Challenge Stigma Research Articles

Student nurse perceptions of experiential learning to understand personality disorder

People with personality disorder diagnoses have been described as a challenging group to work with, and this has led to negative perceptions and stigmatisation of the clinical label. A hypothesis that these negative perceptions are rooted in a lack of empathy, directly related to a lack of understanding of the lived experience of these conditions, led to the development of a teaching session using experiential learning. The session used simulation to allow students to adopt the role of a person diagnosed with a personality disorder and interact in a facilitated scenario. A qualitative and phenomenological design saw the perceptions of four student nurses captured through a focus group and interview. Students described the teaching session as beneficial in having improved their empathy and increased their understanding of the experience of people living with personality disorder diagnoses, allowing them the understanding to be able to challenge stigma, giving them a desire to role model good practice to others and increasing their confidence in working with people with personality disorder diagnoses. This has clear implications for practice through increasing understanding and reducing the potential for negative perceptions, thus potentially improving the experience of mental health care for people with personality disorders.

Current approaches to HIV prevention, treatment and care.

Acquired immune deficiency syndrome (AIDS) was first labelled as a new illness in 1981; it took two more years to discover a causative virus, which was named human immunodeficiency virus (HIV) in 1985. Nurses who practised during those times may recall the fear, panic, stigma, ethical dilemmas and refusals to care that were associated with the pandemic. Four decades later, HIV can be considered a long-term condition rather than a life-limiting disease, as a result of developments in treatment. However, the UK has the highest number of people living with the virus since the pandemic was first identified, and there remains a need to challenge stigma and prejudice in relation to HIV and AIDS, to ensure that people receive timely access to HIV testing, treatment and preventive measures. This article explores the role of nurses in all areas of practice in preventing onward transmission of HIV, providing treatment and patient education, and promoting the well-being of people living with HIV.

Integration of Pediatric Behavioral Health Services in Primary Care: Improving Access and Outcomes with Collaborative Care.

To examine collaborative care interventions to integrate pediatric mental health services into primary care as a means of addressing barriers to mental health service delivery, improving access to care, and improving health outcomes. Selective review of published literature addressing structural and attitudinal barriers to behavioural health service delivery and the integration of behavioural health services for pediatric mental problems and disorders into primary care settings, with a special focus on Canadian and U.S. Integration of pediatric behavioural health services in primary care has potential to address structural and attitudinal barriers to care delivery, including shortages and the geographical misdistribution of behavioural health specialists. Integration challenges stigma by communicating that health cannot be compartmentalized into physical and mental components. Stepped collaborative care interventions have been demonstrated to be feasible and effective in improving access to behavioural health services, outcomes, and patient and family satisfaction relative to existing care models. Collaborative integration of behavioural health services into primary care is a promising means of improving access to care and outcomes for children and adolescents struggling with mental problems and disorders. Dissemination to real-world practice settings will likely require changes to existing models of reimbursement and the culture of health service delivery.

Death, contagion and shame: The potential of cancer survivors' advocacy in Zambia

ABSTRACTCancer has become a global health concern with marked differences in the incidence and mortality rates between developing and developed countries. Understanding the factors that shape uptake of preventative and screening services is the key. We use in-depth interviews with 13 Zambian urban-based female cancer survivors to explore the facilitators and barriers to screening, diagnosis and treatment, with a particular focus on cultural influences. We identified a central theme (i.e. a story told about cancer) in all of the interviews: ‘cancer is a death sentence’. Most women referenced this theme to describe their own, their family members', or community members' reactions to their diagnosis, along with references to cancer as ‘contagious’ and ‘a shameful illness’. We also identified a theme entitled ‘survivors as advocates’, within which women described engaging in advocacy work to challenge stigma, misconceptions and misinformation about cancer; and advocating early detection and diagnosis, compliance with medical treatment and the sharing of success stories. This analysis points to the need for survivors to be front and center of preventative efforts. Their personal experiences, legitimacy and connections in the community, and their enthusiasm in helping others should be fostered, particularly in low-resource settings.

Reclaim the Menopause: A pilot study of an evidence-based menopause course for symptom management and resilience building.

Reclaim the Menopause is a community-based menopause course developed by Hands Inc. and supported by Hackney Learning Trust. The course provides evidence-based education, cognitive behaviour therapy and psychosocial support to promote menopause awareness, challenge stigma and increase self-management amongst menopausal women. Ethnicity was an important aspect of the work, as Hands Inc. was keen to reach women who might not otherwise access interventions. All course participants were Black British (as were two of the three facilitators). Course attendees reported reduced menopausal symptoms as well as improvements in mood and the quality of their lives.

