Stigma Reduction Programs Research Articles

A psychometric evaluation of the Opening Minds Scale for Workplace Attitudes (OMS-WA), a measure of public stigma towards mental illnesses in the workplace

The anti-stigma Opening Minds initiative (Mental Health Commission of Canada) identified the workplace as one of four critical areas for stigma evaluation and programming. Researchers found, however, that no validated tool to measure stigma in this context existed at the time. The purpose of the current research was to develop and assess the psychometric properties of a multi-component quantitative measure of public stigma towards mental illnesses in the workplace: Opening Minds Scale for Workplace Attitudes (OMS-WA). Three studies are discussed. Study 1 outlines the initial development of the OMS-WA, finding a five-factor structure with 23 items (EFA analysis; N = 207). Study 2 utilized employees from various businesses to further validate the OMS-WA, (N = 107), finding good internal consistency and good convergent/divergent validity. Study 3 utilized baseline data from two national large-scale stigma reduction and resiliency programs (first responders and general workplaces) to confirm the factor structure, finding good model fit and reliability with both samples (N = 5385; N = 1207). Together, these results provide strong evidence of the OMS-WA. Its use in measuring workplace stigma related to mental illness is recommended. Considerable future evaluation is warranted, and directions for generalizability studies, as well as suggestions for using the OMS-WA in intervention trials, are provided.

Stigmatizing intimate relationships in schizophrenia: a study comparing mental health professionals, health students and the general population

Background Discrimination in intimate relationships (IR) is frequently reported among persons with schizophrenia. Despite ongoing effort of international organizations to combat mental illness stigma, there remain a limited understanding of specific IR-related stereotypes. Aims The study aimed to i) identify the stereotypes related to IR of persons with schizophrenia held by Mental Health Professionals (MHP), health students and the general population, and ii) explore the effects of several factors associated with these stereotypes. Methods This study used a mixed-methods approach. A survey developed collaboratively with persons with lived experience of mental health conditions (PWLE) was disseminated among MHP, health students and the general population. Results The majority of the nine IR-related stereotypes previously identified by PWLE were endorsed by the participants (N = 532). PWLE were perceived as particularly incompetent in the domain of IR (e.g. to achieve couple project). Stereotypes endorsement varied among the groups. Continuum beliefs, perceived similarities and recovery beliefs were negatively associated with stereotype endorsement. Conclusions The general population, MHP and health students endorsed several stereotypes regarding IR of persons with schizophrenia. The results provide support for the role of theoretical beliefs in IR stigmatization, suggesting they may be relevant targets for evidence-based stigma reduction programs.

Analysis and mapping of harm reduction research in the context of injectable drug use: identifying research hotspots, gaps and future directions

BackgroundHarm reduction is a crucial approach in addressing the multifaceted challenges of injectable drug use. This paper presents an analysis and mapping of the existing literature on harm reduction research in the context of injectable drug use. By reviewing a comprehensive set of scholarly articles, this study identifies research hotspots, knowledge gaps, and future directions in the field. The findings provide valuable insights for researchers, policymakers, and practitioners to guide future research efforts and inform evidence-based harm reduction interventions.MethodsData for the study was obtained from the Scopus database, using keywords and phrases related to harm reduction and injectable drug use. Validation methods were employed to verify the accuracy and comprehensiveness of the search strategy. Data analysis involved identifying growth patterns, key contributors, mapping frequent terms, identifying research hotspots, and identifying emerging research directions.ResultsA total of 971 articles were found, with a notable increase from 2015 to 2022. The International Journal of Drug Policy (n = 172, 17.7%) and the Harm Reduction Journal (n = 104, 10.7%) were the most prolific journals, and the United States (n = 558, 57.5%) had the highest number of publications. The Johns Hopkins University (n = 80, 8.5%) was the most prolific institution. Mapping of frequent author keywords revealed the main keywords, including harm reduction, HIV, hepatitis C, and opioid overdose. The highly cited articles cover a broad time span and focus on topics like naloxone distribution, HIV and hepatitis C transmission, while recent articles concentrate on emerging issues such as the impact of the COVID-19 pandemic, fentanyl-related concerns, stigma reduction, and needle and syringe programs. Both sets of articles share a common focus on harm reduction strategies, but recent publications highlight current challenges and developments in the field.ConclusionsThis study provides insights into research landscape on harm reduction in injectable drug use. Research is concentrated in high-income countries, emphasizing the need for more research in low- and middle-income countries. Recent publications focus on emerging challenges like COVID-19 and fentanyl. Research gaps highlight the need for studies in diverse populations, social determinants, program evaluation, and implementation strategies to enhance harm reduction interventions.

