Lecture 3 Health 112.pdf

Stigma and Health Lecture 3 Associate Professor Damian Scarf  Lecture 3 Outline 1. What is stigma? 2. How does stigma lead to prejudice? 3. How do we combat stigma?  Definitions of Stigma An “attribute that is deeply discrediting” and that reduces the...

Stigma and Health Lecture 3 Associate Professor Damian Scarf  Lecture 3 Outline 1. What is stigma? 2. How does stigma lead to prejudice? 3. How do we combat stigma?  Definitions of Stigma An “attribute that is deeply discrediting” and that reduces the bearer “from a whole and usual person to a tainted, discounted one” (Goffman 1963, p. 3). “stigmatized individuals possess (or are believed to possess) some attribute, or characteristic, that conveys a social identity that is devalued in a particular social context” (Crocker et al. 1998, p. 505). Jones et al. (1984) A “mark” (attribute) that links a person to undesirable characteristics (stereotypes).  Stigmatized Conditions AIDS/HIV MENTAL ILLNESS CANCER LEPROSY OBESITY EPILEPSY  Stigma Is A Social Construction, Not A Fact.  Mental Illness (MI) Stigma “The single most important barrier to overcome in the community is the stigma and associated discrimination towards persons suffering from mental and behavioural disorders” (World Health Organisation [WHO], 2001, p.98). Mental Illness (MI) Stigma Symptoms and Limitations Stigma (incl. prejudice & discrimination) From MI Stigma to Prejudice DISTINGUISHING & LABELING DIFFERENCES ASSOCIATING DIFFERENCES WITH NEGATIVE ATTRIBUTES SEPARATING “US” FROM “THEM” DISCRIMINATION  Primary Sources of MI Stigma NEWS MOVIES “Stabbing with needle in psychiatric A Beautiful Mind unit.” ODT, 2022 Shutter Island “Ferry passenger stabbed by mental health patient wielding scissors.” Donnie Darko ODT, 2023 Silver Linings Playbook “Psychiatric patient avoids jail after man paralysed.” ODT, 2008 Joker  2022 2001 1975 1995 2012 2010 2001  News 10% 13% Danger to Others 49% Problem for Others Hopeless Vitim 29% Strange Behaviour Personal Responsibility Pejorative Language 18% 41%  Movies 17% 24% Unpredictable Behaviour 71% Violent Behaviours Self-Harm 69% Suicide Genius 83%  Testing the Impact of Movies 38:13 1:14:46 26:51  Measuring MI Prejudice Fear Malevolence “I would feel unsafe being around “People with mental illness should someone who is mentally ill” support themselves and not expect handouts” Authoritarianism Unpredictability “People who are mentally ill should be “People with mental illness often do forced to have treatment” unexpected things”  Testing MI Prejudice Time 1 Time 2 (Before Movie) (After Movie) Measure Measure Prejudice Prejudice  Testing MI Prejudice Fear* Malevolence 4.0 3.0 Mean Mean 3.0 2.0 Joker Joker Control Control 2.0 1.0 Before After Before After Authoritarianism* Unpredictability 4.0 5.0 Mean Mean 3.0 4.0 Joker Joker Control Control 2.0 3.0 Before After Before After How do we combat stigma? CONTACT EDUCATION PROTEST  Contact Aim: Contact with people who are successfully managing a mental illness, usually including opportunities for active discussion and learning Targets: General public or selected subgroups, usually high school or university students Outcome: Reduce stereotypes; improved attitudes; reduce desire for interpersonal distance.  Education Aim: Replace myths and misinformation with accurate information. Targets: General public or selected subgroups. Outcome: Improved knowledge; improved mental health literacy; better recognition of symptoms; early help seeking.  Protest Aim: Formal (often written) objection to negative representations. Targets: Opinion leaders or stigmatizers (for example, politicians, journalists, and manufacturers). Outcome: Suppress negative attitudes; remove negative representations and content. Case Study  Like Minds History Established in 1995 by the Ministry of Health in response to the Mason Report. One of the first comprehensive campaigns in the world to counter the prejudice and discrimination associated with mental distress. Combined national television campaigns, other media and communication activities with community action and education. Advertising Campaign ‘Are you prepared to judge?’ ‘You can make the difference’ ‘Know me before you judge me’ ‘Discrimination is still the biggest barrier’ ‘Be there, stay involved’  Measuring Impact : Stereotypes Once a person gets a mental illness they are always unwell Strongly Strongly 1 2 3 4 5 6 7 Disagree Agree People who have had a mental illness are never going to be able to contribute much to society Strongly 1 2 3 4 5 6 7 Strongly Disagree Agree People who have a mental illness are more likely than other people to be dangerous Strongly Strongly 1 2 3 4 5 6 7 Disagree Agree  …are always unwell …never going to …likely to be 64 contribute dangerous 90 45 62 % that Strongly Disagree/Disagree % that Strongly Disagree/Disagree % Strongly Disagree/Disagree 88 40 60 86 35 58 84 30 82 56 25 80 54 20 78 15 52 76 74 10 50 5 72 48 70 0 Before After Before After Before After (2000) (2012) (2000) (2012) (2000) (2012)  Measuring Impact: Prejudice If I got a mental illness, I would feel ashamed Strongly Strongly 1 2 3 4 5 6 7 Disagree Agree I would feel uncomfortable talking to someone who had a mental illness Strongly 1 2 3 4 5 6 7 Strongly Disagree Agree If I got a mental illness, I think some of my friends would reject me Strongly Strongly 1 2 3 4 5 6 7 Disagree Agree...I would feel I would feel....my friends ashamed uncomfortable... would reject me 50 90 90 % that Strongly Disagree/Disagree % that Strongly Disagree/Disagree % that Strongly Disagree/Disagree 45 80 80 40 70 70 35 60 60 30 50 50 25 40 40 20 30 30 15 10 20 20 5 10 10 0 0 0 Before After Before After Before After (2000) (2012) (2000) (2012) (2000) (2012)  Lecture 3 Outline 1. What is stigma? 2. How does stigma lead to prejudice? 3. How do we combat stigma?