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      250 labels used to stigmatise people with mental illness

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          Abstract

          Background

          The stigma against people with mental illness is a major barrier to help-seeking in young people for mental health problems. The objective of this study was to investigate the extent of stigma in relation to treatment avoidance in 14 year-old school students in England in relation to how they refer to people with mental illness.

          Methods

          This is a qualitative, cross-sectional study. The data were gathered as part of the baseline assessment for an intervention study intended to reduce stigma among 14 year old school students. The participating schools were two grammar (selective) schools and three comprehensive (non-selective) schools. At the start of the lesson, the students were asked 'What sorts of words or phrases might you use to describe someone who experiences mental health problems?' Words and terms used to refer to mental illness were enumerated. Using the grounded theory approach, words and terms were grouped in terms of their denotative and connotative meanings. Labels were then derived to capture the key themes attached by the students to the concepts of mental illness. The frequencies of occurrence for each word were also tabulated.

          Results

          400 of the 472 participating students (85%) provided 250 words and terms to describe a person with mental illness. Five themes were identified from the data. The first theme called 'popular derogatory terms' (116 items) accounted for nearly half of the words examined. The second theme occurred less often and was described as 'negative emotional state' (61 items). The third theme demonstrated the confusion of young people between physical disabilities, learning difficulties and mental health problems (38 items). The use of psychiatric diagnoses (15 items) and terms related to violence (9 items) were unexpectedly uncommon.

          Conclusion

          Our findings suggest the hypothesis that help-seeking by mentally ill young people may be improved by interventions that address both their lack of factual information about mental illness, and those which reduce their strong negative emotional reactions towards people with mental illness.

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          Most cited references50

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          Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression.

          The authors' goal was to examine the extent to which perceived stigma affected treatment discontinuation in young and older adults with major depression. A two-stage sampling design identified 92 new admissions of outpatients with major depression. Perceived stigma was assessed at admission. Discontinuation of treatment was recorded at 3-month follow-up. Although younger patients reported perceiving more stigma than older patients, stigma predicted treatment discontinuation only among the older patients. Patients' perceptions of stigma at the start of treatment influence their subsequent treatment behavior. Stigma is an appropriate target for intervention aimed at improving treatment adherence and outcomes.
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            10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. Developmental epidemiology.

            To describe the growth of developmental epidemiology in the past decade and to illustrate it with examples of recent studies. A review of publications on developmental epidemiology in the past 10 years and a discussion of some key examples. The authors describe how the interaction between developmental psychopathology and psychiatric epidemiology has produced developmental epidemiology, the study of patterns of distribution of psychiatric disorders in time as well as in space. They give two examples of the kinds of questions that developmental epidemiology can help to answer: (1) Is the prevalence of autism increasing? Does the use of vaccines explain the increase? (2) Is there an epidemic of child and adolescent depression? Finally, they describe two areas of science that are beginning to inform developmental epidemiology: molecular genetics and the use of biological measures of stress. While child and adolescent psychiatric epidemiology continues, as described in the first of these reviews, to address questions of prevalence and burden, it has also expanded into new areas of research in the past decade. In the next decade, longitudinal epidemiological data sets with their rich descriptive data on psychopathology and environmental risk over time and the potential to add biological measures will provide valuable resources for research into gene-environment correlations and interactions.
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              Stigma interventions and research for international health.

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                Author and article information

                Journal
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                2007
                28 June 2007
                : 7
                : 97
                Affiliations
                [1 ]Service User Research Enterprise, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
                [2 ]Section of Community Mental Health Health Service and Population Research Department Institute of Psychiatry, King's College London, London, UK
                [3 ]Rethink severe mental illness, Royal London House, Finsbury Square, London, UK
                Article
                1472-6963-7-97
                10.1186/1472-6963-7-97
                1925070
                17598894
                f5ba0b61-eba5-4295-842b-ae6e2043d5d6
                Copyright © 2007 Rose et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 January 2007
                : 28 June 2007
                Categories
                Research Article

                Health & Social care
                Health & Social care

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