Bibliographie Pôle formation Bibliothèque médicale Henri Ey 01 45 65 89 66 [email protected] Santé mentale et médias/société Le 12 septembre 2014, par Céline Bentz La recherche Santé mentale et médias/société, stigmatisation Pour Aude Caria Psycom Requête Pubmed : ((("media"[Title/Abstract]) OR "stigma"[Title/Abstract])) AND ((("mental health"[Title/Abstract]) OR "mental illness"[Title/Abstract]) OR "psychiatry"[Title/Abstract]) 27 références sélectionnées: Article Disponible à la BM 1. HABIB Marc. Peut-on encore être fou au XXIe siècle? Médias et psychiatrie. TRANSFAIRE ET CULTURES : REVUE D'ANTHROPOLOGIE MEDICALE CLINIQUE 2010 ; (3) : 51-62. Article A lire en ligne depuis les postes du CHSA : http://www.empremium.com/articl e/403801 2. GIORDANA Jean-Yves. Lutter contre la stigmatisation, un enjeu majeur en santé mentale. SOINS PSYCHIATRIE 2011 ; (275) : 14-8. La manière dont la société considère les personnes identifiées comme malades psychiques fait partie intégrante du travail des professionnels en santé mentale. Il s'agit d'une problématique essentielle dans le quotidien des soignants et des patients. Des stratégies existent et permettent de lutter contre la stigmatisation et les discriminations. [résumé d'auteur] Article A lire en ligne : http://www.inpes.sa nte.fr/SLH/pdf/sante -homme-419.pdf 3. FAYARD Annick Coord., FORTIN Jacques Coord. Stigmatisation : quel impact sur la santé ? [dossier]. Voir les parties Pourquoi et comment lutter contre la stigmatisation en santé mentale ? et Réduire la stigmatisation des personnes souffrant de troubles psychiques : une synthèse de la littérature SANTE DE L'HOMME 2012 ; (419) : 7-44. Voir aussi : glossaire : A lire en ligne : http://www.santem entale5962.com/IM G/pdf/les_mots_qui _fachent_aout_2014 .pdf 4. COLIN Alexandra, GALLAND Damien, NOTREDAME Charles Edouard. Les mots qui fâchent... Petit glossaire de précautions sémantiques en psychiatrie. Lille : Fédération régionale de Recherche en santé mentale Nord-Pas-deCalais, 2013. Les auteurs ont fait un constat : 'Les journalistes mesurent de plus en plus l’importance de traiter le sujet des troubles mentaux, première cause de handicap dans le monde et pourtant, ils demeurent mal informés sur ces questions. En région Nord - Pas-de-Calais, la Fédération régionale de recherche en psychiatrie et santé mentale a initié un partenariat unique avec l’Ecole Supérieure de Journalisme. L’objectif : sensibiliser les journalistes et futurs journalistes aux grandes notions de la maladie mentale et de la psychiatrie'[d'après le résumé d'éditeur] Article A lire en ligne : http://www.orspere .fr/IMG/pdf/Rhizom e_42_BAT2.pdf 5. OEYNHAUSEN Marc. Stigmatisation en psychiatrie : le poids des médias. RHIZOME 2011 ; (42) : 14. La loi du 5 juillet 2011 relative 'aux droits et à la protection des personnes faisant l'objet de soins psychiatriques et à leurs modalités de prise en charge' et ses décrets d'application sont entrés en vigueur le 1er août. A travers cette loi se pose plus largement la question des représentations sociales des personnes souffrant de troubles psychiques relayées par les médias. [résumé d'auteur] Livre Disponible au sein 6. LEMOINE Patrick. Le mystère du nocebo. de notre réseau documentaire Ascodocpsy Paris : Odile Jacob ; 2011. Les médias sont capables d'altérer notre santé. Les preuves dans ce sens abondent. Mais comment et pourquoi ? Aujourd'hui, nous sommes en permanence informés, inondés même, de tout ce qui se passe sur la planète, et ce n'est évidemment pas sans conséquence. Les médias, les journaux, Internet, la télévision, par le flux d'informations catastrophes qu'ils diffusent, auraient-ils le pouvoir de nous rendre physiquement malades, sans parler de la dépression, de l'insomnie, de l'angoisse, en un mot, du mal-être qu'ils peuvent engendrer ? Dans ce livre, Patrick Lemoine analyse l'apparition d'un phénomène nouveau : l'effet nocebo, exact contrepoint du bénéfique placebo. Quel est exactement son mystérieux impact ? Une réflexion critique et salutaire à propos de notre système de communication, qui nous incitera à nous protéger et à retrouver un optimisme raisonnable. [résumé d'éditeur] Article A lire en ligne depuis les postes du CHSA : http://www.empremium.com/articl e/792489 7. LAMBOY Béatrice, SAIAS Thomas. Réduire la stigmatisation des personnes souffrant de troubles psychiques par une campagne de communication ? Une synthèse de la littérature. ANNALES MEDICO PSYCHOLOGIQUES 2013 ; 171(2) : 77-82. La lutte contre la stigmatisation des personnes souffrant de troubles psychiques représente un axe majeur des politiques publiques dans le domaine de la santé mentale. Au niveau international, de nombreux programmes de déstigmatisation destinés au grand public ont été développés ces dernières années (campagnes de communication généralistes ou plus ciblées). Cependant, peu de recherches évaluatives ont été réalisées dans le domaine. Les quelques études portant sur les campagnes de communication n’ont pas pu montrer d’effets significatifs. Les campagnes généralistes et ponctuelles sont largement remises en question, et un certain nombre de problèmes se posent dès l’élaboration stratégique de ces actions : absence de définition opérationnelle de la stigmatisation, limites ambiguës entre préjugés stigmatisants et faits avérés, objectifs des programmes flous et imprécis, motivations ambivalentes des porteurs des actions, non-évaluation du poids et des conséquences effectives de la stigmatisation dans le vécu