Effect of Stigma on Mental Health

Effect of Stigma on Mental HealthFrom thousands of years, debate has been going on among practiti unitaryrs how to treat affable angryness. Several modifications generate been done from burning, chaining, locking them in homes and drilling their heads to unchaining and treating them like humans (Foerschner, 2010). But the nurses who work in mental health setting still face the problems in delivering c ar in a stigma free environment in order to promote the health of ment bothy ill patients (Stuart, 2009). For such mentally ill clients we need to accept their behavior rather than stigmatization (Angermeyer Matschinger, 2003). Stigma is a collection of ostracize attitudes, beliefs, thoughts, and behaviors that influence the individual, or the general everyday, to fear, reject, avoid, be prejudiced, and discriminate deal (Gary, 2005). The reason behind selection of this topic is that to accepting mentally ill patient with the intention of promoting their health. In West, stigma to mental illness is properly recognized, as managed and prevented. Yet, in Eastern cultures, being mentally ill is still seen as a mark of dishonor for family, mental health patients are still stigmatized and socially isolated and supposed as being haunted by evil spirit or jinn (Naeem, Ayub, Javed, Irfan, Haral Kingdon, 2006). Additionally, mental health is considered to be the most avoided field in Pakistan due to the stigma attached to it (Qasim, 2012).Not so long I have being in psychiatric setting where we all were sitting in caf having our break together, suddenly a man in brown traditional clothes with leather jacket wearing black goggles ask one of our associate if he want some tea? he answered no, that individual sat on nearby table and ask waiter to forge one zinger burger. While noting his getup which was not according to weather and unusual behavior, my colleague abruptly ask our faculty Maam is he mad or what? After hearing those words that patient suddenly pushe s his chair and leaves the caf. This is how people unintentionally target psychiatric patient by hitting their egotism rather accepting them as a part of society and understand there awkward behavior as a part of their illness. In a society stigma marks a boundary between normal and outsider, and between us and them (Link Phelan, 2001). Question is how we can break this boundary of discrimination which is causing barrier to recovery of mentally ill clients?The case scenario will now be analyzed on a social cognitive model explains how public and self-importance stigma are formed and maintained. There are 3 components that structure this model are stereotype, prejudice, and discrimination. Social psychologists see stereotypes as information larn by society (Augoustinos, Ahrens, Innes, 1994 Esses, Haddock, Zanna, 1994 Hilton von Hippel, 1996 Judd Park, 1993 Krueger, 1996 Mullen, Rozell, Johnson, 1996). Without sentiment we quickly create expectation and impression of people w ho fit in to a stereotyped group, (Hamilton Sherman, 1994) just like my colleague label that person as mad. Prejudice endorse people may show a negative reactions by conducting their learned negative stereotype. (Devine, 1988, 1989, 1995 Hilton von Hippel, 1996 Krueger, 1996). Prejudice may lead to discriminatory behavior (Weiner, 1995) just like my colleague discriminate that person as one who is not following societal norms and discriminate his behavior from normal to abnormal (for social cognitive model refer appendix fig 1.).Being stigmatized has several harmful effects on the individual, the immediate family and the community too. At first in the name of honor or embarrassment, the individual and family doesnt reach the health care provider for treatment options. It also cause non-adherence to effective treatment regimen. Self stigma is another effect resulting in low self esteem, negative self perception and self care when a person internalizes the discriminatory behavior and societal stigmatizing attitude. Lastly stigma has also affects the attitude of health care provider. Study has shown that in infirmary setting nurses display punishing attitude and use unacceptable manner for treating them, like unnecessarily retraining them (Pinto-Foltz Logsdon, 2009).To reduce stigma and discrimination against people with mental health disorders the largest ever program was launched in England on Jan 21, 2009, called Time to Change. By referring social cognitive model this program aims to show that change is possible that would gain hope to people who are deleteriously exhausted by discrimination (refer appendix fig 2.) (Henderson Thornicroft). A few procedures for stigma decrease are accounted in the literature. These interventions and techniques force be used at diverse levels the intrapersonal, interpersonal, organizational/institutional, group, and governmental/structural (McLeroy et al, 1988 Richard et al, 1996). Firstly, intrapersonal level has alway s remained a primary focus to change the behavior of an individual. Interventions are done to change the individuals knowledge, behavior, attitude, self concept, enhancing self esteem, coping skills, strengthening, and financial support. We can carry out these interventions via individual counseling or cognitive behavioral therapy (CBT) and Self help advocacy and support groups (Heijnders caravan Der Meij, 2006). Secondly, intervention at interpersonal level deals with the impact of social gathering and social support on the health of mentally ill client. The interpersonal environment of the patient overwhelms their family, friends and work environment. They intend to build connections between patient and his/her interpersonal environment in order to restore or promote their health. This could be carry out through Care and support by family, Home care teams, and Community-based rehabilitation (Heijnders Van Der Meij, 2006). Furthermore, the organizational level also being used i n order to change the perception of public towards stigma and its effect on individual. This could be effect through training programs and institutional changes which increase knowledge of the disease and effect of stigma on the lives of mentally ill clients (Heijnders Van Der Meij, 2006). Additionally stigma decrease can be intervene at community level whose aim is to increase knowledge about mental illness and stigma attached to it. For stigma reduction campaign, education is often used as a first step and it may combine with the other strategies as well. Educational interventions may include presentations, discussions, simulations, audiotapes, and movies, focusing specific populations (Heijnders Van Der Meij, 2006). Lastly, on governmental level work can be carried out in order to structure such constitution which aims to protect the rights of the people who are suffering from stigmatizing illness (Heijnders Van Der Meij, 2006). The World Health Organization (WHO) argued th at policies on discrimination, access to prevention and care, confidentiality of care and individuals rights can make a significant impact (2002).In Conclusion it is recommended that clients dignity and safety should remain paramount at all times. To break the chain of stigma the social cognitive model should be vigilantly applied in psychiatric setting. Patient-centred approach is required, which starts with intrapersonal level, which gives power to affected person to development self esteem and stigma reduction related programs at other levels. There is nothing either good or bad, but thinking makes it so (Shakespeare, Hamlet, Act 2 Scene 2).