Challenging stigma in mental health care: The power of compassion in your community

Challenging stigma in mental health care: The power of compassion in your community

Discourse in Action: Parents’ use of medical and social models to resist disability stigma

Discourse in Action: Parents’ use of medical and social models to resist disability stigma

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

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. 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. 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. 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.

Are social networks useful to challenge stigma attached to mental disorders? Findings from the time to change social marketing campaign 2009–2014

Are social networks useful to challenge stigma attached to mental disorders? Findings from the time to change social marketing campaign 2009–2014

Popular television and public mental health: creating media entertainment from mental distress

This paper explores how tensions and power differentials within public mental health interact with the practices of media production in entertainment television. I present the findings of a qualitative study involving semi-structured interviews with story consultants from mental health organisations and Senior Executives, Producers and script-writers from UK television series (n = 14). Story advisors welcome the opportunity to reach larger and younger audiences in distinct ways and to share the ‘lived experience’ of mental distress through well-researched characters. They accept their relative lack of power to negotiate dramatic storylines which conflate mental distress with criminality and may undermine their anti-stigma ideals. The ‘medical model’ is prioritised in mainstream television drama and the causes of mental distress framed in biomedical terms. Storylines tend to emphasise the certain benefits of medication and marginalise self-management of conditions. Television industry professionals recognise their anti-stigma public service role and are receptive to working with programme consultants to help create authentic characters. Perceptions of the nature of drama as requiring resolution may help to explain the principal focus on biomedical conceptualisations of mental distress. Medication provides a relatively simple on-screen solution to resolve complex stories. Entertainment television operates within limited ideological frames. Mental distress and stigma are addressed at an individual, not collective level. Debates within the survivor movement and public mental health concerning medication, treatment and recovery tend to be obscured. These might provide a productive alternative vein of storytelling that could broaden our understanding of the social meaning of suffering and thus help challenge stigma.

Visibility, respectability, and disengagement: The everyday resistance of mothers with disabilities

Visibility, respectability, and disengagement: The everyday resistance of mothers with disabilities

Improving exchange with consumers within mental health organizations: Recognizing mental ill health experience as a 'sneaky, special degree'.

Stigmatizing views towards consumers may be held even by those working within mental health organizations. Contemporary mental health policies require organizations to work collaboratively with consumers in producing and delivering services. Using social exchange theory, which emphasises mutual exchange to maximise benefits in partnership, the current study explores the perspectives of those working within organizations that have some level of consumer leadership. Interviews were conducted with 14 participants from a range of mental health organizations. Data were transcribed, and analyzed using thematic analytic and discursive psychological techniques. Findings suggest stigma is still prevalent even in organizations that have consumers in leadership positions, and consumers are often perceived as less able to work in mental health organizations than non-consumers. Several discourses challenged such a view - showing how consumers bring value to mental health organizations through their expertise in the mental health system, and their ability to provide safety and support to other consumers. Through a social exchange theory lens, the authors call for organizations to challenge stigma and promote the value that consumers can bring to maximize mutual benefits.

The impact of social marketing campaigns on reducing mental health stigma: Results from the 2009–2014 Time to Change programme

The impact of social marketing campaigns on reducing mental health stigma: Results from the 2009–2014 Time to Change programme

Stigma and the Structure of Title IX Compliance

This article analyzes the relationship between the structure of federal Title IX investigations and the existing evidence addressing the emotional and mental health needs of sexual harassment and sexual assault victims. The article argues that federal requirements for investigating sexual harassment should be restructured so as to address the challenges stigma poses for the realization of Title IX's objectives.

Early intervention for stigma towards mental illness? Promoting positive attitudes towards severe mental illness in primary school children

Purpose Stigma towards severe mental illness (SMI) is widespread, exacerbating mental health problems, and impacting on help-seeking and social inclusion. Anti-stigma campaigns are meeting with success, but results are mixed. Earlier intervention to promote positive mental health literacy rather than challenge stigma, may show promise, but little is known about stigma development or interventions in younger children. The purpose of this paper is to investigate children’s knowledge, attitudes and behaviour towards SMI and whether we can positively influence children’s attitudes before stigma develops. Design/methodology/approach A cross-sectional study investigated mental health schema in 7-11 year olds. An experimental intervention investigated whether an indirect contact story-based intervention in 7-8 year olds led to more positive mental health schema. Findings Young children’s schema were initially positive, and influenced by knowledge and contact with mental illness and intergroup anxiety, but were more stigmatising in older girls as intergroup anxiety increased. The indirect contact intervention was effective in promoting positive mental health schema, partially mediated by knowledge. Social implications Intervening early to shape concepts of mental illness more positively, as they develop in young children, may represent a more effective strategy than attempting to challenge and change mental health stigma once it has formed in adolescents and adults. Originality/value This study is the first to investigate an intervention targeted at the prevention of stigma towards SMI, in young children, at the point that stigma is emerging.