des personnes souffrant de troubles psychiques... Enfin, l’appartenance des actions anti-stigma au champ de la réhabilitation est aussi rappelée. [résumé d'auteur] Article Disponible à la bibliothèque 8. ARVEILLER Jean-Paul. De quelques représentations contradictoires agitant la psychiatrie. PRATIQUES EN SANTE MENTALE 2011 ; 57(2) : 5-9. L'ambivalence des représentations sociales vis-à-vis de la psychiatrie renvoie depuis ses débuts à la question fondamentale de la liberté individuelle. Primordiale pour tout être humain, cette liberté est aussi conditionnelle dès lors que la personne présente de tels troubles et de telles difficultés qu'elle nécessite d'être contrôlée dans ses faits et gestes par une société normalement responsable de l'intérêt collectif ? La psychiatrie et ce qu'elle traite, c'est-à-dire la folie et les malades mentaux, représentent la face sombre du corps social, celle dont la communauté a honte, qu'elle veut cacher (à ses propres yeux), ou du moins éloigner (de sa vue en situant les hôpitaux psychiatriques loin de la ville) et qu'elle craint tout autant. À condition de ne pas être eux-mêmes enclins à cette ambivalence, politiques et professionnels de la santé mentale ont encore beaucoup à accomplir pour convaincre que la pathologie psychiatrique ne constitue pas un authentique fléau social et que les malades, fussent-ils mentaux, appartiennent, comme tout individu, au corps social. [résumé d'auteur] Article Disponible à la bibliothèque 9. JODELET Denise. Considérations sur le traitement de la stigmatisation en santé mentale. PRATIQUES EN SANTE MENTALE 2011 ; 57(2) : 27-38. Loin d'être évidente à comprendre, la stigmatisation des pathologies psychiatriques et-ou des troubles psychiques et des malades mentaux ne peut, selon l'auteure de l'article, ancienne directrice d'études à l'École des Hautes Études en Sciences Sociales (EHESS) de Paris, être abordée qu'au regard de l'évolution historique, politique et sociale. Une connaissance trop scientifique, trop experte, de ces pathologies et troubles (souvent réduits à un seul terme, celui de folie) et de ces malades (perçus comme fous), ne permet nullement de faire évoluer le regard posé par la société et les sujets qui la composent et qui en édictent les normes. L'information ne doit pas manquer, la communication ne doit pas être biaisée (notamment par des allégations de dangerosité et des discours sécuritaires) pour que les représentations sociales liées à la santé mentale aient une chance de changer. En 1963, Erving Goffman avait pourtant ouvert la voie en matière de transmission du savoir sur la stigmatisation. [résumé d'auteur] Article A lire en ligne depuis les postes du CHSA : http://www.empremium.com/articl e/888663 10. JOUET E, MOINEVILLE M, FAVRIEL S, LERICHE P, GREACEN T. Impact significatif auprès des conseillers à l'emploi d'une action de sensibilisation à la santé mentale et de déstigmatisation incluant des usagersformateurs. ENCEPHALE 2014 ; 40(2) : 136-42. Les programmes et actions visant à lutter contre la stigmatisation et la discrimination à l'encontre des personnes vivant avec un trouble psychique se développent internationalement. Les actions de déstigmatisation faisant intervenir des usagers des services psychiatriques ont montré leur efficacité au niveau international. Cette étude évalue les effets sur les connaissances, croyances, attitudes et désir de distance sociale de conseillers de Missions locales parisiens d'une sensibilisation au handicap psychique à laquelle ont participé des usagers-formateurs. Quatre-vingt-neuf professionnels ont participé à huit journées de sensibilisation entre décembre 2008 et juin 2009. Celles -ci s'appuyaient sur deux axes pédagogiques complémentaires : les connaissances théoriques apportées par un psychiatre puis des témoignages et échanges avec un usager-formateur. Un questionnaire administré en début et en fin de journée a évalué l'impact de la journée sur les connaissances, croyances, pratiques des participants ainsi que sur leur désir de distance sociale par rapport aux personnes malades. Cette intervention formative de courte durée axée sur une approche à la fois expérientelle et médicale a eu des effets positifs sur les connaissances, les croyances et le désir de distance sociale des conseillers d'accompagnement à l'insertion professionnelle par rapport à la maladie mentale. Elle confirme leur besoin d'information et améliore leur confiance à intervenir auprès d'un tel public. Des recherches complémentaires sont nécessaires pour déterminer les effets à moyen terme de ce type d'action de déstigmatisation dans le domaine de l'insertion professionnelle et notamment sur les pratique [Résumé d'auteur] Livre Disponible à la BM 11. GIORDANA Jean-Yves Dir., ANGERMEYER Matthias, BALLESTER ROSELLO Josep, BENRADIA Imane, BERTINI Marie-Joseph, BOGGERO Martine, et al. Stigmatisation en psychiatrie et en santé mentale. Issy-les-Moulineaux : Elsevier Masson ; 2010. La stigmatisation dans le champ de la psychiatrie et de la santé mentale repose, à la fois, sur la méconnaissance, l'ignorance des principaux aspects des maladies psychiques et sur une forme de construction sociale au sujet des troubles psychiques qui prend appui sur l'identification, chez une personne, d'une marque distinctive à laquelle est attribué un caractère socialement honteux, en même temps qu'elle confère à la personne une identité sociale. Des croyances d'ordre culturel, dont les médias font écho, génèrent la peur de ces maladies