Activism against stigma: Exploring awareness-raising activities in the healthcare context
Abstract
Stigma suffered by people labelled with mental health diagnoses is something frequent within the healthcare context. Anti-stigma organizations and campaigns have focused their efforts on reducing discrimination in this area. The activist figure is fundamental for people who have experienced this stigma to be the protagonists of this change. Our aim in this study has been to deepen the experience that anti-stigma activists in mental health have when participating in actions to raise awareness in the healthcare context. We carried out a thematic analysis of semi-structured interviews conducted with five activists. We identified two thematic blocks: Stigma and Activism. The Stigma block consists of the themes Prejudice, Discriminatory Behaviours, and Self-Stigma, while the Activism block is composed of the themes Positive Effects, Strategies, and Impact. The present study has allowed us to have deeper knowledge of the subjective experiences of stigma in the healthcare field through the experience of participants in campaigns to combat it, and to understand why activism can be a beneficial strategy to raise awareness among professionals and for the well-being and empowerment of the activists themselves.
Keywords
Activism, Thematic analysis, Social stigma, Mental healthReferences
Andrés-Rodríguez, Laura; Pérez-Aranda, Adrián; Feliu-Soler, Albert; Rubio-Valera, Maria; Aznar-Lou, Ignacio; Serrano-Blanco, Antoni; Juncosa, Miquel; Tosas, Anaïs; Bernadàs, Albert & Luciano, Juan V. (2017). Effectiveness of the “What’s Up!” Intervention to Reduce Stigma and Psychometric Properties of the Youth Program Questionnaire (YPQ): Results from a Cluster Non-randomized Controlled Trial Conducted in Catalan High Schools. Frontiers in Psychology, 8(SEP), 1-12. https://doi.org/10.3389/fpsyg.2017.01608
Angermeyer, Matthias C. & Matschinger, Herbert (2005). Labeling - Stereotype - Discrimination: An investigation of the stigma process. Social Psychiatry and Psychiatric Epidemiology, 40(5), 391-395. https://doi.org/10.1007/s00127-005-0903-4
Aznar-Lou, Ignacio; Serrano-Blanco, Antoni; Fernández, Ana; Luciano, Juan V. & Rubio-Valera, Maria (2015). Attitudes and intended behaviour to mental disorders and associated factors in catalan population, Spain: cross-sectional population-based survey. BMC Public Health, 16(1), 127. https://doi.org/10.1186/s12889-016-2815-5
Braun, Virginia & Clarke, Victoria. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Corker, Elizabeth; Hamilton, Sarah; Henderson, Claire; Weeks, Craig; Pinfold, Vanessa; Rose, Diana; Williams, Paul; Flach, Clare; Gill, Valdeep; Lewis-Holmes, Elanor & Thornicroft, Graham. (2013). Experiences of discrimination among people Using mental health services in England 2008-2011. British Journal of Psychiatry, 202(s55), s58-s63. https://doi.org/10.1192/bjp.bp.112.112912
Corrigan, Patrick W. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614-625. https://doi.org/10.1037/0003-066X.59.7.614
Corrigan, Patrick W.; Druss, Benjamin G. & Perlick, Deborah A. (2014). The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychological Science in the Public Interest, 15(2), 37-70. https://doi.org/10.1177/1529100614531398
Corrigan, Patrick W.; Kerr, Amy & Knudsen, Lissa (2005). The stigma of mental illness: Explanatory models and methods for change. Applied and Preventive Psychology, 11(3), 179-190. https://doi.org/10.1016/j.appsy.2005.07.001
Corrigan, Patrick W. & Watson, Amy C. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1(1), 16-20. http://www.ncbi.nlm.nih.gov/pubmed/16946807
Eiroa-Orosa, Francisco José & García-Mieres, Helena (2019). A Systematic Review and Meta-analysis of Recovery Educational Interventions for Mental Health Professionals. Administration and Policy in Mental Health and Mental Health Services Research, 46(6), 724-752. https://doi.org/10.1007/s10488-019-00956-9
Eiroa-Orosa, Francisco José & Limiñana-Bravo, Laura (2019). An Instrument to Measure Mental Health Professionals’ Beliefs and Attitudes towards Service Users’ Rights. International Journal of Environmental Research and Public Health, 16(2), 244. https://doi.org/10.3390/ijerph16020244
Eiroa-Orosa, Francisco José & Lomascolo, María (2018). Training mental health activists increases the well-being of participants with high baseline levels of self-stigma: results of the Obertament training evaluation. American Journal of Orthopsychiatry, 88(6), 617-625. https://doi.org/10.1037/ort0000376
Eiroa-Orosa, Francisco José; Lomascolo, María & Tosas-Fernández, Anaïs (2021). Efficacy of an Intervention to Reduce Stigma Beliefs and Attitudes among Primary Care and Mental Health Professionals: Two Cluster Randomised-Controlled Trials. International Journal of Environmental Research and Public Health, 18(3), 1214. https://doi.org/10.3390/ijerph18031214
Gaebel, Wolfgang; Rössler, Wulf & Sartorius, Norman (Eds.) (2017). The Stigma of Mental Illness - End of the Story? Springer.
