Discrimination and Prejudice Against the Mentally Ill People - Research Paper

Introduction

Discrimination and prejudice against the mentally ill people by the public are socially damaging. This contributes to the widespread stigmatization against the mentally ill people. The stigma against people with mental illness results in adverse outcome coupled with self-stigmatisation as well as loss of self-esteem (Henderson, Evans-Lacko and Thornicroft 2013). Mental health illnesses are characterized by diverse society forces with stigma standing out distinctly among the affected populations. The issue requires combined efforts from the healthcare providers as well as the general public to allow the mentally affected individuals to live and coexist in the society with limited restrictions as well as eliminate stigma (Griffiths M, Carron-Arthur, Parsons and Reid 2014). The need to create a conducive environment for the mentally ill in the society calls for various strategies to reduce stigma to the mentally ill (Mehta, Kassam, Leese, Butler and Thornicroft 2009). The role of public health in mental health promotion is very crucial in addressing the growing burden of mental illness to UK society. As pointed out by National Academies of Sciences, Engineering, and Medicine, (2016), the inadequacies in the treatment of mental illnesses are evident worldwide with each country exhibiting discrepancies in the efforts to address the issue adequately.

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The major concern, however, is the reduction of stigma in mentally ill patients. Primary strategies to increase awareness and reduce the rate of stigma in people with a mental health issue such as education and campaigns are common due to the increase in the awareness in public on mental health issues in the society. Stigmatisation impacts on a large number of severe mental cases in developed countries. A majority of these cases go untreated regardless of the presence of large facilities that can improve their outcome (Eisenberg, Speer, Hunt 2012). Various approaches can be applied in addressing stigma in society. Education programs, literacy campaigns on mental health and improved contact with the mentally ill are some of the approaches that influence the perception of the people in the UK on mentally ill people (Mellor 2014). According to Evans-Lacko, Malcolm, West, Rose, London, Rusch, Little, Henderson and Thornicroft (2013), social marketing campaigns are used to sensitize people and increase reachability of the public which helps in modifying and promoting certain health issues. The strategies increase the knowledge, raise awareness in mental health cases and encourage interaction with the mentally ill. The attitudes of different people can be impacted based on the interaction, education and literacy campaigns implemented.

Literature Review

Factual information is presented through educational anti-stigma interventions. According to the National Academies of Sciences, Engineering, and Medicine, anti-stigma education provides for correction of the perceptions, misinformation and contradicting beliefs and attitudes towards the mental illness. National Academies of Sciences, Engineering, and Medicine highlights that educational programs counter unrealistic stereotypes and with factual information. Researches by Chisholm, Patterson, Torgerson, Turner, Jenkinson, and Birchwood (2016), points out mental health issues are associated with negative stereotypes with mentally ill people deemed strange and bizarre in behaviour. Regardless of the contribution in the society, they are regarded as incompetent and dependent. According to Chisholm et al. (2016), some of the legal documents referred to mentally ill people as lunatics which indicates the perception of the society on mental health problems. However, Chisholm et al. demonstrate that over the years, a significant acceptance level has been realized in Scotland with 85% of the study participants in the survey carried out advocating for equal rights to the people with mental problems. On the contrary, a series of surveys in England outlines a decline in the attitudes of the population with regards to mental illness. A survey carried out in 2007 highlighted 32% of the participants deem mentally ill people to be a burden in society (Naylor, Cowie, Walters, Talamelli and Dawkins 2009).

According to Evans-Lacko, Malcolm, West, Rose, London, Rusch Little, Henderson, and Thornicroft (2013), stigma has many adverse consequences such as low self-esteem and low quality of life. Stigma also impacts on the work, financial and other psychological triggers such as suicidal thoughts. These are the common challenges that face the mentally ill.

According to the National Academies of Sciences, Engineering, and Medicine (2016), there have been remarkable efforts both at the national and local levels to implement policies and strategies aimed at improving the lives of the people suffering from mental and substance use disorders. The article states that despite the advancement in the initiatives and legislation, the attitudes of mental and substance use disorders have been deteriorating leading to discrimination and stigma. This article proposes for campaigns that will aid with the study of stigma change and appropriate measures that can help encourage people to get treatment. The report provides that some discrimination policies have enhanced stigmatization and there is need to change the existing systems based on the research conducted on stigmatization.