pour le groupe social avec, en corollaire, un fort sentiment de dévalorisation pour ceux qui en sont atteints. Ils peuvent devenir la cible d'attitudes négatives, les préjugés à l'encontre des malades psychiques faisant référence à des notions de violence, de dangerosité, d'inadaptation, d'incurabilité, d'absence de motivation, voire de paresse. La stigmatisation peut engendrer la discrimination et le déni des droits légitimes, et constitue un obstacle majeur à leur réinsertion et à leur accès aux soins. Ainsi se perpétue un cercle vicieux qui alimente la souffrance et isole davantage les personnes malades, sans parler des effets délétères sur les relations familiales et sociales, sur l'emploi, le logement, l'insertion sociale, l'estime de soi, la confiance en soi. Comment faire évoluer la perception du grand public ? Des actions d'information, de sensibilisation et d'éducation doivent être renouvelées auprès des élus, des décideurs, des prestataires de service, sans oublier les médias, qui ont un grand pouvoir de renforcer ou de minimiser le phénomène d'exclusion. Cette lutte doit adopter des approches multisectorielles en y associant le monde scolaire, le système pénal ou juridique, le pôle emploi, les services de logement ou encore l'aide sociale afin d'améliorer l'humanité des rapports avec les usagers des services de santé mentale et renforcer la protection de leurs droits fondamentaux. [Résumé d’éditeur] Article A lire en ligne : http://www.ncbi.nl m.nih.gov/pmc/artic les/pmid/25114531/ 12. Neuropsychiatr Dis Treat. 2014 Jul 29;10:1399-405. doi: 10.2147/NDT.S54081. eCollection 2014. Perspectives on perceived stigma and self-stigma in adult male patients with depression. Latalova K, Kamaradova D, Prasko J. Author information Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, Olomouc, Czech Republic. Abstract There are two principal types of stigma in mental illness, ie, "public stigma" and "self-stigma". Public stigma is the perception held by others that the mentally ill individual is socially undesirable. Stigmatized persons may internalize perceived prejudices and develop negative feelings about themselves. The result of this process is "self-stigma". Stigma has emerged as an important barrier to the treatment of depression and other mental illnesses. Gender and race are related to stigma. Among depressed patients, males and African-Americans have higher levels of self-stigma than females and Caucasians. Perceived stigma and self-stigma affect willingness to seek help in both genders and races. African-Americans demonstrate a less positive attitude towards mental health treatments than Caucasians. Religious beliefs play a role in their coping with mental illness. Certain prejudicial beliefs about mental illness are shared globally. Structural modeling indicates that conformity to dominant masculine gender norms ("boys don't cry") leads to self-stigmatization in depressed men who feel that they should be able to cope with their illness without professional help. These findings suggest that targeting men's feelings about their depression and other mental health problems could be a more successful approach to change help-seeking attitudes than trying to change those attitudes directly. Further, the inhibitory effect of traditional masculine gender norms on help-seeking can be overcome if depressed men feel that a genuine connection leading to mutual understanding has been established with a health care professional. Article A lire en ligne depuis les postes du CHSA : http://www.science direct.com/science/ article/pii/S0165032 713006368 13. J Affect Disord. 2013 Dec;151(3):805-20. doi: 10.1016/j.jad.2013.08.014. Epub 2013 Aug 26. Bipolar disorder and stigma: a systematic review of the literature. Ellison N1, Mason O, Scior K. Author information 1Clinical, Educational and Health Psychology Research Department, University College London, London WC1E 7HB, United Kingdom. Electronic address: [email protected]. Abstract AIM: The degree to which bipolar disorder is stigmatised by the public and the extent of internalised stigma for people with this disorder, their families, and carers has been a relatively neglected area of research. This review aimed to determine what is currently known about stigma and bipolar disorder. METHOD: A systematic search of the literature was conducted to identify publications which investigated public attitudes and/or beliefs about bipolar disorder or explored internalised stigma in bipolar disorder. The electronic databases PsychINFO, Medline, Embase, and Web of Science were searched for articles published between 1992 and 2012. RESULTS: Twenty five articles met the reviews inclusion criteria. There are inconsistent findings regarding public stigma, although there is some evidence that bipolar disorder is viewed more positively than schizophrenia and less positively than depression. There is a moderate to high degree of internalised stigma in bipolar disorder, although the literature raises questions regarding its ubiquity in this population. LIMITATIONS: Limiting the search by year of publication and excluding studies where stigma was not the main focus could mean stigma has wider implications than were identified. CONCLUSIONS: This review is the first systematic synthesis of research relating to stigma and bipolar disorder. In comparison to research on other mental health problems, there is a dearth of literature exploring stigma in bipolar disorder. The literature is largely