Experiences with Mental Health Services: perspectives of diagnosed people in Catalonia, Spain

Authors

Abstract

The field of mental health is marked by social exclusion, stigmatization, discrimination by society and violation of human rights; aspects that constitute significant challenges for national and international development in public health. In this phenomenological study, from the perspective of social representation, we interviewed 12 people diagnosed with a mental disorder in Catalonia, Spain, to investigate their experience with mental health services. Most experiences with health services were marked by a hierarchical model in power structures, in which the perspectives of people diagnosed were delegitimized. The legitimacy of specialized and public representations about mental health shaped the lives of the participants, as they felt voiceless and impotent, having their representations subjugated. Constructive experiences were related to being heard, cared for and understood by health professionals. By considering people diagnosed with a mental disorder, significant contributions can be made to improve the provision of comprehensive, effective and sensitive mental health care.

Keywords

Mental Health Services, Mental Disorders, Delivery of Health Care, Spain

References

Angermeyer, Matthias C. & Dietrich, Sandra (2006). Public beliefs about and attitudes towards people with mental illness: a review of population studies, Acta Psychiatrica Scandinavica, 113(3),163-179.

Aspers, Patrik (2004). Empirical Phenomenology: an approach for qualitative research. Papers in Social Research Methods Qualitative Series, 9, 1-15.

Bernal-Delgado, Enrique; Garcia-Armesto, Sandra; Oliva, Juan; Sanchez Martinez, Fernando I.; Repullo, José R.; Pena-Longobardo, Luz M.; Ridao-Lopez, Manuel; Hernandez-Quevedo, Cristina (2018). Spain: Health System Review. Health Syst Transit., 20(2), 1-179.

Bobes, Julio; Garcia-Portilla Parellada, Maria P.; Bascaran, Maria T.; Saiz, Pilar A. & Arango, Celso (2012). The state of psychiatry in Spain. International Review of Psychiatry, 24(4), 347-355. https://doi.org/10.3109/09540261.2012.691090

Buszewicz, Marta; Pistrang, Nancy; Barker, Chris; Cape, John & Martin, Jonathan (2006). Patients’ experiences of GP consultations for psychological problems: A qualitative study. British Journal of General Practice, 56(528), 496-503.

Chen, Xintong (2021). The Effect of Media Representations and Stigma on Public Perception of Mental Disorders from Late 20th to Early 21st Century. Advances in Social Science, Education and Humanities Research, 615, 622-625. https://doi.org/10.2991/assehr.k.211220.106

Corrigan, Patrick (2004). How stigma interferes with mental health care. The American Psychologist, 59(7), 614-625. https://doi.org/10.1037/0003-066X.59.7.614

Costa-Font, Joan; Hita, Juan C.; Alonso, Jordi; Salvador-Carulla, Luis & McDaid, David (2008). New and old challenges in the reform of mental health systems in Spain. Eurohealth, 14(4), 14-17.

Dixit, Shikha (2005). Meaning and Explanations of Mental Illness: A Social Representations Approach. Psychology & Developing Societies, 17(1), 1-18. https://doi.org/10.1177/097133360501700101

Epstein, Ronald M. (2006). Making communication research matter: What do patients notice, what do patients want, and what do patients need? Patient Education and Counseling, 60(3), 272-278. https://doi.org/10.1016/j.pec.2005.11.003

Flick, Uwe (2009). An Introduction to Qualitative Research. Sage Publications.

Foster, Juliet L.H. (2001). Unification and differentiation: a study of the social representations of mental illness. Papers on Social Representations, 10, 3.1-3.18.

Foster, Juliet L.H. (2003). Beyond otherness: controllability and location in mental health service clients’ representations of mental health problems. Journal of Health Psychology, 8(5), 632-644. https://doi.org/10.1177/13591053030085012

Foster, Juliet L.H. (2013). What can social psychologists learn from architecture? The asylum as example. Journal for the Theory of Social Behaviour, 44(2), 131-147. https://doi.org/10.1111/jtsb.12034

Foucault, Michel (1967). Madness and Civilization: A history of insanity in the age of reason. Tavistock Publications.