Sympathy, shame, and few solutions: News media portrayals of fetal alcohol spectrum disorders

Sympathy, shame, and few solutions: News media portrayals of fetal alcohol spectrum disorders

Virtual voices: social support and stigma in postnatal mental illness Internet forums

Many women with postnatal mental illness do not get the treatment they need and this is often because stigma prevents disclosure. The purpose of this study was to explore online social support for postnatal mental illness, how women experience stigma and potential disadvantages of using Internet forums. Interviews were conducted with fifteen participants who had suffered postnatal mental illness and had used forums. Systematic thematic analysis identified common themes in relation to social support, stigma and disadvantages of using forums. Most women felt they benefited from visiting forums by developing a shared understanding and discourse about their illness. Findings suggest future research should investigate if women benefit from using online social support provided by forums, if use challenges stigma and further explore potential concerns about using forums.

STIs/HIV Stigma and health: A short review

STIs/HIV Stigma and health: A short review

An unlikely hero? Challenging stigma through community engagement

Purpose – The purpose of this paper is to describe a high-profile social enterprise in Blackpool, England, called Jobs, Friends and Houses (JFH) that has created a visible social identity of recovery and meaningful activity, to assess how stigma is challenged through active and visible community engagement. Design/methodology/approach – Case study based on in-depth individual interview and focus group, supplemented by participant in-depth interviews. Findings – The paper describes one particular incident in which a worker at JFH intervened in a violent attack, possibly saving a woman’s life. The paper describes the experiences of internalised stigma and external exclusion being challenged by the development of a positive social identity and a pro-social community role that has high visibility. Data are presented showing the strong social identity experienced by participants and recognised by external stakeholders. Research limitations/implications – This is a pilot study which uses an opportunistic design and much stronger longitudinal designs will be needed to address the issues raised in the paper. Social implications – The paper argues that the visibility of the pro-social identity has been central to challenging stereotypes and discriminating attitudes and suggests that a social identity approach may be central to generating and sustaining a recovery community and to confronting and reversing long-held stigmatised attitudes. Originality/value – The paper is important as it discusses the impact of recovery through engagement in meaningful activities that challenge stigma and exclusion through work. The paper is framed in terms of a social identity model of recovery.

Stigma, activism, and well-being among people living with HIV

ABSTRACTEvidence demonstrates that HIV stigma undermines the psychological and physical health of people living with HIV (PLWH). Yet, PLWH describe engaging in HIV activism to challenge stigma, and research suggests that individuals may benefit from activism. We examine associations between experiences of HIV stigma and HIV activism, and test whether HIV activists benefit from greater well-being than non-activists. Participants include 93 PLWH recruited from drop-in centers, housing programs, and other organizations providing services to PLWH in the Northeastern USA between 2012 and 2013 (mean age = 50 years; 56% Black, 20% White, 18% Other; 61% non-Latino(a), 39% Latino(a); 59% male, 38% female, 3% transgender; 82% heterosexual, 15% sexual minority). Participants completed a cross-sectional written survey. Results of regression analyses suggest that PLWH who experienced greater enacted stigma engaged in greater HIV activism. Anticipated, internalized, and perceived public stigma, however, were unrelated to HIV activism. Moreover, results of a multivariate analysis of variance suggest that HIV activists reported greater social network integration, greater social well-being, greater engagement in active coping with discrimination, and greater meaning in life than non-activists. Yet, HIV activists also reported somewhat greater depressive symptoms than non-activists, suggesting that the association between HIV activism and well-being is complex. By differentiating between HIV stigma mechanisms, the current study provides a more nuanced understanding of which experiences of HIV stigma may be associated with HIV activism. It further suggests that engagement in activism may offer benefits to PLWH, while raising the possibility that activists could experience greater depressive symptoms than non-activists. Given the preliminary nature of this study, future research should continue to examine these complex associations between HIV stigma, activism, and well-being among PLWH. As this work continues, PLWH, as well as interventionists and clinicians invested in improving well-being among PLWH, should carefully weigh the benefits and potential costs of activism.