Stigma of mental health and attitude towards psychological help-seeking behaviour among students of a health science institute in Karnataka: a cross-sectional study

Background: Mental health illnesses are becoming a prime cause of concern among young adults. Many individuals with mental disorders do not get the necessary health care. Objectives: To assess the attitude towards seeking professional psychological help and stigma of mental illness among the students of a health science institute, to assess the association between stigma and attitude towards seeking psychological help with select socio demographic variables and to determine the correlation between attitude towards seeking professional psychological help and stigma of mental illness. Methods: A cross-sectional study was done on 215 students in Karnataka. The study tool consisted of questionnaires on socio-demographic profile and two sets of validated scales (Attitude Toward Seeking Professional Psychological Help Scale and Perceived Devaluation Discrimination Scale). Results: The study showed males had more positive attitude towards seeking professional psychological help than females. Individuals with history of present/past illness were more open towards seeking professional psychological help. Pearson correlation test between ATSPPHS and PDDS showed a negative correlation. Conclusions: Psychological help seeking attitude needs to be improved among the students. Educational institutes need to incorporate mental health awareness and stigma reduction program in their curriculum.

Examining the association between perceived stigma, its correlates, and restrictions in participation among persons with disabilities in Nepal: a cross-sectional study

BackgroundDisability stigma in low- and middle-income countries is one of the most persistent and complex barriers limiting persons with disabilities (PwDs) from enjoying their rights and opportunities. Perceived stigma among PwDs and its impact on participation restriction is rarely assessed in Nepal.ObjectiveThis study aimed to measure the extent of perceived stigma by PwDs, identify its relationships with specific demographic factors, and assess the impact on social participation.MethodsA cross-sectional survey was conducted between May and July 2022 among PwDs in Nepal, with a sample of 371. The Explanatory Model Interview Catalog (EMIC) stigma scale and P-scale suitable for people affected by stigmatized conditions were used, and the generated scores were analyzed. One-way ANOVA was performed to determine group differences for sociodemographic variables, and linear regression and correlational analysis were used to identify their association and measure the strength and direction of the relationship.ResultsThe mean stigma score was 16.9 (SD 13.8). 42% of respondents scored higher than the mean. The scores differed significantly by disability type, caste and ethnicity, education, occupation, and household wealth. Over 56% reported participation restriction, and 38% had severe/extreme restriction. Approximately 65% of participants with intellectual disabilities, 53% with multiple disabilities, and 48.5% of persons with severe or profound disabilities experienced severe or extreme restrictions. Perceived stigma had a positive correlation with Disability type (r = 0.17, P < 0.01) and negative correlations with Severity of disability (r= -0.15, P < 0.05), and Household wealth (r= -0.15, P < 0.01). Education was inversely associated with both stigma (r= -0.24, P < 0.01), and participation restriction (β= -9.34, P < 0.01). However, there was no association between stigma and participation restriction (β= -0.10, P > 0.05).ConclusionAll participants exhibited stigma in general; however, the severity varied based on disability type, level of education, and sociocultural circumstances. A large proportion of participants reported facing a high degree of restrictions in participation; however, no association was detected between perceived stigma and participation restriction. A significant negative linear correlation was observed between education and participation restriction. Stigma reduction programs focusing on education and empowerment would be especially important for overcoming internalized stigma and increasing the participation of PwDs.

Interventions for Reduction of Stigma in People with Schizophrenia: A Systematic Review and Meta-analysis

People with schizophrenia experienced a higher level of internalized stigma compared to people with other mental disorders. Internalized stigma could lead to pervasive negative effects in their life. Although internalized stigma interventions have shown some benefits, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness in people with schizophrenia. This study aims at examining the effectiveness of internalized stigma reduction in people with schizophrenia through a systematic review and meta-analysis. Two electronic databases were searched. Studies were included if they (1) involved community or hospital-based interventions on internalized stigma, (2) included participants who were given a diagnosis of schizophrenia, and (3) were empirical and quantitative in nature. Thirteen articles were selected for extensive review and seven for meta-analysis. A variety of psychosocial interventions were utilized with the majority employing psychoeducation, cognitive behavioral therapy (CBT), social skills training, hope instillation program, and against stigma program. The internalized stigma was used to examine the efficacy of the intervention. Seven studies involving a total of 799 patients were included in the meta-analysis. Assuming a random effects model, the meta-analysis revealed an improvement in internalized stigma favoring the internalized stigma intervention (95% confidence interval [0.492; 1754], P = 0.001), but the heterogeneity among individual effect sizes was substantial (I 2 = 93.20%). Most internalized stigma reduction programs appear to be effective. This systematic review was unable to show light in indicating the most effective intervention, however, demonstrates evidence that psychoeducation is promising. Large-scale randomized control trials and multicomponents of intervention are required to further develop the evidence based of more targeted interventions.

