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      Perceived stigmatization and discrimination of people with mental illness: A survey-based study of the general population in five metropolitan cities in India

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          Abstract

          Background:

          India faces a significant gap between the prevalence of mental illness among the population and the availability and effectiveness of mental health care in providing adequate treatment. This discrepancy results in structural stigma toward mental illness which in turn is one of the main reasons for a persistence of the treatment gap, whereas societal factors such as religion, education, and family structures play critical roles. This survey-based study investigates perceived stigma toward mental illness in five metropolitan cities in India and explores the roles of relevant sociodemographic factors.

          Materials and Methods:

          Samples were collected in five metropolitan cities in India including Chennai ( n = 166), Kolkata ( n = 158), Hyderabad ( n = 139), Lucknow ( n = 183), and Mumbai ( n = 278). Stratified quota sampling was used to match the general population concerning age, gender, and religion. Further, sociodemographic variables such as educational attainment and strength of religious beliefs were included in the statistical analysis.

          Results:

          Participants displayed overall high levels of perceived stigma. Multiple linear regression analysis found a significant effect of gender ( P < 0.01), with female participants showing higher levels of perceived stigma compared to male counterparts.

          Conclusion:

          Gender differences in cultural and societal roles and expectations could account for higher levels of perceived stigma among female participants. A higher level of perceived stigma among female participants is attributed to cultural norms and female roles within a family or broader social system. This study underlines that while India as a country in transition, societal and gender rules still impact perceived stigma and discrimination of people with mental illness.

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          Most cited references 42

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          A Modified Labeling Theory Approach to Mental Disorders: An Empirical Assessment

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            Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.

            Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.
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              Labeling Mental Illness: The Effects of Received Services and Perceived Stigma on Life Satisfaction

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                Author and article information

                Journal
                Indian J Psychiatry
                Indian J Psychiatry
                IJPsy
                Indian Journal of Psychiatry
                Medknow Publications & Media Pvt Ltd (India )
                0019-5545
                1998-3794
                Jan-Mar 2018
                : 60
                : 1
                : 24-31
                Affiliations
                Department of Psychiatry and Psychotherapy, Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
                [1 ]Department of Psychiatry, Ernst Moritz Arndt University, Greifswald, Germany
                [2 ]Center for Public Mental Health, Untere 12 Zeile 13, A-3482 Gö-sing am Wagram, Austria
                [3 ]AKT Neuropsychiatric Centre, Allahabad, Uttar Pradesh, India
                Author notes
                Address for correspondence: Dr. Kerem Böge, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany. E-mail: Kerem.boege@ 123456charite.de
                Article
                IJPsy-60-24
                10.4103/psychiatry.IndianJPsychiatry_406_17
                5914258
                Copyright: © 2018 Indian Journal of Psychiatry

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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