inconclusive. Future research is needed to replicate tentative findings and address methodological limitations before the field can move on to the development of anti-stigma interventions. Article 14. Cochrane Database Syst Rev. 2013 Jul 23;7:CD009453. doi: 10.1002/14651858.CD009453.pub2. Mass media interventions for reducing mental health-related stigma. Clement S1, Lassman F, Barley E, Evans-Lacko S, Williams P, Yamaguchi S, Slade M, Rüsch N, Thornicroft G. Author information 1Health Service and Population ResearchDepartment, King’s College London, Institute of Psychiatry, London, UK. [email protected]. Abstract BACKGROUND: Mental health-related stigma is widespread and has major adverse effects on the lives of people with mental health problems. Its two major components are discrimination (being treated unfairly) and prejudice (stigmatising attitudes). Anti-stigma initiatives often include mass media interventions, and such interventions can be expensive. It is important to know if mass media interventions are effective. OBJECTIVES: To assess the effects of mass media interventions on reducing stigma (discrimination and prejudice) related to mental ill health compared to inactive controls, and to make comparisons of effectiveness based on the nature of the intervention (e.g. number of mass media components), the content of the intervention (e.g. type of primary message), and the type of media (e.g. print, internet). SEARCH METHODS: We searched eleven databases: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 7, 2011); MEDLINE (OvidSP),1966 to 15 August 2011; EMBASE (OvidSP),1947 to 15 August 2011; PsycINFO (OvidSP), 1806 to 15 August 2011; CINAHL (EBSCOhost) 1981 to 16 August 2011; ERIC (CSA), 1966 to 16 August 2011; Social Science Citation Index (ISI), 1956 to 16 August 2011; OpenSIGLE (http://www.opengrey.eu/), 1980 to 18 August 2012; Worldcat Dissertations and Theses (OCLC), 1978 to 18 August 2011; metaRegister of Controlled Trials (http://www.controlled-trials.com/mrct/mrct_about.asp), 1973 to 18 August 2011; and Ichushi (OCLC), 1903 to 11 November 2011. We checked references from articles and reviews, and citations from included studies. We also searched conference abstracts and websites, and contacted researchers. SELECTION CRITERIA: Randomised controlled trials (RCTs), cluster RCTs or interrupted time series studies of mass media interventions compared to inactive controls in members of the general public or any of its constituent groups (excluding studies in which all participants were people with mental health problems), with mental health as a subject of the intervention and discrimination or prejudice outcome measures. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed the risk of bias of included studies. We contacted study authors for missing information. Information about adverse effects was collected from study reports. Primary outcomes were discrimination and prejudice, and secondary outcomes were knowledge, cost, reach, recall, and awareness of interventions, duration/sustainability of media effects, audience reactions to media content, and unforeseen adverse effects. We calculated standardised mean differences and odds ratios. We conducted a primarily narrative synthesis due to the heterogeneity of included studies. Subgroup analyses were undertaken to examine the effects of the nature, content and type of mass media intervention. MAIN RESULTS: We included 22 studies involving 4490 participants. All were randomised trials (3 were cluster RCTs), and 19 of the 22 studies had analysable outcome data. Seventeen of the studies had student populations. Most of the studies were at unclear or high risk of bias for all forms of bias except detection bias.Findings from the five trials with discrimination outcomes (n = 1196) were mixed, with effects showing a reduction, increase or consistent with no evidence of effect. The median standardised mean difference (SMD) for the three trials (n = 394) with continuous outcomes was -0.25, with SMDs ranging from -0.85 (95% confidence interval (CI) -1.39 to 0.31) to -0.17 (95% CI -0.53 to 0.20). Odds ratios (OR) for the two studies (n = 802) with dichotomous discrimination outcomes showed no evidence of effect: results were 1.30 (95% CI 0.53 to 3.19) and 1.19 (95% CI 0.85 to 1.65).The 19 trials (n = 3176) with prejudice outcomes had median SMDs favouring the intervention, at the three following time periods: -0.38 (immediate), -0.38 (1 week to 2 months) and -0.49 (6 to 9 months). SMDs for prejudice outcomes across all studies ranged from -2.94 (95% CI -3.52 to 2.37) to 2.40 (95% CI 0.62 to 4.18). The median SMDs indicate that mass media interventions may have a small to medium effect in decreasing prejudice, and are equivalent to reducing the level of prejudice from that associated with schizophrenia to that associated with major depression.The studies were very heterogeneous, statistically, in their populations, interventions and outcomes, and only two meta-analyses within two subgroups were warranted. Data on secondary outcomes were sparse. Cost data were provided on request for three studies (n = 416), were highly variable, and did not address cost-effectiveness. Two studies (n = 455) contained statements about adverse effects and neither reported finding any. AUTHORS' CONCLUSIONS: Mass media interventions may reduce prejudice, but there is insufficient evidence to determine their effects on discrimination. Very little is known about costs, adverse