Graham, Tanya; Rose, Diana; Murray, Joanna; Ashworth, Mark & Tylee, André (2014). User-generated quality standards for youth mental health in primary care: a participatory research design using mixed methods. BMJ Quality & Safety, 23(10), 857-66. https://doi.org/10.1136/bmjqs-2014-002842

Groenewald, Thomas (2004). A Phenomenological Research Design Illustrated. International Journal, 3(1), 1-26. https://doi.org/10.1177/160940690400300104

Horgan, Aine; Donovan, Moira O.; Manning, Fionnuala; Doody, Rory; Savage, Eileen; Dorrity, Claire; O’Sullivan, Hazel; Goodwin, John; Greaney, Sonya; Biering, Pall; Bjornsson, Einar; Bocking, Julia; Russell, Siobhan, Griffin, Martha; MacGabhann, Liam; Jan van der Vaart, Kornelis; Allon, Jerry; Granerud, Arild; Hals, Elisabeth; Pulli, Jarmo; Vatula, Annaliina; Ellilä, Heikki; Lahti, Mari & Happell, Brenda (2021). ‘Meet Me Where I Am’: Mental health service users’ perspectives on the desirable qualities of a mental health nurse. International Journal of Mental Health Nursing, 30(1), 136-147. https://doi.org/10.1111/inm.12768

Howarth, Caroline; Foster, Juliet & Dorrer, Nike (2004). Exploring the Potential of the Theory of Social Representations in Health Research - and vice versa? Journal of Health Psychology, 9(2), 229-243. https://doi.org/10.1177/1359105304040889

ISGlobal (2023). La Salud Mental en España. Barcelona Institute for Global Health. https://www.isglobal.org/en/-/salud-mental-espana-analisis-estrategia-recomendaciones

Jodelet, Denise (1991). Social representations. EDUERJ.

Jørgensen, Kim; Dahl, Mette B. & Frederiksen, Jesper (2020). Coherence in intersectoral collaboration between psychiatric centres and community mental healthcare: a critical discourse analysis. Nordic Journal of Nursing Research, 40(3), 130-141. https://doi.org/10.1177/2057158520935388

Jørgensen, Kim; Rasmussen, Tonie; Hansen, Morten; Andreasson, Kate & Karlsson, Bengt (2021). User Involvement in the Handover between Mental Health Hospitals and Community Mental Health: a critical discourse analysis. International Journal of Environmental and Research Public Health, 18(3352), 1-13. https://doi.org/10.3390/ijerph18073352

Keusch, Gerald; Wilentz, Joan & Kleinman, Arthur (2006). Stigma and global health: Developing a research agenda. Lancet, 367(9509), 525-527. https://doi.org/10.1016/S0140-6736(06)68183-X

Kleinman, Arthur & Benson, Peter (2006). Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It. PLoS Medicine, 3(10), 1673-1676. https://doi.org/10.1371/journal.pmed.0030294

Lacerda, Beatriz & Santos, Eduardo (2020). Media Representations on mental illness: a scoping review protocol. Millenium – education and social development, 2(7), 71-76. https://doi.org/10.29352/mill0207e.08.00364

Lee, Sing; Lee, Margaret T.Y; Chiu, Marcus Y.L. & Kleinman, Arthur (2005). Experience of social stigma by people with schizophrenia in Hong Kong. British Journal of Psychiatry, 186(2), 153-157. https://doi.org/10.1192/bjp.186.2.153

Maestre-Miquel, Clara; López-de-Andrés, Ana; Ji, Zichen; Miguel-Diez, Javier; Brocate, Arturo; Sanz-Rojo, Sara; López-Farre, Antonio; Carabantes-Alarcon, David; Jiménez-García, Rodrigo & Zamorano-León, José J. (2021). Gender Differences in the Prevalence of Mental Health, Psychological Distress and Psychotropic Medication Consumption in Spain: A Nationwide Population-Based Study. International Journal of Environmental Research and Public Health, 18(12), 1-15. https://doi.org/10.3390/ijerph18126350

McLaren, Thomas; Peter, Lina‑Jolien; Tomczyk, Samuel; Muehlan, Holger; Schomerus, Georg & Schmidt, Silke (2023). The Seeking Mental Health Care model: prediction of help‑seeking for depressive symptoms by stigma and mental illness representations. BMC Public Health, 23(69), 1-12. https://doi.org/10.1186/s12889-022-14937-5

Morant, Nicola (1995). What is Mental Illness? Social Representations of Mental Illness among British and French Mental Health Professionals. Papers on Social Representations, 4(1), 41-52.