COVID-19 Linked Social Stigma Among Arab Survivors: A Cross-Sectional Experiences from the Active Phase of the Pandemic.

This study aimed to explore the magnitude and variability of the disease-linked stigma among COVID-19 survivors and their experiences of social stigma, coping strategies, contextual challenges, and preferences for support. An Arabic version of the social stigma survey questionnaire was designed and validated to obtain socio-demographic characteristics and quantitative measures of stigma encountered by the survivors. 482 COVID-19 survivors completed the survey, and the data were analyzed using descriptive statistics and thematic analysis. The results of this study revealed the prevalence of high levels of both perceived external stigma and enacted stigma among participants. Enacted and Internalized stigma were associated with survivors' educational background/ status. The participants suggested three levels of support: organizational, social, and personal. Establishing an online stigma reduction program and national psychological crisis interventions at the organizational level. It is crucial to assist coping mechanisms and societal reintegration techniques at the social level. These results provide valuable insights for holistic health policy formation and preparedness strategies for future pandemics, helping survivors promote health and reintegrate into society, where stigma reduction and psychological crisis interventions are underdeveloped.

Occupational burnout and public stigma associated with employee mental well-being: A multi-industry, cross-sectional study during COVID-19.

While mental illness (e.g., depression, anxiety) has been examined frequently in the workplace, the COVID-19 pandemic has only increased the attention towards mental illness. Mental well-being views mental health as a continuum from ill health to thriving. Few studies have examined factors associated with mental well-being in the workplace. Public stigma for mental illness, the general population's negative attitude towards mental illness, and occupational burnout are examined. The purpose of this study was to examine the relationship between burnout and public stigma on mental well-being in a sample of employees across industries in the United States. Employees surveyed from 16 companies from various industries were assessed. Room Here, a non-profit organization whose goal is to improve employee mental fitness, gathered data from these companies located in the western mountain region of the U.S. Data were collected during the pandemic. Across this portfolio of companies, 259 employees were included in the sample. Survey assesses respondents' mental well-being, stigma towards mental illness, and occupational burnout. Ordinary least squares (OLS) regression was used in this cross-sectional study on secondary data. Results suggested occupational burnout was associated with a decrease in mental well-being, while public stigma was associated with an improvement in mental well-being. This study sought to examine the relationship between mental well-being, burnout, and public stigma. Employee burnout and public stigma were related to mental well-being. Implications for burnout and stigma reduction programs are discussed as well as future research.

Longitudinal impact of experienced discrimination on mental health among people with mental disorders

The present study examined the longitudinal impact of stigma on mental health among people with mental disorders. Specifically, this study tested whether higher levels of experienced discrimination would be longitudinally associated with lower levels of symptomatic remission, functional restoration, well-being, and life satisfaction and whether these associations would be mediated by higher levels of self-stigma content and process. A total of 202 people with mental disorders completed questionnaires at three time points (i.e., T1, T2, and T3) over two years. Path analyses showed that experienced discrimination at T1 was positively associated with self-stigma content and process at T2, which were, in turn, negatively associated with symptomatic remission, functional restoration, well-being, and life satisfaction at T3. Bootstrap analyses further revealed that experienced discrimination at T1 had indirect effects on symptomatic remission, functional restoration, well-being, and life satisfaction at T3 through self-stigma content and process at T2. This study shows that experienced discrimination may exacerbate self-stigma content and process and, in turn, impede recovery and wellness among people with mental disorders. Our findings highlight the importance of designing and implementing stigma and self-stigma reduction programs in order to enable people with mental disorders to attain mental illness recovery and positive mental health.

Challenges to the provision of home care and support for people with severe mental illness: Experiences and perspectives of patients, caregivers, and healthcare providers in Dar es Salaam, Tanzania.