Methodology I

The search methodology was conducted under the guidelines of the Centre for Reviews and Dissemination's guidelines for systematic reviews in health care that facilitated the meta-analysis of the studies. Resource material was obtained by the use of search engines which included CINAL, PsycINFO, and MEDLINE. A list of reliable resources was derived from these databases by the search of keywords such as mental illness, stigma, education and public awareness. The search for the keywords aided in obtaining eligible sources for the study. In ensuring a broad scope of the study coverage, the initial search was broad to cover a large study population.

Inclusion Criteria

When keywords were deployed in search of eligible sources, over four thousand articles were obtained. However, this number is relatively high to work with, and therefore the topics were limited to the ones with the primary keywords of the study, that is, stigma and discrimination. A total of 370 sources were obtained from the refined search which gave room for a workable number of sources. However, 340 sources were still high to work with, and therefore, the search was limited to sources that dated only back to ten years ago, that is, 2009. This aided trimming the study sources to be utilized in the study yielding 70 sources. Based on the abstracts of these sources, it was established that the issues addressed entailed mental illness stigmatization in society. In this light, it was determined that mental health illness is a disorder which affects a wide range of people in society.

Stigma and discrimination were highlighted as negative stereotypes, attitudes, and treatment of the people with mental illness in society. The discrimination and the prejudice against the mentally ill limits their ability to interact as well as treated with respect and accorded equal rights like any other person. The sources obtained from the search engines reflected sources up to 2018. Sources not written in English were further excluded from the study which reduced the study sources. Additionally, the use of key phrases such as mental disorder, strategies to address discrimination such as contact and campaigns. Most importantly, the study was determined to obtain four study sources. The four sources highlighted the effects of stigma reduction along with supporting quantitative and qualitative support addressed in numbers and percentages in highlighting the effectiveness of the approaches of stigma reduction based on PRISMA diagram indicated in the appendix. PICOS diagram indicated below was used to provide a guide for the inclusion criteria. On the other hand, an online database search diagram was adopted for the summary of the inclusion criteria.

Methodology II

The final articles obtained by the use if CASP tool with a list of ten questions addressed in the article. The CASP was used in the determination of the relevancy of the article in the study and influence the choice for the article. The presentation of the critique of the four articles is summarized below.

Title Methodology Methods Sample Results/Findings Strengths & Weaknesses

Chisholm, K., Patterson, P., Torgerson, C., Turner, E., Jenkinson, D. and Birchwood, M., 2016. Impact of contact on adolescents' mental health literacy and stigma: the SchoolSpace cluster randomised controlled trial. BMJ open, 6(2), p.e009435. doi:10.1136/bmjopen-2015009435

Quantitative study-Cluster Randomised Controlled Trial Questionnaires were administered to students with parent's consent and from the randomly stratified classes of study participants Selection of classes was done by blocking which facilitated random stratification of classes.

Random allocation concealed and was generated by computer algorithm. Parents and guardians of year 8 students were asked to participate Contact had positive effects on reducing stigma for adults and adolescents with a mental illness. Additionally, contact showed a positive impact on literacy enhancement on mental illness. Participants were recruited between 1 May 2011 and 30 April 2012. 769 participants completed the pretest and were randomised to condition. 657 (85%) provided follow-up data. At 2-week follow-up, attitudinal stigma improved in both conditions with no significant effect of condition (95% CI 0.40 to 0.22, p=0.5, d=0.01). Significant improvements were found in the education-alone condition compared with the contact and education condition for the secondary outcomes of knowledge-based stigma, mental health literacy, emotional well-being and resilience, and help seeking attitudes.

Strengths

• This was the first study to carry out intergroup RCT on intergroup contact and education.
• Schools were used to represent UK diversity and generalisability. Weaknesses
• Researches concentrate on mid to late adolescents, while stigmatisation occurs in childhood and early adolescence
• Intervention was well received but was only assessed in one school

Evans-Lacko, S., Henderson, C. and Thornicroft, G., 2013. Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009-2012. The British Journal of Psychiatry, 202(s55), pp.s51-s57. doi: 10.1192/bjp.bp.112.112979

Quantitative- survey. The survey was carried out in 1700 respondents across England. Quota sampling was adopted to select the study sample.

Quota sampling was used to attract a diverse demographic representation. Approximately 1700 respondents were surveyed from 2009 to 2012 with the study sample selected using the random location method. There was no sig...