Morant, Nicola (1998). The social representation of mental ill-health in communities of mental health practitioners in the UK and France. Social Science Information, 37(4), 663-685.

Morant, Nicola (2006). Social representations and professional knowledge: the representation of mental illness among mental health practitioners. British Journal of Social Psychology, 45, 817-838. https://doi.org/10.1348/014466605x81036

Moscovici, Serge (1973). Health and illness. A social psychological analysis. In Claudine Herzlich (Ed.), Health and illness. A social psychological analysis (pp. 9-14). Academic P.

Patel, Vikram; Saxena, Shekhar; Lund, Crick; Thornicroft, Graham; Baingana, Florence; Bolton, Paul; Chisholm, Dan; Collins, Pamela Y.; Cooper, Janice; Eaton, Julian; Herrman, Helen; Herzallah, Mohammad M.; Huang, Yueqin; Jordans, Mark; Kleinman, Arthur; Mora, Maria E. M.; Morgan, Ellen; Niaz, Unaiza; Omigbodun, Olayinka; Prince, Martin… Unutzer, Jurgen (2018). The Lancet Commission on global mental health and sustainable development. Lancet, 392(10157), 1553-1598. https://doi.org/10.1016/S0140-6736(18)31612-X.

Pope, Catherine; Ziebland, Sue & Mays, Nicholas (2000). Qualitative research in health care: analysing qualitative data. BMJ - Clinical Research, 320(7227), 114-116. https://doi.org/10.1136/bmj.320.7227.114

Ringer, Agnes & Holen, Mari (2016). “Hell no, they’ll think you’re mad as a hatter”: Illness discourses and their implications for patients in mental health practice. Health, 20(2), 161-175. https://doi.org/10.1177/1363459315574115.

Rodríguez, Francisco (2004). La representación social de la enfermedad y de la institución psiquiátrica en el paciente mental. Cuaderno Venezolano de Sociología, 13(2), 229-247.

Rogers, Anne; May, Carl & Oliver, Dianne (2001). Experiencing depression, experiencing the depressed: the separate worlds of patients and doctors. Journal of Mental Health, 10(3), 317-333. https://doi.org/10.1080/09638230020023840

Rose, Diana (2001). Users’ Voices: the perspectives of mental health service users on community and hospital care. Sainsbury Centre for Mental Health.

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

Trevillion, Kylee; Stuart, Ruth; Ocloo, Josephine; Broeckelmann, Eva; Jeffreys, Stephen; Jeynes, Tamar; Allen, Dawn; Russe, Jessica; Billings, Jo; Crawford, Mike J.; Dale, Oliver; Haigh, Rex; Moran, Paul; McNicholas, Shirley; Nicholls, Vicky; Foyel, Una; Simpson, Alan; Lloyd‑Evans, Brynmor; Johnson, Sonia & Oram, Sian (2022). Service user perspectives of community mental health services for people with complex emotional needs: a co-produced qualitative interview study. BMC Psychiatry, 22(55), 1-18. https://doi.org/10.1186/s12888-021-03605-4

World Health Organization [WHO] (2010). mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: Mental Health Gap Action Programme (mhGAP). Autor.

World Health Organization [WHO] (2013). Mental Health Action Plan 2013-2020. Autor.

World Health Organization [WHO] (2014). Premature death among people with severe mental disorders. Autor.

World Health Organization [WHO] (2015). Data and Statistics: Prevalence of mental disorders. European Office. Department of Mental Health. http://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/data-and-statistics.

World Health Organization [WHO] (2022). World mental health report: transforming mental health for all. https://www.who.int/publications/i/item/9789240050860

Zamorano, Sara; Sáez-Alonso, María; González-Sanguino, Clara & Muñoz, Manuel (2023). Social stigma towards mental health problems in Spain: A systematic review. Clínica y Salud, 34(1), 23-34. https://doi.org/10.5093/clysa2023a5

Author Biographies

Liana Cristina Dalla Vecchia Pereira, Federal University of Santa Catarina

PhD in Human Sciences (UFSC). Department of Psychology, University professor at the Federal University of Santa Catarina, Brazil.

Carlos Alberto Severo Garcia-Jr, Federal University of Santa Catarina

PhD in Human Sciences (UFSC). Department of Health Sciences, University professor at the Federal University of Santa Catarina, Brazil.

Published

25-07-2024

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