A balance between hospital-based and community-based services is needed to effectively provide mental health services for people with mental illness. As an essential part of community mental health services, home-based care plays an important role in meeting patients' needs, and should, therefore, be appropriately provided. To achieve this, there is a need to understand the challenges faced and take relevant actions to address them. This study aimed to explore challenges to home care and support for people with mental illness in Temeke district, Dar es Salaam. We used a descriptive qualitative study approach to explore challenges to home care and support for people with mental illness among patients, their caregivers, and healthcare providers. The purposeful sampling method was used to recruit participants at Temeke hospital, data was collected using in-depth interviews and focus group discussions, and analysis was performed using a content analysis framework. Four main themes highlighting challenges encountered in the provision of home care and support for individuals with mental illness were revealed. They include poor understanding of mental illness, abandonment of patients' care responsibilities, disputes over preferred treatment, and lack of outreach services for mental health. Participants also provided suggestions to improve home care and support for people with mental illness. Home care for people with mental illness is affected by poor knowledge of the mental illness, social stigma, and lack of outreach visits. There is a need for the provision of health education regarding mental illness, stigma reduction programs, and funding and prioritization for outreach home visits to improve home care and support for people with mental illness. Further research is needed to determine the magnitude of these challenges and factors that can facilitate the provision of support in similar settings.

A Game-Based School Program for Mental Health Literacy and Stigma on Depression (Moving Stories): Cluster Randomized Controlled Trial.

Depressive symptoms are highly prevalent among adolescents in Western countries. However, although treatment for depressive symptoms is available, many adolescents do not seek help when they need it. Important barriers to help-seeking among adolescents include low mental health literacy and high stigma. Therefore, we have developed a game-based school program, Moving Stories, which combines mental health literacy training for depression with contact with someone with lived experience both in the digital and nondigital world. The aim of this study is to conduct a first test of the effectiveness of the newly developed game-based program, Moving Stories, using a cluster randomized controlled trial. A total of 185 adolescents participated, divided over 10 classes from 4 schools. Half of the classes were randomly selected to follow the Moving Stories program, whereas the other half were in the control group, where no intervention was provided. The adolescents filled out digital questionnaires at 4 time points, with questions on mental health literacy, stigma, depressive symptoms, and the program itself (before the program, after the program, 3-month follow-up, and 6-month follow-up). Using R (R Foundation for Statistical Computing), we ran linear mixed-effects models for all continuous outcome variables and generalized linear mixed-effects models for all binary outcome variables. Compared with the control group, participants in the Moving Stories group improved after the program in personal stigma (b=-0.53, 95% CI -1.02 to -0.03; t179.16=-2.08; P=.04). Effects on personal stigma lasted over time (3-month follow-up: b=-0.57, 95% CI -1.11 to -0.03; t174.39=-2.07; P=.04). Most adolescents in the Moving Stories group participated in the introduction (97/99, 98%) and contact session (93/99, 94%), played the game for 4 or 5 days (83/99, 83%), and indicated that they would recommend the game to their peers (90/98, 92%). The results of this study show the potential of Moving Stories as a stigma reduction program. With changes in the program to improve its effects on mental health literacy, Moving Stories could be implemented in schools to improve help-seeking in adolescents and reduce the negative consequences and burden of depressive symptoms. Dutch Trial Register NTR7033; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7033. RR2-10.2196/11255.

Applying Theoretical Perspectives and Activism to Understand and Combat Mental Health Stigma

Mental health-related stigma results in individual, communal, and societal consequences such as stereotypical thoughts, prejudiced feelings and attitudes, discriminatory behaviours, social injustice, and inequity toward individuals with mental health issues. As a result, individuals living with mental illness often experience decreased self-esteem, loss of identity, isolation, exacerbated mental illness, internalized self-stigma, housing and employment discrimination, academic challenges, and barriers in various aspects of life. Research indicated that stigma continues to persist despite increased knowledge about mental health, expanded treatment options, and an abundance of mental health promotion and stigma reduction programs. Thus, we must further examine mental health-related stigma from various theoretical conceptualizations to understand its persistence. This paper applied two theoretical frameworks: Social Learning Theory and Sociological Imagination Theory to better understand mental health stigma. It argues that activism aids in reducing mental health stigma. This paper also suggests that program developers of future mental health stigma reduction efforts should apply activism into their initiatives to promote social justice and equity for people living with mental disorders.

