that the latter are better than the former; nor let (some) women scoff at other women, it may be the latter is better than the former, nor defame one another, nor insult one another by nicknames. How bad is it, to insult one’s brother after having faith”