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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The last 5 years have seen a resurgence of interest in insight, with better definitions and operationalizations of the concept. However, recent work has paid little attention to the ways in which patients' understanding of their illnesses may be shaped by perceptions of mental illness and treatment prevailing in their cultures and social groups. We review work by social scientists on cultural and social variations in lay perceptions of mental illness and on the stigma attached to mental illness, and argue that these varying views are likely to be one of the influences on insight, requiring further exploration in research on this subject.
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PMID:Insight and psychosis: a social perspective. 748 Apr 32

Persons with dual diagnoses of psychiatric illness and substance abuse represent a large subpopulation within the mental health system, but mental health service delivery systems typically do not adequately address their special needs. The literature on dual diagnoses is marked by the paucity of information on such persons in rural settings. This paper describes the characteristics of a rural community mental health system, which illustrate the difficulties in treating persons with dual diagnoses in rural communities. These problems include a fragmented system of services, centralized services in a large geographic area, overly restrictive regulations, conceptual differences in treatment approaches, confidentiality and stigma in a rural culture, and the academic and professional isolation of mental health workers, leading to high turnover and a shortage of staff having sufficient training and experience to work with persons with dual diagnoses. Some recommendations to address these problems and to improve the delivery of services to persons with dual diagnoses are suggested.
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PMID:The treatment of persons with dual diagnoses in a rural community. 770 Oct 19

There is potential for the stigma of mental health care to directly affect an active duty member's career. The authors are aware of cases in which fear of adverse career consequences has led service members to avoid needed mental health care. In order to investigate the legitimacy of this fear, the authors surveyed 252 USN and USMC commanding and executive officers concerning their attitudes about service members who had received mental health and other services; 138 responded. Overall the responses were neutral and there were relatively few negative evaluations of service members who had received services. Military health care providers should take an active role in diminishing the stigma of mental illness, and in allaying fears of adverse career consequences for seeking care.
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PMID:Psychiatric stigma in the military. 780 Jan 75

The author presents his perspectives on the relationship between antipsychiatry and the stigma of mental illness. Stigma has existed at least since biblical times, when madness as demonic possession and punishment for sin became codified in religious belief and practice. The antipsychiatry movement dates from the 18th century, when psychiatry first emerged as a medical specialty and the first mental hospitals were built. Over the years psychiatry has been a target for antipsychiatry groups competing for influence or authority over the mentally ill. At various times these groups have included neurologists, social workers, new religions, consumers, and psychiatrists themselves. Their common ground has been objection to psychiatry as a hospital-centered medical specialty legally authorized to institutionalize and treat patients. In the late 19th century, treatment of hospitalized patients increased the stigma of mental illness and provided fuel for the antipsychiatry movement. During that period psychiatrists began to see heredity as the cause of mental illness, became pessimistic about restoring patients to sanity, and adopted essentially a custodial approach to care that included use of physical restraints. However, recent advances in biological treatments have undercut antipsychiatry and rekindled optimism about recovery that may go far in eliminating stigma.
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PMID:Reflections on antipsychiatry and stigma in the history of American psychiatry. 782 37

The importance of consumers in planning, providing and evaluating mental health services has received increasing recognition. Consumer participation as staff members on professional multidisciplinary teams describes one model of consumer involvement in providing services. This report gives the perspective of the professional leadership of such a team which employs two full-time "consumer advocates" (CAs). CAs have made significant and valuable contributions to the clinical work of the team by virtue of their street smarts, engagement skills, peer support, positive role modeling, fighting stigma, and education of co-workers. However, the CA/professional collaboration presented a number of challenging questions for ongoing discussion, including: 1) What is the role of the CA? 2) What are the boundaries between CAs and patients and the implications of these boundaries for the potential effectiveness of CAs? 3) What supervision should the CA have and with whom? 4) What is the impact of the CA's individual experience with mental illness on their work? Examples are presented of both the clinical contribution of CAs and how the importance of addressing the above questions became evident in the work of the team. We found that CAs were extremely important team members; however, an ongoing dialogue between consumers and professionals is essential to operationalize this important collaboration.
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PMID:Consumers as service providers: the promise and challenge. 783 46

This study uses a stress-coping-support framework to examine the predictors of caregiver burden with a sample of 103 lower social class family caregivers of persons with chronic mental illness. Results of multiple regression analyses show that the greater the frequency of client behavioral symptoms and the lower the amount of perceived support from family members, the higher the level of overall caregiver burden. Examination of the predictors of specific types of burden-family disruption, stigma, strain, and dependency-reveal that different constellations of variables predict different types of burden. The need for mental health agencies to address caregiver and client concerns is addressed. Implications are presented for practice and future research.
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PMID:Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness. 785 Nov 1

Upon deinstitutionalization, a mentally ill person's awareness of the stigma attached to his or her illness can negatively influence any effort to become a productive member of society. Support systems are vital in that they facilitate such efforts. The family is perhaps the most important support system because it provides emotional support, which is crucial because it promotes a sense of self-esteem and decreases depression, anxiety, sickness, and mortality. An awareness of stigma on the part of the family could undermine its role as a support system for a relative with mental illness.
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PMID:Studying mental illness: a student's perspective. 793 3

Upon deinstitutionalization, a mentally ill person's awareness of the stigma attached to his or her illness can negatively influence any effort to become a productive member of society. Support systems are vital in that they facilitate such efforts. The family is perhaps the most important support system because it provides emotional support, which is crucial because it promotes a sense of self-esteem and decreases depression, anxiety, sickness, and mortality. An awareness of stigma on the part of the family could undermine its role as a support system for a relative with mental illness.
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PMID:Educating the paraprofessional staff on the psychiatric unit. A neglected topic. 793 4

Mental health policy has evolved haphazardly, reflecting fragmentation of authority, competing ideologies, limitations of current knowledge and technologies, and changes in entitlements and insurance associated with health and welfare programs. While seeking parity with general health services, the mental health sector requires as well a range of health and social services that extends well beyond acute care, particularly for those with severe and persistent illness. Despite recent advances in articulating health, disability, and social services programs, much remains undone. The stigma of mental illness affects both intergovernmental cooperation and public response. Health reform provides an opportunity to address neglected areas and to build a closer connection with general health services. New coalitions of advocates for the mentally ill, the elderly, and persons with disabilities could construct a coherent long-term-treatment orientation that would benefit all.
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PMID:Establishing mental health priorities. 793 44

The Oregon Health Plan is an approach to health care reform that increases access to mental health and chemical dependency services. A key feature is the integration of mental and physical health care. The mental health community had to educate policy makers about the importance of mental health and chemical dependency services. They constructed a prioritized list of mental health and chemical dependency services and interdigitated the list with the set of physical health services. The result is a unique attempt to develop a seamless health care system that minimizes discrimination against persons affected by mental illness. The opportunity to achieve parity for mental health must not be delayed or compromised; to do so would worsen the lives of persons already affected by the trauma and stigma associated with mental illness.
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PMID:Prioritization of mental health services in Oregon. 793 45


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