effects or other outcomes. Our review found few studies in middle- and low-income countries, or with employers or health professionals as the target group, and none targeted at children or adolescents. The findings are limited by the quality of the evidence, which was low for the primary outcomes for discrimination and prejudice, low for adverse effects and very low for costs. More research is required to establish the effects of mass media interventions on discrimination, to better understand which types of mass media intervention work best, to provide evidence about cost-effectiveness, and to fill evidence gaps about types of mass media not covered in this review. Such research should use robust methods, report data more consistently with reporting guidelines and be less reliant on student populations. Article A lire en ligne depuis les postes du CHSA : http://link.springer.c om/article/10.1007/ s00127-013-0729-4 15. Soc Psychiatry Psychiatr Epidemiol. 2014 Jan;49(1):79-87. doi: 10.1007/s00127-013-0729-4. Epub 2013 Jul 9. Stigma in patients with schizophrenia receiving community mental health care: a review of qualitative studies. Mestdagh A1, Hansen B. Author information 1Faculty of Medicine, LUCAS - Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium, [email protected]. Abstract PURPOSE: The aim of this review is to identify consistent themes among the qualitative literature on stigma as experienced by patients with schizophrenia receiving community mental health care. With the treatment focus of schizophrenia nowadays shifting more and more towards community-based mental health care, professionals need to be aware of the increased vulnerability of their clients in their social environment as a result of stigma towards their disease. In-depth knowledge on stigma is critical in order to offer a dignifying community mental health care. METHODS: A systematic search of the qualitative literature in Web of Science, PubMed, PsycINFO and Francis was performed to review the subjective experiences and ideas on stigma in outpatients with schizophrenia. RESULTS: Three major themes were identified in 18 studies and need to be taken into consideration when implementing an adequate community mental health care: (i) the continuing existence of stigma inherent in the health care setting, (ii) the importance of relational aspects of stigma encounters in daily life and (iii) the significance of the behavioural aspects related to previous stigma experiences and beliefs among patients. CONCLUSIONS: Despite much effort in community treatment, patients still experience stigma and discrimination. Community mental health care professionals should not only be aware of structural problems in mental health care, but should also pay considerable attention towards the relational and behavioural aspects in their clients' life concerning stigma. Furthermore, they have the crucial role in the community to raise awareness about stigma in order to increase their clients' acceptance in society. Article A lire en ligne: http://www.ncbi.nl m.nih.gov/pubmedh ealth/PMH0064858 16. J Nerv Ment Dis. 2013 Jun;201(6):490-503. doi: 10.1097/NMD.0b013e31829480df. Effects of short-term interventions to reduce mental health-related stigma in university or college students: a systematic review. Yamaguchi S1, Wu SI, Biswas M, Yate M, Aoki Y, Barley EA, Thornicroft G. Author information 1Department of Psychiatric Rehabilitation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan. [email protected] Abstract Although there are many interventions to reduce mental health-related stigma in university or college students, their overall effect is unknown. This article systematically reviews intervention studies and aims to identify the effective approaches. We searched 11 bibliographic databases, Google, Web sites of relevant associations, and reference lists and contacted specialists. A total of 35 studies (N = 4257) of a wide range of interventions met the inclusion criteria. Social contact or video-based social contact interventions seemed to be the most effective in improving attitudes and reducing desire for social distance. Evidence from one study suggests that a lecture that provided treatment information may enhance students' attitudes toward the use of services. However, methodological weaknesses in many studies were also found. There was a lack of evidence for interventions in medical students, for long-term effects of interventions, or for having a positive impact on actual behaviors. Further research having more rigorous methods is needed to confirm this. Article 17. J Health Soc Behav. 2013 Mar;54(1):1-21. doi: 10.1177/0022146512471197. Epub 2013 Jan 16. The public stigma of mental illness: what do we think; what do we know; what can we prove? Pescosolido BA. Author information Indiana University, Bloomington, IN 47405, USA. [email protected] Abstract By the 1990s, sociology faced a frustrating paradox. Classic work on mental illness stigma and labeling theory reinforced that the "mark" of mental illness created prejudice and discrimination for individuals and family members. Yet that foundation, coupled with deinstitutionalization of mental health care, produced contradictory responses. Claims that stigma was dissipating were made, while others argued that intervention efforts were needed to reduce stigma. While signaling the critical role of theory-based research in establishing the pervasive effects of stigma, both claims directed resources away from social science research. Yet the contemporary scientific foundation underlying both claims was weak. A reply came in a resurgence of research directed toward mental illness stigma nationally and internationally, bringing together researchers from different disciplines for the first time. I report on the general population's attitudes, beliefs, and behavioral dispositions that targeted public stigma and implications for the next decade of research and intervention efforts. Article 18. Psychiatr Serv. 2012 Oct;63(10):963-73. doi: 10.1176/appi.ps.201100529. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Corrigan PW1, Morris SB, Michaels PJ, Rafacz JD, Rüsch N. Author information 1Illinois Institute of Technology, 3424 S. State St., Chicago, IL 60616, USA. [email protected] Abstract OBJECTIVE: Public stigma and discrimination have pernicious effects on the lives of people with serious mental illnesses. Given a plethora of research on changing the stigma of mental illness, this article reports on a meta-analysis that examined the effects of antistigma approaches that included protest or social activism, education of the public, and contact with persons with mental illness. METHODS: The investigators heeded published guidelines for systematic literature reviews in health care. This comprehensive and systematic review included articles in languages other than English, dissertations, and population studies. The search included all articles from the inception of the databases until October 2010. Search terms fell into three categories: stigma, mental illness (such as schizophrenia and depression), and change program (including contact and education). The search yielded 72 articles and reports meeting the inclusion criteria of relevance to changing public stigma and sufficient data and statistics to complete analyses. Studies represented 38,364 research participants from 14 countries. Effect sizes were computed for all studies and for each treatment condition within studies. Comparisons between effect sizes were conducted with a weighted one-way analysis of variance. RESULTS: Overall, both education and contact had positive effects on reducing stigma for adults and adolescents with a mental illness. However, contact was better than education at reducing stigma for adults. For adolescents, the opposite pattern was found: education was more effective. Overall, face-to-face contact was more effective than contact by video. CONCLUSIONS: Future research is needed to identify moderators of the effects of both education and contact. Article A lire en ligne : http://www.ncbi.nl m.nih.gov/pmc/artic les/pmid/22833051/ 19. Adm Policy Ment Health. 2013 Sep;40(5):384-99. doi: 10.1007/s10488-012-0430-z. Public stigma of mental illness in the United States: a systematic literature review. Parcesepe AM1, Cabassa LJ. Author information 1Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. [email protected] Abstract Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public's stigma toward mental disorders, (2) summarize stigma findings focused on the public's stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental disorders and advance research in this area. Public stigma of mental illness in the U.S. was widespread. Findings can inform interventions to reduce the public's stigma of mental illness. Article A lire en ligne depuis les postes du CHSA : http://link.springer.c om/article/10.1007/ s00127-012-0491-z 20. Soc Psychiatry Psychiatr Epidemiol. 2012 Apr;47 Suppl 1:1-38. doi: 10.1007/s00127-012-0491-z. Fighting stigma of mental illness in midsize European countries. Beldie A1, den Boer JA, Brain C, Constant E, Figueira ML, Filipcic I, Gillain B, Jakovljevic M, Jarema M, Jelenova D, Karamustafalioglu O, Kores Plesnicar B, Kovacsova A, Latalova K, Marksteiner J, Palha F, Pecenak J, Prasko J, Prelipceanu D, Ringen PA, Sartorius N, Seifritz E, Svestka J, Tyszkowska M, Wancata J. Author information 1Department of Psychiatry Middelfart, Region of Southern Denmark, Middelfart, Denmark. Abstract PURPOSE: Stigma is the most powerful obstacle to the development of mental health care. Numerous activities aiming to reduce the stigma of mental illness and the consequent negative discrimination of the mentally ill and their families have been conducted in Europe. Descriptions of many of these activities are not easily available, either because there are no publications that describe them, or because descriptions exist only in local languages. This supplement aims to help in overcoming this imbalance by providing a description of anti-stigma activities in 14 countries in Europe regardless of the language in which they were published and regardless whether they were previously published. METHODS: The review was undertaken by experts who were invited to describe anti-stigma activities in the countries in which they reside. It was suggested that they use all the available evidence and that they consult others in their country to obtain a description of anti-stigma activities that is as complete as possible. RESULTS: The anti-stigma activities undertaken in the countries involved are presented in a tabular form. The texts contributed by the authors focus on their perception of the stigma of mental illness and of activities undertaken to combat it in their country. CONCLUSIONS: Although much has been done against the stigmatization and discrimination of the mentally ill, fighting stigma remains an essential task for mental health programs and for society. The descriptions summarized in this volume might serve as an inspiration for anti-stigma work and as an indication of potential collaborators in anti-stigma programs. Article A lire en ligne depuis les postes du CHSA : http://publications.c paapc.org/media.php? mid=1334 21. Can J Psychiatry. 