The Stigma

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

The author of The Presentation of Self in Everyday Life analyzes a person’s feelings about himself and his relationship to people society calls “normal.” Stigma is an illuminating excursion into the situation of persons who are unable to conform to standards that society calls normal. Disqualified from full social acceptance, they are stigmatized individuals. Physically deformed people, ex-mental patients, drug addicts, prostitutes, or those ostracized for other reasons must constantly strive to adjust to their precarious social identities. Their image of themselves must daily confront, and be affronted by, the image others reflect back to them. Drawing extensively on autobiographies and case studies, sociologist Erving Goffman analyzes the stigmatized person’s feelings about himself and his relationship to “normals” He explores the variety of strategies stigmatized individuals employ to deal with the rejection of others, and the complex sorts of information about themselves they project. In Stigma, the interplay of alternatives the stigmatized individual must face every day is brilliantly examined by one of America’s leading social analysts. “This short book established the conceptual understanding of stigma that continues to buttress contemporary sociological thinking.” —Sociological Review

This book makes a highly innovative contribution to overcoming the stigma and discrimination associated with mental illness – still the heaviest burden both for those afflicted and those caring for them. The scene is set by the presentation of different fundamental perspectives on the problem of stigma and discrimination by researchers, consumers, families, and human rights experts. Current knowledge and practice used in reducing stigma are then described, with information on the programmes adopted across the world and their utility, feasibility, and effectiveness. The core of the volume comprises descriptions of new approaches and innovative programmes specifically designed to overcome stigma and discrimination. In the closing part of the book, the editors – all respected experts in the field – summarize some of the most important evidence- and experience-based recommendations for future action to successfully rewrite the long and burdensome ‘story’ of mental illness stigma and discrimination.

Many mentally ill people are the victims of stigma, which leads to additional suffering and humiliation. Negative stereotypes and prejudicial attitudes against them are often reinforced by their media representation as unpredictable, violent and dangerous. Hence the importance of the study of stigma as an explanatory construct of much that transpires in the management of the mentally ill in our societies. This book describes the experience of stigmatization at the level of the individual, and seeks to measure stigma and discrimination from the following perspectives: Self imposed stigma due to shame, guilt and low self esteem; Socially imposed stigma due to social stereotyping and prejudice; and Structurally imposed stigma, caused by policies, practices, and laws that discriminate against the mentally ill. This book briefly describes programmes that aim to reduce such stigma then looks at ways to evaluate their effectiveness. It is the first book to focus on evaluation and research methodologies in stigma and mental health. It also: presents new interventions to reduce stigma describes the various international programmes which help reduce stigma discusses the use of the internet as an international tool to promote awareness of stigma in mental health Understanding the Stigma of Mental Illness is essential reading for clinicians and researchers who wish to apply or develop stigma reduction programmes. It is also a valuable addition to the libraries of political analysts, policy makers, clinicians, researchers, and all those interested in how to approach and measure this distressing social phenomenon.

Despite efforts to redress the prejudice and discrimination faced by people with mental illness, a pervasive stigma remains. Many well-meant programs have attempted to counter stigma with affirming attitudes of recovery and self-determination. Yet the results of these efforts have been mixed. In The Stigma Effect, psychologist Patrick W. Corrigan examines the unintended consequences of mental health campaigns and proposes new policies in their place. Corrigan analyzes the agendas of government agencies, mental health care providers, and social service agencies that work with people with mental illness, dissecting how their best intentions can misfire. For example, a campaign to change the language around mental illness by replacing supposedly stigmatizing words with empowering ones has made little difference in how people with mental health conditions are viewed. Educational programs that frame mental illness as a brain disorder have made the general public less likely to blame people for their illnesses, but also skeptical that such conditions can be cured. Ultimately, Corrigan argues that effective strategies require leadership by those with lived experience, as their recovery stories replace ideas of incompetence and dangerousness with ones of hope and empowerment. As an experienced clinical researcher, as an advocate, and as a person who has struggled with such prejudices, Corrigan challenges readers to carefully examine anti-stigma programs and reckon with their true effects.

Up until now, many articles have been written to portray stigma and discrimination which occur with people living with HIV/AIDS (PLWHA) in many parts of the world. But this is the first book which attempts to put together results from empirical research relating to stigma, discrimination and living with HIV/AIDS. The focus of this book is on issues relevant to stigma and discrimination which have occurred to individuals and groups in different parts of the globe, as well as how these individuals and groups attempt to deal with HIV/AIDS. The book comprises chapters written by researchers who carry out their projects in different parts of the world and each chapter contains empirical information based on real life situations. This can be used as an evidence for health care providers to implement socially and culturally appropriate services to assist individuals and groups who are living with HIV/AIDS in many societies. The book is of interest to health care providers who have their interests in working with individuals and groups who are living with HIV/AIDS from a cross-cultural perspective. It will be useful for students and lecturers in courses such as anthropology, sociology, social work, nursing, public health and medicine. In particular, it will assist health workers in community health centres and hospitals in understanding issues related to HIV/AIDS and hence provide culturally sensitive health care to people living with HIV/AIDS from different social and cultural backgrounds. The book is useful for anyone who is interested in HIV/AIDS-related stigma and discrimination in diverse social and cultural settings.

This book is a collection of writings on how society has stigmatized mentally ill persons, their families, and their caregivers. First-hand accounts poignantly portray what it is like to be the victim of stigma and mental illness. Stigma and Mental Illness also presents historical, societal, and institutional viewpoints that underscore the devastating effects of stigma.

A compassionate and captivating examination of evolving attitudes toward mental illness throughout history and the fight to end the stigma. For centuries, scientists and society cast moral judgments on anyone deemed mentally ill, confining many to asylums. In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy. Nobody’s Normal argues that stigma is a social process that can be explained through cultural history, a process that began the moment we defined mental illness, that we learn from within our communities, and that we ultimately have the power to change. Though the legacies of shame and secrecy are still with us today, Grinker writes that we are at the cusp of ending the marginalization of the mentally ill. In the twenty-first century, mental illnesses are fast becoming a more accepted and visible part of human diversity. Grinker infuses the book with the personal history of his family’s four generations of involvement in psychiatry, including his grandfather’s analysis with Sigmund Freud, his own daughter’s experience with autism, and culminating in his research on neurodiversity. Drawing on cutting-edge science, historical archives, and cross-cultural research in Africa and Asia, Grinker takes readers on an international journey to discover the origins of, and variances in, our cultural response to neurodiversity. Urgent, eye-opening, and ultimately hopeful, Nobody’s Normal explains how we are transforming mental illness and offers a path to end the shadow of stigma.