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Coping with stigma and discrimination: evidence from mental health service users in England

  • A. Isaksson (a1), E. Corker (a2) (a3), J. Cotney (a4), S. Hamilton (a4), V. Pinfold (a4), D. Rose (a2), N. Rüsch (a5), C. Henderson (a2), G. Thornicroft (a2) and S. Evans-Lacko (a2) (a6)...

Abstract

Aims.

Mental health stigma and discrimination are significant problems. Common coping orientations include: concealing mental health problems, challenging others and educating others. We describe the use of common stigma coping orientations and explain variations within a sample of English mental health service users.

Methods.

Cross-sectional survey data were collected as part of the Viewpoint survey of mental health service users’ experiences of discrimination (n = 3005). Linear regression analyses were carried out to identify factors associated with the three stigma coping orientations.

Results.

The most common coping orientation was to conceal mental health problems (73%), which was strongly associated with anticipated discrimination. Only 51% ever challenged others because of discriminating behaviour, this being related to experienced discrimination, but also to higher confidence to tackle stigma.

Conclusions.

Although stigma coping orientations vary by context, individuals often choose to conceal problems, which is associated with greater anticipated and experienced discrimination and less confidence to challenge stigma. The direction of this association requires further investigation.

Copyright

Corresponding author

*Address for correspondence: A. Isaksson, Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany. (Email: alexandra.isaksson@uniklinik-freiburg.de)

