Abstract
Background: Reducing the stigma surrounding mental illness is a global public health priority. Traditionally, anti-stigma campaigns were led by mental health professionals/organisations and had an emphasis on increasing mental health literacy. More recently, it has been argued that people with lived experience have much to contribute in terms of extending and strengthening these efforts. The purpose of this paper was to elicit views and suggestions from people with lived experience (PWLE) as well as from informal caregivers of people with mental health conditions, on effective strategies to combat the stigma surrounding mental illness. Methods: Six focus group discussions (FGDs) were carried out with PWLE recruited at outpatient services at the Institute of Mental Health, Singapore, and five FGDs were carried out with informal caregivers who responded to advertisements for the study between March and November 2018. In all, the sample comprised 42 PWLE and 31 caregivers. All the FGDs were transcribed verbatim and were analysed using thematic analysis. A pragmatic approach was adopted for the study, and the researchers did not assume any particular philosophical orientation. Results: Four overarching themes depicting strategies to combat stigma were identified through thematic analysis. They were (1) raising mental health awareness, (2) social contact, (3) advocacy by influential figures or groups, and (4) the legislation of anti-discriminatory laws. Conclusions: These strategies were in line with approaches that have been used internationally to disrupt the process of stigma. Our study has further identified nuanced details on how these strategies can be carried out as well as possible areas of priority in the Singapore landscape.
Highlights
The stigma of living with a mental health condition has been described as being worse than the experience of the illness itself [1]
The aversive reactions that members of the general population have towards people with mental illness is known as public stigma and can be understood in terms of (i) stereotypes, (ii) prejudice, and (iii) discrimination
Beyond the interpersonal manifestations of public stigma towards people with mental health conditions, societal-level conditions such as institutional policies and practices and cultural norms have been found to be biased against people with mental health conditions, resulting in a lack of opportunities and resources being afforded to them [4]
Summary
The stigma of living with a mental health condition has been described as being worse than the experience of the illness itself [1]. Beyond the interpersonal manifestations of public stigma towards people with mental health conditions, societal-level conditions such as institutional policies and practices and cultural norms have been found to be biased against people with mental health conditions, resulting in a lack of opportunities and resources being afforded to them [4]. These socio-political disinclinations, known as structural stigma, result in people with mental health conditions being excluded from employment, living in unstable and unsafe. The purpose of this paper was to elicit views and suggestions from people with lived experience (PWLE) as well as from informal caregivers of people with mental health conditions, on effective strategies to combat the stigma surrounding mental illness.
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