https://doi.org/10.1007/978-3-319-27839-1
Gerlinger, Gabriel; Hauser, Marta; De Hert, Marc; Lacluyse, Kathleen; Wampers, Martien & Correll, Christoph U. (2013). Personal stigma in schizophrenia spectrum disorders: A systematic review of prevalence rates, correlates, impact and interventions. World Psychiatry, 12(2), 155-164. https://doi.org/10.1002/wps.20040
Goffman, Erving (1963). Stigma: Notes on the Management of Spoiled Identity. Prentice-Hall.
Goldman, Howard H. & Morrissey, Joseph P. (1985). The alchemy of mental health policy: homelessness and the fourth cycle of reform. American Journal of Public Health, 75(7), 727-731. https://doi.org/10.2105/AJPH.75.7.727
Hayward, Peter & Bright, Jenifer A. (1997). Stigma and mental illness: A review and critique. Journal of Mental Health, 6(4), 345-354. https://doi.org/10.1080/09638239718671
Henderson, Claire; Noblett, Jo; Parke, Hannah; Clement, Sarah; Caffrey, Alison; Gale-Grant, Oliver; Schulze, Beate; Druss, Benjamin & Thornicroft, Graham. (2014). Mental health-related stigma in health care and mental health-care settings. The Lancet Psychiatry, 1(6), 467-482. https://doi.org/10.1016/S2215-0366(14)00023-6
Hervey, Nicholas (1986). Advocacy or folly: The Alleged Lunatics’ Friend Society, 1845-63. Medical History, 30(03), 245-275. https://doi.org/10.1017/S0025727300045701
Jenkins, Janis Hunter & Carpenter-Song, Elizabeth A. (2009). Awareness of Stigma Among Persons With Schizophrenia. The Journal of Nervous and Mental Disease, 197(7), 520-529. https://doi.org/10.1097/nmd.0b013e3181aad5e9
Krupchanka, Dzmitry & Thornicroft, Graham (2017). Discrimination and Stigma. In Wolfgang Gaebel, Wulf Rössler & Norman Sartorius (Eds.), The Stigma of Mental Illness - End of the Story? (pp. 123-139). Springer.
https://doi.org/10.1007/978-3-319-27839-1_7
Large, Matthew M.; Ryan, Christopher J.; Nielssen, Olav B. & Hayes, Rachel A. (2008). The danger of dangerousness: why we must remove the dangerousness criterion from our mental health acts. Journal of Medical Ethics, 34(12), 877-881. https://doi.org/10.1136/jme.2008.025098
Lien, Yin-Yi; Lin, Hui-Shin; Lien, Yin-Ju; Tsai, Chi-Hsuan; Wu, Ting-Ting; Li, Hua & Tu, Yu-Kang (2021). Challenging mental illness stigma in healthcare professionals and students: a systematic review and network meta-analysis. Psychology & Health, 36(6), 669-684. https://doi.org/10.1080/08870446.2020.1828413
Link, Bruce G.; Struening, Elmer L.; Neese-Todd, Sheree; Asmussen, Sara; Phelan, Jo C.; Consequences, The; With, People & Illnesses, Mental. (2001). Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services, 52(12), 1621-1626.