2012 Aug;57(8):457-63. From sin to science: fighting the stigmatization of mental illnesses. Arboleda-Flórez J1, Stuart H. Author information 1Queen's University, Kingston, Ontario. [email protected] Abstract Our paper provides an overview of current stigma discourse, the origins and nature of the stigma associated with mental illnesses, stigmatization by health providers, and approaches to stigma reduction. This is a narrative review focusing on seminal works from the social and psychological literature, with selected qualitative and quantitative studies and international policy documents to highlight key points. Stigma discourse has increasingly moved toward a human rights model that views stigma as a form of social oppression resulting from a complex sociopolitical process that exploits and entrenches the power imbalance between people who stigmatize and those who are stigmatized. People who have a mental illness have identified mental health and health providers as key contributors to the stigmatization process and worthy targets of antistigma interventions. Six approaches to stigma reduction are described: education, protest, contact-based education, legislative reform, advocacy, and stigma self-management. Stigma denigrates the value of people who have a mental illness and the social and professional support systems designed to support them. It creates inequities in funding and service delivery that undermine recovery and full social participation. Mental health professionals have often been identified as part of the problem, but they can redress this situation by becoming important partners in antistigma work. Article A lire en ligne depuis les postes du CHSA : http://link.springer.c om/article/10.1007/ s00406-011-0252-0 22. Eur Arch Psychiatry Clin Neurosci. 2011 Nov;261 Suppl 2:S119-23. doi: 10.1007/s00406-011-0252-0. Epub 2011 Sep 21. Measuring the stigma of psychiatry and psychiatrists: development of a questionnaire. Gaebel W1, Zäske H, Cleveland HR, Zielasek J, Stuart H, Arboleda-Florez J, Akiyama T, Gureje O, Jorge MR, Kastrup M, Suzuki Y, Tasman A, Sartorius N. Author information 1Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany. [email protected] Abstract The stigma of mental illness is a severe burden for people suffering from mental illness both in private and public life, also affecting their relatives, their close social network, and the mental health care system in terms of disciplines, providers, and institutions. Interventions against the stigma of mental illness employ complementary strategies (e.g., protest, education, and contact) and address different target groups (e.g., school children and teachers, journalists, stakeholders). Within this framework, the World Psychiatric Association has adopted an Action Plan with the goal to improve the image of psychiatry and to reduce potential stigmatizing attitudes toward psychiatry and psychiatrists. To evaluate such interventions, a questionnaire has been developed that assesses opinions and attitudes toward psychiatrists and psychiatry in different samples of medical specialists (psychiatrists and general practitioners). The questionnaire comprises scales about perceived stigma in terms of the perception of societal stereotypes, self-stigma in terms of stereotype agreement, perceived stigma in terms of structural discriminations, discrimination experiences, stigma outcomes, and attitudes toward a second medical discipline. It is available in several languages (Arab, English, German, Japanese, Polish, and Spanish) and can easily be adapted for utilization in other medical specialties. Article 23.Soc Sci Med. 2010 Dec;71(12):2150-61. doi: 10.1016/j.socscimed.2010.09.030. Epub 2010 Oct 12. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Livingston JD1, Boyd JE. Author information 1Forensic Psychiatric Services Commission, BC Mental Health & Addiction Services, British Columbia, Canada. [email protected] Abstract An expansive body of research has investigated the experiences and adverse consequences of internalized stigma for people with mental illness. This article provides a systematic review and meta-analysis of the extant research regarding the empirical relationship between internalized stigma and a range of sociodemographic, psychosocial, and psychiatric variables for people who live with mental illness. An exhaustive review of the research literature was performed on all articles published in English that assessed a statistical relationship between internalized stigma and at least one other variable for adults who live with mental illness. In total, 127 articles met the inclusion criteria for systematic review, of which, data from 45 articles were extracted for meta-analyses. None of the sociodemographic variables that were included in the study were consistently or strongly correlated with levels of internalized stigma. The review uncovered a striking and robust negative relationship between internalized stigma and a range of psychosocial variables (e.g., hope, self-esteem, and empowerment). Regarding psychiatric variables, internalized stigma was positively associated with psychiatric symptom severity and negatively