Using a mixed-methods approach to adapt an HIV stigma reduction to address intersectional stigma faced by men who have sex with men in Ghana.

IntroductionIn Ghana, men who have sex with men (MSM) are estimated to be 11 times more likely to be living with HIV than the general population. Stigmas at the intersection of HIV, same‐sex and gender non‐conformity are potential key drivers behind this outsized HIV disease burden. Healthcare workers (HCWs) are essential to HIV prevention, care and treatment and can also be sources of stigma for people living with HIV and MSM. This article describes the process and results of adapting an evidence‐based HIV stigma‐reduction HCW training curriculum to address HIV, same‐sex and gender non‐conformity stigma among HCWs in the Greater Accra and Ashanti regions, Ghana.MethodsSix steps were implemented from March 2020 to September 2021: formative research (in‐depth interviews with stigma‐reduction trainers [n = 8] and MSM living with HIV [n = 10], and focus group discussions with HCWs [n = 8] and MSM [n = 8]); rapid data analysis to inform a first‐draft adapted curriculum; a stakeholder adaptation workshop; triangulation of adaptation with HCW baseline survey data (N = 200) and deeper analysis of formative data; iterative discussions with partner organizations for further refinement; external expert review; and final adaptation with the teams of HCWs and MSM being trained to deliver the curriculum.ResultsKey themes emerging under four immediately actionable drivers of health facility intersectional stigma (awareness, fear, attitudes and facility environment) informed the adaptation of the HIV training curriculum. Based on the findings, existing curriculum exercises were placed in one of four categories: (1) Expand—existing exercises that needed modifications to incorporate deeper MSM and gender non‐conformity stigma content; (2) Generate—new exercises to fill gaps; (3) Maintain—exercises to keep with no modifications; and (4) Eliminate—exercises that could be dropped given training time constraints. New exercises were developed to address gender norms, the belief that being MSM is a mental illness and stigmatizing attitudes towards MSM.ConclusionsGetting to the “heart of stigma” requires understanding and responding to both HIV and other intersecting stigma targeting sexual and gender diversity. Findings from this study can inform health facility stigma reduction programming not only for MSM, but also for other populations affected by HIV‐related and intersectional stigma in Ghana and beyond.

Teen Mental Health First Aid: 12-month outcomes from a cluster crossover randomized controlled trial evaluation of a universal program to help adolescents better support peers with a mental health problem

Backgroundteen Mental Health First Aid (tMHFA) is a universal mental health literacy, stigma reduction, help-seeking, and suicide prevention program designed for adolescents in Years 10–12 of secondary school (16–18 years). tMHFA is delivered by trained instructors, in a regular classroom setting, to increase the knowledge, attitudes and behaviours that adolescents’ require to better support peers with mental health problems or mental health crises.MethodsTo explore the efficacy of tMHFA, a cluster crossover randomised controlled trial was conducted with Year 10 students in four schools in Victoria, Australia, using physical first aid training as the control intervention. Of the 1942 eligible students, 1,624 completed baseline and 894 completed follow-up surveys. Online surveys, administered one week before training and again 12-months later, included vignettes depicting peers John (depression and suicide risk) and Jeanie (social anxiety/phobia), measures of mental health first aid (quality of first aid intentions, confidence, first aid behaviours provided, and first aid behaviours received), mental health literacy (beliefs about adult help, help-seeking intentions), and stigma (social distance, weak-not-sick, dangerous/unpredictable, and would not tell anyone).ResultsThe primary outcome—quality of first aid intentions towards the John vignette—showed statistically significant group x time interactions, with tMHFA students reporting more helpful and less unhelpful first aid intentions, than PFA students did over time. Confidence in providing first aid also showed significant interactions. First aid behaviours—both those provided to a peer with a mental health problem and those received from a peer—showed null results. Ratings of both beliefs about adult help and help-seeking intentions were found to be significantly improved among tMHFA students at follow-up. A group x time interaction was found on one stigma scale (would not tell anyone).ConclusionsThis trial showed that, one year after training, tMHFA improves first aid intentions towards peers with depression and suicide risk, confidence in helping peers with mental health problems, willingness to tell someone and seek help from an adult or health professional if experiencing a mental health problem.Trial registrationThis research was registered with Australia New Zealand Clinical Trials Registry: ACTRN12614000061639.