Link, Bruce G. & Stuart, Heather (2017). On Revisiting Some Origins of the Stigma Concept as It Applies to Mental Illnesses. In Wolfgang Gaebel, Wulf Rössler & Norman Sartorius (Eds.), The Stigma of Mental Illness - End of the Story? (pp. 3-28). Springer. https://doi.org/10.1007/978-3-319-27839-1_1
Livingston, James D. & Boyd, Jennifer E. (2010). Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science and Medicine, 71(12), 2150-2161. https://doi.org/10.1016/j.socscimed.2010.09.030
Nash, Michael (2013). Diagnostic overshadowing: a potential barrier to physical health care for mental health service users. Mental Health Practice, 17(4), 22-26. https://doi.org/10.7748/mhp2013.12.17.4.22.e862
Obertament (2013). Estrategias de lucha contra el estigma en salud mental. Dossiers Del Tercer Sector, 26, 1-18.
Obertament (2016). L’estigma i la discriminació a la atenció a la salut. https://www.spora.ws/wp-content/uploads/2017/03/2016.-Cat.-Estigma-i-Salut.pdf
Ramos Montes, Josep (2021). Paternalismo y autonomismo en la relación de ayuda: una reflexión desde la salud mental. Folia Humanística, 2(4), 1-21.
Renn, Kristen A. (2007). LGBT Student Leaders and Queer Activists: Identities of Lesbian, Gay, Bisexual, Transgender, and Queer Identified College Student Leaders and Activists. Journal of College Student Development, 48(3), 311-330. https://doi.org/10.1353/csd.2007.0029
Rubio-Valera, Maria; Aznar-Lou, Ignacio; Vives-Collet, Mireia; Fernández, Ana; Gil-Girbau, Montserrat & Serrano-Blanco, Antoni (2018). Reducing the Mental Health-Related Stigma of Social Work Students. Research on Social Work Practice, 28(2), 164-172. https://doi.org/10.1177/1049731516641492
Rubio-Valera, Maria; Fernández, Ana; Evans-Lacko, Sara; Luciano, Juan Vivente; Thornicroft, Graham; Aznar-Lou, Ignacio & Serrano-Blanco, Antoni (2016). Impact of the mass media OBERTAMENT campaign on the levels of stigma among the population of Catalonia, Spain. European Psychiatry, 31, 44-51. https://doi.org/10.1016/j.eurpsy.2015.10.005
Sashidharan, Sashi P.; Mezzina, Roberto & Puras, Dainius (2019). Reducing coercion in mental healthcare. Epidemiology and Psychiatric Sciences, 28(6), 605-612. https://doi.org/10.1017/S2045796019000350
Saunders, Benjamin; Sim, Julius; Kingstone, Tom; Baker, Shula; Waterfield, Jackie; Bartlam, Bernadette; Burroughs, Heather & Jinks, Clare (2018). Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & Quantity, 52(4), 1893-1907. https://doi.org/10.1007/s11135-017-0574-8
Schulze, Beate (2007). Stigma and mental health professionals: A review of the evidence on an intricate relationship. International Review of Psychiatry, 19(2), 137-155. https://doi.org/10.1080/09540260701278929
Sheehan, Lindsay; Nieweglowski, Katherine & Corrigan, Patrick W. (2017). Structures and Types of Stigma. In Wolfgang Gaebel, Wulf Rössler & Norman Sartorius (Eds.), The Stigma of Mental Illness - End of the Story? (pp. 43-66). Springer. https://doi.org/10.1007/978-3-319-27839-1_3
Vázquez-Barquero, José Luis & García, José (1999). Deinstitutionalization and psychiatric reform in Spain. European Archives of Psychiatry and Clinical Neuroscience, 249(3), 128-135. https://doi.org/10.1007/s004060050077
Published
Downloads
Funding data
-
Ministerio de Ciencia e Innovación
Grant numbers RYC2018-023850-I -
Ministerio de Ciencia e Innovación
Grant numbers PID2021-125403OA-I00
Copyright (c) 2024 Francisco José Eiroa-Orosa, Maria Rovira Gimó

This work is licensed under a Creative Commons Attribution 4.0 International License.