associated with treatment adherence. The review draws attention to the lack of longitudinal research in this area of study which has inhibited the clinical relevance of findings related to internalized stigma. The study also highlights the need for greater attention on disentangling the true nature of the relationship between internalized stigma and other psychosocial variables. Article 24.Issues Ment Health Nurs. 2010 Jul;31(7):450-5. doi: 10.3109/01612840903537167. Stigma in mental health: clients and professionals. Horsfall J1, Cleary M, Hunt GE. Author information 1Sydney South West Area Mental Health Service, Concord Hospital, Sydney, Australia. Abstract Stigmatising attitudes are not uncommon among mental health professionals who may be less than optimistic about outcomes for people with long-term mental health problems. These perceptions are probably related to the professionals' experiences, such as those working in the public sector dealing with clients in the most disturbed phases of mental illness. We provide an overview of stigma and some contemporary stigma conceptualisations and then explore some stigma-reducing strategies for mental health professionals. The way that mental health professionals work with patients can have an important effect on their recovery. Article A lire en ligne : http://www.ncbi.nl m.nih.gov/pmc/artic les/pmid/20338040/ 25. BMC Health Serv Res. 2010 Mar 25;10:80. doi: 10.1186/1472-6963-10-80. Experiences of mental illness stigma, prejudice and discrimination: a review of measures. Brohan E1, Slade M, Clement S, Thornicroft G. Author information 1Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. [email protected] Abstract BACKGROUND: There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. METHOD: A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. RESULTS: 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. CONCLUSIONS: The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose. Article 26. Adm Policy Ment Health. 2010 Mar;37(1-2):61-70. doi: 10.1007/s10488010-0294-z. Stigma in child and adolescent mental health services research: understanding professional and institutional stigmatization of youth with mental health problems and their families. Heflinger CA1, Hinshaw SP. Author information 1Department of Human and Organizational Development, Peabody College of Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA. [email protected] Abstract To understand the low utilization rates of child and adolescent mental health services, it is necessary to recognize the kinds of professional and institutional stigma that may produce barriers to care. We address the large literature on the stigmatization of mental illness, linkages between such literature and children's mental health services use, and the kinds of professional and institutional attitudes and practices that communicate shame and low expectations to youth and their families. It will take recognition of such stigmatizing practices-including overcoming resistance to the messages presented herein-to make real progress in the effort to increase utilization of evidence-based practices. Multi-faceted, multi-level, and multi-disciplinary approaches to both research and intervention are recommended. Article A lire en ligne : http://www.ncbi.nl m.nih.gov/pmc/artic les/pmid/20215931/ 27. J Am Acad Child Adolesc Psychiatry. 2010 Feb;49(2):92-103; quiz 198. The stigma of childhood mental disorders: a conceptual framework. Mukolo A1, Heflinger CA, Wallston KA. Author information 1Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN 37203-1738, USA. [email protected] Abstract OBJECTIVE: To describe the state of the literature on stigma associated with children's mental disorders and highlight gaps in empirical work. METHOD: We reviewed child mental illness stigma articles in (English only) peer-reviewed journals available through Medline and PsychInfo. We augmented these with adult-oriented stigma articles that focus on theory and measurement. A total of 145 articles in PsychInfo and 77 articles in MEDLINE met search criteria. The review process involved identifying and appraising literature convergence on the definition of critical dimensions of stigma, antecedents, and outcomes reported in empirical studies. RESULTS: We found concurrence on three dimensions of stigma (negative stereotypes, devaluation, and discrimination), two contexts of stigma (self, general public), and two targets of stigma (self/individual, family). Theory and empirics on institutional and self-stigma in child populations were sparse. Literature reports few theoretic frameworks and conceptualizations of child mental illness stigma. One model of help seeking (the FINIS) explicitly acknowledges the role of stigma in children's access and use of mental health services. CONCLUSIONS: Compared with adults, children are subject to unique stigmatizing contexts that have not been adequately studied. The field needs conceptual frameworks that get closer to stigma experiences that are causally linked to how parents/caregivers cope with children's emotional and behavioral problems, such as seeking professional help. To further research in child mental illness, we suggest an approach to adapting current theoretical frameworks and operationalizing stigma, highlighting three dimensions of stigma, three contexts of stigma (including institutions), and three targets of stigma (self/child, family, and services).
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