Stigma towards people with a diagnosis of severe mental disorder in primary healthcare centers: perspectives of service users and health teams in Chile

Pamela Grandón,Sandra Saldivia,Natalia Ulloa-Vidal,Pamela Vaccari,Alexis Vielma-Aguilera,Félix Cova,Víctor Victoriano,Raúl Ramírez-Vielma

doi:10.1186/s13033-020-0340-5

Pamela Grandón, Sandra Saldivia + Show 6 more

Open Access

https://doi.org/10.1186/s13033-020-0340-5

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Abstract

BackgroundStigma towards people diagnosed with a severe mental disorder (SMD) is one of the main obstacles for these service users to receive timely and relevant healthcare. This study was undertaken to understand how stigmatizing attitudes are demonstrated towards people with SMD in primary healthcare centers (PHC) from the perspective of those affected and primary healthcare professionals.MethodsWe used a qualitative exploratory research design to contrast the differences and similarities regarding stigmatizing attitudes towards people with SMD in primary healthcare centers (PHC) from the perspective of two groups: (i) people diagnosed with a severe mental disorder, and (ii) healthcare professionals. Data was collected through semi-structured interviews and discussion groups and subsequently analyzed using Atlas.ti software.ResultsOur results indicate that both service users and healthcare professionals manifest stereotypes, prejudices, and discriminatory behavior in health care. In addition, structural aspects of the health system and organizational culture appear to contribute to stigmatization. Both groups agreed that there is a need for healthcare professionals to have more education, specialization, and skill development related to mental health issues.ConclusionsInterventions to reduce the stigma towards people with SMD in PHC must consider delivery of information about mental disorders, development of skills in the healthcare professionals, and modifications in the culture of the health centers.

Highlights

Stigma is a relational and social process in which negative characteristics are attributed to groups or individuals based on prejudice that leads to discriminatory behavior [1, 2]
The topics for people diagnosed with severe mental disorder (SMD) were: a) Attitudes and behavior of healthcare professionals b) Strategies used by service users to improve their medical attention c) Bureaucracy of the health system
B) Lack of knowledge about mental health c) Stereotype and stigma towards people diagnosed with SMD d) Professional role e) Health system resources

Summary

Introduction

Stigma is a relational and social process in which negative characteristics are attributed to groups or individuals based on prejudice that leads to discriminatory behavior [1, 2]. Healthcare professionals have more negative attitudes towards people diagnosed with SMD than towards service users with other psychiatric diagnoses [16]. Stigma towards people with SMD in healthcare professionals is related to negative experiences with service users, a perception of lacking the skills to manage this population, and a shortage of information and training in mental health [13, 17]. Stigma towards people diagnosed with a severe mental disorder (SMD) is one of the main obstacles for these service users to receive timely and relevant healthcare. This study was undertaken to understand how stigmatiz‐ ing attitudes are demonstrated towards people with SMD in primary healthcare centers (PHC) from the perspective of those affected and primary healthcare professionals

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