References

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Bos, AER, Kanner, D, Muris, P, Janssen, B, Mayer, B (2009). Mental illness stigma and disclosure: consequences of coming out of the closet. Issues in Mental Health Nursing 30, 509513.
Brohan, E, Gauci, D, Sartorius, N, Thornicroft, G (2011). Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: the GAMIAN-Europe study. Journal of Affective Disorders 129, 5663.
Brohan, E, Clement, S, Rose, D, Sartorius, N, Slade, M, Thornicroft, G (2013). Development and psychometric evaluation of the Discrimination and Stigma Scale (DISC). Psychiatry Research 208, 3340.
Corker, E, Hamilton, S, Henderson, C, Weeks, C, Pinfold, V, Rose, D, Williams, P, Flach, C, Gill, V, Lewis-Holmes, E, Thornicroft, G (2013). Experiences of discrimination among people using mental health services in England 2008–2011. British Journal of Psychiatry 202 (Suppl. 55), s58s63.
Corker, E, Hamilton, S, Robinson, E, Cotney, J, Pinfold, V, Rose, D, Thornicroft, G, Henderson, C (2016). Viewpoint survey of mental health service users’ experiences of discrimination in England 2008–2014. Acta Psychiatrica Scandinavica 134 (Suppl. 446), 613.
Corrigan, PW, Rao, D (2012). On the self-stigma of mental illness: stages, disclosure, and strategies for change. Canadian Journal of Psychiatry 57, 464469.
Corrigan, PW, Kosyluk, KA, Rüsch, N (2013). Reducing self-stigma by coming out proud. American Journal of Public Health 103, 794800.
Evans-Lacko, S, Malcolm, E, West, K, Rose, D, London, J, Rusch, N, Little, K, Henderson, C, Thornicroft, G (2013). Influence of Time to Change's social marketing interventions on stigma in England 2009–2011. British Journal of Psychiatry 202 (Suppl. 55), s77s88.
Henderson, C, Brohan, E, Clement, S, Williams, P, Lassman, F, Schauman, O, Dockery, L, Farrelly, S, Murray, J, Murphy, C, Slade, M, Thornicroft, G (2013). Decision aid on disclosure of mental health status to an employer: feasibility and outcomes of a randomised controlled trial. British Journal of Psychiatry 203, 350357.
Henderson, RC, Corker, E, Hamilton, S, Williams, P, Pinfold, V, Rose, D, Webber, M, Evans-Lacko, S, Thornicroft, G (2014). Viewpoint survey of mental health service users’ experiences of discrimination in England 2008–2012. Social Psychiatry and Psychiatric Epidemiology 49, 15991608.
Holmes, EP, River, LP (1998). Individual strategies for coping with the stigma for severe mental illness. Cognitive and Behavioral Practice 5, 231239.
Holzinger, A, Floris, F, Schomerus, G, Carta, MG, Angermeyer, MC (2012). Gender differences in public beliefs and attitudes about mental disorder in western countries: a systematic review of population studies. Epidemiology and Psychiatric Sciences 21, 7385.
Ilic, M, Reinecke, J, Bohner, G, Hans-Onno, R, Beblo, T, Driessen, M, Frommberger, U, Corrigan, PW (2011). Protecting self-esteem from stigma: a test of different strategies for coping with the stigma of mental illness. International Journal of Social Psychiatry 58, 246257.
Lasalvia, A, Zoppei, S, Van Bortel, T, Bonetto, C, Cristofalo, D, Wahlbeck, K, Bacle, SV, Van Audenhove, C, van Weeghel, J, Reneses, B, Germanavicius, A, Economou, M, Lanfredi, M, Ando, S, Sartorius, N, Lopez-Ibor, JJ, Thornicroft, G (2013). Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381, 5562.
Lasalvia, A, Van Bortel, T, Bonetto, C, Jayaram, G, van Weeghel, J, Zoppei, S, Knifton, L, Quinn, N, Wahlbeck, K, Cristofalo, D, Lanfredi, M, Sartorius, N, Thornicroft, G (2015). Cross-national variations in reported discrimination among people treated for major depression worldwide: the ASPEN/INDIGO international study. British Journal of Psychiatry 207, 507514.
Lewer, D, O'Reilly, C, Mojtabai, R, Evans-Lacko, S (2015). Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors. British Journal of Psychiatry 207, 221226.
Link, B (1989). A modified labeling theory approach to mental disorders: an empirical assessment. American Sociological Review 54, 400423.
Link, BG, Mirotznik, J, Cullen, FT (1991). The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided? Journal of Health and Social Behavior 32, 302320.
Link, BG, Struening, EL, Neese-todd, S, Asmussen, S, Phelan, JC (2002). On describing and seeking to change the experience of stigma. American Journal of Psychiatric Rehabilitation 6, 201231.
Link, BG, Yang, LH, Phelan, JC, Collins, PY (2004). Measuring mental illness stigma. Schizophrenia Bulletin 30, 511541.
Livingston, JD, Boyd, JE (2010). Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Social Science and Medicine 71, 21502161.
Major, B, O'Brien, LT (2005). The social psychology of stigma. Annual Review of Psychology 56, 393421.
Miller, CT, Kaiser, CR (2001). A theoretical perspective on coping with stigma. Journal of Social Issues 57, 7392.
Moses, T (2014). Coping strategies and self-stigma among adolescents discharged from psychiatric hospitalization: a 6-month follow-up study. International Journal of Social Psychiatry, 110.
Rüsch, N, Evans-Lacko, SE, Henderson, C, Flach, C, Thornicroft, G (2011). Knowledge and attitudes as predictors of intentions to seek help for and disclose a mental illness. Psychiatric Services 62, 675678.
Rüsch, N, Abbruzzese, E, Hagedorn, E, Hartenhauer, D, Kaufmann, I, Curschellas, J, Ventling, S, Zuaboni, G, Bridler, R, Olschewski, M, Kawohl, W, Rossler, W, Kleim, B, Corrigan, PW (2014). Efficacy of coming out proud to reduce stigma's impact among people with mental illness: pilot randomised controlled trial. British Journal of Psychiatry 204, 391397.
Sarkin, A, Lale, R, Sklar, M, Center, KC, Gilmer, T, Fowler, C, Heller, R, Ojeda, VD (2015). Stigma experienced by people using mental health services in San Diego County. Social Psychiatry and Psychiatric Epidemiology 50, 747756.
Schibalski, JV, Müller, M, Ajdacic-Gross, V, Vetter, S, Rodgers, S, Oexle, N, Corrigan, PW, Rössler, W, Rüsch, N (2017). Stigma-related stress, shame and avoidant coping reactions among members of the general population with elevated symptom levels. Comprehensive Psychiatry 74, 224230.
Sterne, JA, White, IR, Carlin, JB, Spratt, M, Royston, P, Kenward, MG, Wood, AM, Carpenter, JR (2009). Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. British Medical Journal 338, b2393.
Thornicroft, G, Brohan, E, Rose, D, Sartorius, N, Leese, M (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373, 408415.
Vauth, R, Kleim, B, Wirtz, M, Corrigan, PW (2007). Self-efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia. Psychiatry Research 150, 7180.
Webber, M, Corker, E, Hamilton, S, Weeks, C, Pinfold, V, Rose, D, Thornicroft, G, Henderson, C (2014). Discrimination against people with severe mental illness and their access to social capital: findings from the Viewpoint survey. Epidemiology and Psychiatric Sciences 23, 155165.
Webber, MP, Huxley, PJ (2007). Measuring access to social capital: the validity and reliability of the Resource Generator-UK and its association with common mental disorder. Social Science and Medicine 65, 481492.

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