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      La lucha contra el estigma y la discriminación en salud mental: Una estrategia compleja basada en la información disponible Translated title: The struggle against the stigma and discrimination in mental health: A complex strategy based on available data

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          Abstract

          Revisión sobre el estigma y la discriminación que afecta hoy a la enfermedad mental, intentando elaborar un modelo general que pueda orientarnos.

          Translated abstract

          Reviews about stigma and discrimination in mental illness today, and tries to propose a general model for the development of interventions against that.

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          Public conceptions of mental illness: labels, causes, dangerousness, and social distance.

          Laura J Phelan, A Stueve, Bernice Pescosolido … (1999)
          The authors used nationwide survey data to characterize current public conceptions related to recognition of mental illness and perceived causes, dangerousness, and desired social distance. Data were derived from a vignette experiment included in the 1996 General Social Survey. Respondents (n = 1444) were randomly assigned to 1 of 5 vignette conditions. Four vignettes described psychiatric disorders meeting diagnostic criteria, and the fifth depicted a "troubled person" with subclinical problems and worries. Results indicate that the majority of the public identifies schizophrenia (88%) and major depression (69%) as mental illnesses and that most report multicausal explanations combining stressful circumstances with biologic and genetic factors. Results also show, however, that smaller proportions associate alcohol (49%) or drug (44%) abuse with mental illness and that symptoms of mental illness remain strongly connected with public fears about potential violence and with a desire for limited social interaction. While there is reason for optimism in the public's recognition of mental illness and causal attributions, a strong stereotype of dangerousness and desire for social distance persist. These latter conceptions are likely to negatively affect people with mental illness.
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            A national study of violent behavior in persons with schizophrenia.

            Robert Rosenheck, M. Swartz, Linda Lieberman … (2006)
            Violent behavior is uncommon, yet problematic, among schizophrenia patients. The complex effects of clinical, interpersonal, and social-environmental risk factors for violence in this population are poorly understood. To examine the prevalence and correlates of violence among schizophrenia patients living in the community by developing multivariable statistical models to assess the net effects of psychotic symptoms and other risk factors for minor and serious violence. A total of 1410 schizophrenia patients were clinically assessed and interviewed about violent behavior in the past 6 months. Data comprise baseline assessments of patients enrolled in the National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness. Adult patients diagnosed as having schizophrenia were enrolled from 56 sites in the United States, including academic medical centers and community providers. Violence was classified at 2 severity levels: minor violence, corresponding to simple assault without injury or weapon use; and serious violence, corresponding to assault resulting in injury or involving use of a lethal weapon, threat with a lethal weapon in hand, or sexual assault. A composite measure of any violence was also analyzed. The 6-month prevalence of any violence was 19.1%, with 3.6% of participants reporting serious violent behavior. Distinct, but overlapping, sets of risk factors were associated with minor and serious violence. "Positive" psychotic symptoms, such as persecutory ideation, increased the risk of minor and serious violence, while "negative" psychotic symptoms, such as social withdrawal, lowered the risk of serious violence. Minor violence was associated with co-occurring substance abuse and interpersonal and social factors. Serious violence was associated with psychotic and depressive symptoms, childhood conduct problems, and victimization. Particular clusters of symptoms may increase or decrease violence risk in schizophrenia patients. Violence risk assessment and management in community-based treatment should focus on combinations of clinical and nonclinical risk factors.
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              Lessons from social psychology on discrediting psychiatric stigma.

              P Corrigan, D. L. Penn (1999)
              Advocacy, government, and public-service groups rely on a variety of strategies to diminish the impact of stigma on persons with severe mental illness. These strategies include protest, education, and promoting contact between the general public and persons with these disorders. The authors argue that social psychological research on ethnic minority and other group stereotypes should be considered when implementing these strategies. Such research indicates that (a) attempts to suppress stereotypes through protest can result in a rebound effect; (b) education programs may be limited because many stereotypes are resilient to change; and (c) contact is enhanced by a variety of factors, including equal status, cooperative interaction, and institutional support. Future directions for research and practice to reduce stigma toward persons with severe mental illness are discussed.
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                Author and article information

                Contributors
                Marcelino López: Role: ND
                Margarita Laviana: Role: ND
                Luis Fernández: Role: ND
                Andrés López: Role: ND
                Ana María Rodríguez: Role: ND
                Almudena Aparicio: Role: ND
                Journal
                Journal ID (publisher-id): neuropsiq
                Title: Revista de la Asociación Española de Neuropsiquiatría
                Abbreviated Title: Rev. Asoc. Esp. Neuropsiq.
                Publisher: Asociación Española de Neuropsiquiatría (Madrid, Madrid, Spain )
                ISSN (Print): 0211-5735
                ISSN (Electronic): 2340-2733
                Publication date (Print and electronic): 2008
                Volume: 28
                Issue: 1
                Pages: 48-83
                Affiliations
                [03] orgnameFAISEM - Fundación Andaluza para la Integración Social del Enfermo Mental orgdiv1Departamento de programas, evaluación e investigación
                [01] orgnameFAISEM: Fundación Andaluza para la Integración Social del Enfermo Mental
                [02] orgnameServicio Andaluz de Salud orgdiv1Hospital Virgen del Rocio orgdiv2Área de Salud Mental
                Article
                Publisher ID: S0211-57352008000100004
                DOI: 10.4321/s0211-57352008000100004
                SO-VID: 13e7eab8-266f-4f35-bb3f-5065cec4ca48
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                Date received : 09 May 2006
                Date accepted : 13 September 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 204, Pages: 36
                Product

                SciELO Spain


                Keywords: Estigma,discriminación,atención comunitaria en salud mental,Stigma,discrimination,community mental health care
                Data availability:
                Keywords: Estigma, discriminación, atención comunitaria en salud mental, Stigma, discrimination, community mental health care

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