Effect of Stigma on Mental Health

publication of Stigma on Mental HealthFrom thousands of years, debate has been going on among practiti unitaryrs how to treat intellectual disappointmentness. Several modifications have been done from burning, chaining, locking them in homes and dr unhingeding their heads to unchaining and treating them resembling humans (Foerschner, 2010). But the nurses who work in mental wellness setting hushed face the problems in delivering c be in a sucker free environment in order to nurture the wellness of mentally ill patients (Stuart, 2009). For such mentally ill clients we quest to accept their behavior rather than chumptization (Angermeyer Matschinger, 2003). Stigma is a arrangement of prejudicious emplacements, beliefs, thoughts, and behaviors that influence the unmarried, or the general public, to fear, reject, avoid, be prejudiced, and discriminate battalion (Gary, 2005). The reason behind selection of this topic is that to accepting mentally ill patient with the intenti on of promoting their health. In West, stigma to mental illness is in good order recognized, equally managed and prevented. Yet, in Eastern cultures, being mentally ill is still seen as a mark of dishonor for family, mental health patients ar still stigmatized and well-disposedly isolated and supposed as being preoccupied 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). non so long I have being in psychiatric setting where we all were sitting in caf having our switch together, suddenly a man in brown traditional clothes with leather summit wearing black goggles ask one of our ally if he want some tea? he answered no, that somebody sit down on nearby table and ask waiter to bugger off one zinger burger. While noting his getup which was not according to weather and unusual behavior, my colleague abruptly ask our faculty Ma am is he screwball or what? After hearing those words that patient suddenly pushes his professorship and leaves the caf. This is how people unintentionally target psychiatric patient by collision their egotism-esteem rather accepting them as a short-circuit-dance of party and understand there awkward behavior as a part of their illness. In a night club stigma marks a sharpness 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 stigma ar formed and maintained. There are 3 components that structure this model are stereotype, prejudice, and discrimination. Social psychologists see stereotypes as information learned by society (Augoustinos, Ahrens, Innes, 1994 Esses, Haddock, Zanna, 1994 Hilton von Hippel, 1996 Judd Park, 1993 Krueger , 1996 Mullen, Rozell, Johnson, 1996). Without thinking we quickly create expectation and impression of people who sufficient in to a stereotyped group, (Hamilton Sherman, 1994) just like my colleague mark that person as mad. Prejudice endorse people may show a negative reactions by supporting 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 pursual societal norms and discriminate his behavior from normal to abnormal (for social cognitive model refer vermiform process fig 1.).Being stigmatized has several subtle consummations 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 discourse options. It also cause non-adherence to effective treatment regimen. Self stigma is an other 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 hospital setting nurses presentment 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 stir is possible that would bring 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 might be used at diverse directs the intrapersonal, interpersonal, organ isational/institutional, group, and governmental/structural (McLeroy et al, 1988 Richard et al, 1996). Firstly, intrapersonal level has always remained a primary focus to throw 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 Van Der Meij, 2006). Secondly, intervention at interpersonal level deals with the collision of social gathering and social support on the health of mentally ill client. The interpersonal environment of the patient includes their family, friends and work environment. They intend to fabricate connections between patient and his/her interpersonal environment in order to quicken or promote their health. This could be carry out through caution and support by family, Home care teams, and Community-based rehabilitation (Heijnders Van Der Meij, 2006). Furthermore, the organizational level also being used in order to change the perception of public towards stigma and its effect on individual. This could be consummate(a) 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 reduction 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 policy 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 that policies on discrimination, access to prevention and care, confidentiality of care and individuals rights can behave 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, barely thinking makes it so (Shakespeare, Hamlet, Act 2 Scene 2).