Stigma reduction in EIS

Question 1

Types of stigma

Answer 1

1. Public stigma
2. Self-stigma
3. Affiliate stigma –> family of the client endorse public views on the patient
   Chen, 2016 (1-3)
4. Experienced stigma - - ‘experiences of actual discrimination and/or participant restrictions on the part of the person affected’ (Van Brakel, 2006) – around 87% of ppl with psychosis experience stigma
5. Anticipated stigma

Question 2

Impact of Internalised Stigma

Answer 2

1. Reduces help seeking & access to care thus making EI difficult (Corrigan, 2004)
2. High levels of discrimination undermines the achievement of life goals (Corrigan, 2016).
3. High levels of verbal abuse, physical abuse, and bullying (Dinos, 2004)
4. Feelings of rejection & demoralisation (Link, 1987)

Question 3

Integrated Cognitive Model of Stigma (Wood, 2017)

Answer 3

• Cultural context-media, negative stereotypes
• Group identification-identification with a
  stigmatised group
• Stigma triggers-internal & external factors

1. Stigmatising core beliefs
2. Stigma appraisals
3. Emotional and Physiological Consequences
4. Safety seeking behaviours

Question 4

Anti-Stigma Interventions

Answer 4

1. Media campagnes
2. Mental Health in schools

Question 5

Media portrait of MH issues

Answer 5

• Overwhelmingly dramatic & distorted images
• Emphasise dangerousness, criminality, & unpredictability
• Negative consequences on service users
• Perpetuating stigma

Question 6

What is stigma?

Answer 6

1. Prejudice
2. Stereotypes
3. Discrimination

Question 7

Stereotypes

Answer 7

Negative beliefs about a group, often based on cognitive shortcuts

Question 8

Prejudice

Answer 8

Agreement with stereotyped beliefs, or negative emotional reactions such as fear or anger, or both

Question 9

Discrimination

Answer 9

Behavioural consequence of prejudice, such as exclusion from social and economic opportunities

Question 10

Stigmatising core belief

Answer 10

Identified with a stigmatised group & experiences a stigma trigger (media)-activates stigma based core beliefs- weak/vulnerable, unlovable, worthless, inferior, failure

Question 11

Stigma appraisals

Answer 11

Thoughts about self/others, hypervigilance to perceived rejection, heightened selffocused attention, rumination

Question 12

Emotional and Physiological Consequences

Answer 12

Anxiety, shame, depression in response to perceived loss of social rank (Gilbert, 2010)

Question 13

Safety seeking behaviours

Answer 13

Avoidance of self-disclosure, social isolation, threat monitoring of stigma