(ANTI)STIGMA OSOBA S DEMENCIJOM

(ANTI)STIGMA OF PEOPLE WITH DEMENTIA ABSTRACT Dementia, as a progressive illness, represents health, familial, as well as a social risk. The symptoms are complex, and they manifest themselves on both the cognitive and the behavioral level. Therefore, the ill person cannot take care of themselves and the help of another person to meet their daily needs is required. A stigma called a „multidimensional concept“ is often connected with this illness, which carries with it the realization that the individual is different in some characteristics and as such deviates from socially acceptable norms. This paper provides an overview of stigma theories, describes the process of stigmatization and stigma management, as well as risk factors that contribute to the creation and maintenance of stigma towards people with dementia in society. Numerous stigma reduction programs are presented internationally with the aim of making people with dementia visible and valued in the same way as other members of the community. Key words: dementia; stigma; stigma reduction

Longitudinal impact of parents' discrimination experiences on children's internalizing and externalizing symptoms: A 2-year study of families of autistic children.

Although many parents of autistic children are routinely discriminated against, the potential impact of this discrimination on their parenting processes and child-rearing outcomes has seldom been investigated. The present study addressed this gap in the literature by examining the longitudinal associations of parents' discrimination experiences with children's internalizing and externalizing symptoms among families of autistic children and testing whether these associations would be mediated by parental depression, harsh parenting, and coparenting conflict. On three occasions across 2 years (i.e. T1, T2, and T3), 441 parents of autistic children from Hong Kong, China, provided questionnaire data. Path analyses showed that parents' discrimination experiences at T1 had significant direct effects on parental depression, harsh parenting, and coparenting conflict at T2, which, in turn, had significant direct effects on children's internalizing and externalizing symptoms at T3. Bootstrap analyses further demonstrated that parents' discrimination experiences at T1 had significant indirect effects on children's internalizing and externalizing symptoms at T3 via parental depression, harsh parenting, and coparenting conflict at T2. Our findings have important theoretical contributions and significant practical implications. Theoretically, our findings elucidate how parents' discrimination experiences may longitudinally heighten children's internalizing and externalizing symptoms by adversely affecting parental well-being and parent-child and inter-parental relationships. Practically, our findings highlight the importance of designing and implementing community-based stigma reduction programs and family-based stigma coping interventions to reduce parents' discrimination experiences and associated adverse outcomes on well-being, parenting, marriage, and child development.

Associations of perceived stigma, perceived environmental inaccessibility, and self-compassion among people with physical disability in Hong Kong

BackgroundPeople with physical disability are chronically stigmatized. They might internalize ableist attitudes and behaviors that they perceive from others, which can negatively affect social participation and well-being. It is essential to explore potential risk and protective factors associated with stigma perceptions. ObjectiveThe present study proposed and tested the positive associations of perceived environmental inaccessibility and self-coldness with perceived stigma, and the negative associations of self-warmth with perceived stigma, respectively, among people with physical disability in Hong Kong. MethodsA cross-sectional sample of 98 adults with physical disability (42.3% female, mean age = 36.4 years) from 10 nongovernmental organizations in Hong Kong participated in the study. They filled in a self-report questionnaire on perceived stigma, perceived environmental inaccessibility, self-compassion, basic activities of daily living (ADL), instrumental activities of daily living (IADL), and demographics. Main resultsHierarchical multiple regression showed that ADL and IADL alone (Model 1) did not significantly predict perceived stigma. The full model of ADL, IADL, perceived environmental inaccessibility, self-warmth, and self-coldness to predict perceived stigma (Model 2) was significant and explained 53.9% variance in perceived stigma. Perceived environmental inaccessibility and self-coldness were significantly and positively associated with perceived stigma, respectively. Self-warmth was significantly and negatively associated with perceived stigma. ConclusionsThe findings supported the important associations of both external contexts (i.e., as environmental inaccessibility) and internal resources (i.e., as self-compassion) with perceived stigma among people with physical disability. The findings inform future research and three-pronged design approaches to stigma reduction programs for people with physical disability.

