Abstract

Stigmatizing attitudes toward persons with mental syndromes are prevalent in the general population and even among mental health professionals, a problem that may result easily in public avoidance, constant discrimination, and declined help-seeking behavior. The effect of stigma is twofold: Public stigma is the response that the public has to people with mental disorder. Self-stigma is the bigotry which persons with mental disorder turn against themselves. The WHO has advised that stigma is one of the largest barricades to treatment engagement, even if management is operative, even in low-income nations. While before and according to a series of researches the outcome of severe mental illness is generally better in developing societies than in developed countries, and it has been suggested that stigma is less severe or non-existent in unindustrialized nations, the current studies and observations do not confirm such an optimistic hint and the idea that stigma attached to mental illness is a global phenomenon seems a reasonable inference. In the present article, the issue of stigmatization, deinstitutionalization, national goal setting, and real situation of various modules of psychiatric rehabilitation, in the context of social or public psychiatry, especially in developing countries, is discussed, from a practical point of view.

Highlights

  • A mental disorder is a “clinically significant behavioral or psychological disorder that occurs in a person and that is associated with present distress or disability or with a meaningfully increased risk of suffering death, pain, disability, or an important loss of freedom,” which results from “a manifestation of a behavioral, psychological, or biological dysfunction in the individual” [1]

  • Stigmatizing attitudes toward persons with mental syndromes are prevalent in the general population and even among mental health professionals, a problem that may result in public avoidance, constant discrimination, and declined help-seeking behavior

  • While before and according to a series of researches the outcome of severe mental illness is generally better in developing societies than in developed countries, and it has been suggested that stigma is less severe or non-existent in unindustrialized nations, the current studies and observations do not confirm such an optimistic hint and the idea that stigma attached to mental illness is a global phenomenon seems a reasonable inference

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Summary

Introduction

A mental disorder is a “clinically significant behavioral or psychological disorder that occurs in a person and that is associated with present distress or disability or with a meaningfully increased risk of suffering death, pain, disability, or an important loss of freedom,” which results from “a manifestation of a behavioral, psychological, or biological dysfunction in the individual” [1]. Self-stigma is the bigotry which persons with mental disorder turn against themselves Both public and self-stigma may be assumed in terms of three elements: stereotypes, prejudice, and discrimination [3]. Stigmatization of people with mental disorders may result in public evading, steady discrimination, and declined help-seeking behavior. Powerful groups in society impose stereotypically negative labels on those they suppose unwelcome, whom they later devalue and discriminate [9]. This conceptualization of stigma corresponds with a social psychology standpoint that stigmatization links with human cognition via stereotyping and prejudices [10]. Self-stigma theory further postulates that some, among the socially devalued and discriminated patients, internalize public stigma by underestimating themselves and unsuitably changing their behavior and approaches [12]. It is important to understand that these dimensions can either present independently or simultaneously to create stigma [17]

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