severe mental illness

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severe mental illness

• Working together to help everyone affected by
  severe mental illness recover a better quality of
  life

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Northern Ireland context

• Poor mental and physical health
• Poverty, inequality, deprivation
• Emergence from decades of conflict
• High level of suicide
• 8.4 of health and social care spend is on mental
  health- compared to 12 in England
• No service framework
• No priority status

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What is Stigma?

• Problems of knowledge ignorance
• Problems of emotions prejudice
• Problems of behaviour discrimination

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Discrimination in numbers

• Over 80 unemployed
• 40 have no social contacts
• Tripled mortality rate
• Doubled incidence of heart and lung disease
• High levels of homelessness
• Highest level as victims of crime

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What is Stigma?

• Problems of knowledge ignorance
• Problems of emotions prejudice
• Problems of behaviour discrimination

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European Views on Schizophrenia
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What is Stigma?

• Problems of knowledge ignorance
• Problems of emotions prejudice
• Problems of behaviour discrimination

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1. Discrimination at Home

• Adverse reactions by family
• lazy / weak / amusing / bereavement/ shunning
• Negative reactions to family members
• courtesy stigma, stigma by association
• Low status or segregated housing
• Institutions, hospitals or social/care homes
• High rates of homelessness
• Neighbourhood reactions to residential care

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2. Discrimination in Friendships, Intimate
Relationships and Childcare

• Loss of husband/wife/partner
• Disappearance of friends
• Impaired long-term sexual relationships
• Sexual performance affected by drugs
• Lower fertility rate for women with schizophrenia
• Higher rates of loss of children to care

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3. Discrimination at Work

• Lower rates of short-listing and hiring
• More often sacked for poor attendance/performance
• Lower rates of pay
• Poorer promotion prospects
• Dilemma of whether to disclose
• Difficulties in getting reasonable accommodations
  / adjustments

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4. Discrimination in Social Life

• Limitations in leisure and social clubs
• Travel low rates of car ownership
• Less access to affordable insuranceLow income /
  welfare benefits
• Low rates of registration to vote
• Limitation on jury service, property ownership,
  legal ability to sign contracts
• De facto cannot be a reliable witness in court
• Human rights may be fundamentally limited

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5. Discrimination in Healthcare

• Avoidance of seeking help for fear of stigma
• Pessimism of mental health care staff
• Less thorough investigations and treatment for
  physical health problems
• Stigma against mental health care staff
• Consumers often decide to discontinue care

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6. Discrimination in the Media

• Newspaper 40-70 of items-violence
• These do have negative effects on popular views
• 0-Mentally ill characters on TV 10-20 more more
  violent than usual characters
• 85 of children's animations show MI as violent
• Psychiatrists as manipulator, as priest, as
  pervert, as lecher, as stricken, tortured soul
  (Clare, 2004)
• Few direct accounts from consumers
• Usually journalists editorialise

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7. Self-Discrimination

• Avoidance of close personal relationships
• Reluctance to apply for jobs
• Feelings of loss of agency eg cannot volunteer
• anticipated stigma
• Can lead to self-fulfilling prophesies
• ie vicious cycles/circles
• Avoidance of healthcare to avoid the label
• Core identity can change to a disabled person

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Social relationships social support
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