Increasing resiliency and reducing mental illness stigma in post-secondary students: A meta-analytic evaluation of the inquiring mind program

Objective: Worsening student mental health, along with more complex mental illness presentation and increased access to campus mental health services, has led to a mental health “crisis” on campuses. One way to address student mental health needs may be through mental health programs which have been found to increase resiliency and help-seeking, and reduce stigma. Participants: The effectiveness of The Inquiring Mind (TIM), a mental health promotion and mental illness stigma reduction program, was examined in 810 students from 16 Canadian post-secondary institutions. Methods and Results: Using a meta-analytic approach, TIM improved resiliency and decreased stigmatizing attitudes from pre to post, with medium effect sizes (d > .50). Analyses with those that completed the follow-up (about one-third of the sample) showed that effects were mostly retained at three months. Other outcomes also point to the program’s effectiveness. Conclusion: TIM appears to be an effective program for post-secondary students. However, additional research, including randomized control trials, is needed to address study limitations.

Differential Impact of Experienced and Anticipated Discrimination on Sleep and Health Among Sexual Minorities.

For many lesbian, gay, and bisexual (LGB) individuals, stigma may represent a psychosocial stressor that can disrupt sleep and impair health. The present study tested a stigma model of sleep health to examine whether experienced and anticipated discrimination, as well as associated primal threat, would affect sleep quality and, in turn, physical and mental health among LGB individuals. A total of 401 LGB individuals (201 women and 200 men; mean age = 27.48years) from Hong Kong, China, provided cross-sectional questionnaire data on experienced and anticipated discrimination, primal threat, sleep disturbance, and self-rated physical and mental health. Path analyses showed that experienced and anticipated discrimination were associated with higher primal threat, which was, in turn, associated with greater sleep disturbance and then poorer physical and mental health. Bootstrap analyses further revealed that experienced and anticipated discrimination had significant indirect effects on sleep disturbance via primal threat and on physical and mental health via primal threat and sleep disturbance. In addition, multi-group analyses demonstrated that the mediation model held across women and men and across lesbian/gay and bisexual individuals. Theoretically, our findings highlighted the importance of considering the differential effects of experienced and anticipated discrimination, as well as the contributive role of primal threat, on the sleep quality and health status of LGB individuals. Practically, our findings pointed to the necessity of developing community-based stigma reduction programs and individual-oriented stigma coping interventions in order to facilitate LGB individuals to reduce discrimination-related primal threat and thereby improve sleep and health.

Exploring the experience of relatives living with individuals diagnosed with schizophrenia in Oman: A qualitative study.

WHAT IS KNOWN ON THE SUBJECT?: Relatives of individuals diagnosed with schizophrenia experience financial, social, emotional and physical burden. There is a lack of studies on the experience and needs of caregivers of individuals diagnosed with schizophrenia in the Arab world. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This is the first qualitative study to reflect the voice of parents, siblings and spouses living with schizophrenia in the Arab world. The study explored the needs of relatives of hospitalized patients. This study revealed some positive elements of caregiving experience, especially among siblings. The concept of stigma resistance may guide the establishment of stigma reduction programmes. Violence towards the relatives or vice versa is a sensitive issue that needs to be addressed and reported. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses should address parents, spouses and siblings' specific needs and challenges to include them in their relatives' treatment plan. Understanding the experience, feelings and needs of relatives living with schizophrenia would enable mental health nurses to provide a range of interventions to help reduce caregivers' burden and promote the positive gains from the caregiving experience. The study emphasizes the need for culturally adapted family interventions to effectively assist relatives in providing care and adjusting to the caregiving role. ABSTRACT: Introduction Relatives of individuals diagnosed with schizophrenia often experience positive and negative impacts. Much of the literature on family experience with schizophrenia comes from western culture, and less is known about Arabic speaking countries. There has been no previous attempt to qualitatively investigate the lived experience of relatives of hospitalized patients with schizophrenia in the Arab world. Aim To explore the experience and needs of Omani relatives of hospitalized patients diagnosed with schizophrenia. Method Qualitative semi-structured interviews with twenty relatives of hospitalized patients from Oman. The interviews were analysed using framework analysis. Results Parents, spouses and siblings were confronted with a burden specific to the demand of different life situations, and their needs differ accordingly. The findings showed four themes: burden, stigma, violence and needs. Discussion This study provides insight into the experience of Omani relatives living with schizophrenia. Although the caregiving experience appears negative, some positive elements of caregiving experience were prominent among siblings. Furthermore, the violence phenomenon among individuals with schizophrenia needs to be addressed as a priority. Implications for practice Understanding the experience, feelings and needs of relatives living with schizophrenia would enable mental health nurses to provide a range of interventions to help reduce caregivers' burden and promote the positive gains from the caregiving experience. The concept of stigma resistance in the Arab world may guide the establishment of stigma reduction programmes.