Social Work and Mental Health

Introduction to Stigma and Discrimination Against People

The stigma and discrimination associated with mental illness are creating multifaceted problems worldwide. Henderson & Gronholm (2018) described general people create a label on mentally ill people and the labeling will lead to separation, emotional reaction, stereotyping, and discrimination. This is triggered by a stigma differential between those who are being labeled and those who label. The definitions supported by social psychology explains mental illness is more related to prejudice, and the associated discrimination (Pescosolido&Martin,2015).Various anti-stigma programs are initiated in the form of public health interventions to exclude the existing prejudice and discrimination associated with mental illness. Interventions in the form of contact education programs based on inter-group theory can be used to reduce the prevailing prejudice from society (Pescosolido & Martin, 2015). However, the consequences of the anti-stigma interventions are not achieved completely and therefore result in isolation, loneliness, reduced community participation, and social networks. As a result, there is an urgent need to understand and upgrade anti-stigma interventions which will show a positive impact. The results of anti-stigma interventions should not be judged on basis of co-existing evaluations. Reducing stigma interventions should become the core business of all local and national governments and relevant stakeholders. The essay will reflect the statement by Henderson & Gronholm, discrimination based on mental illness leading to social isolation and impaired capital (Henderson & Gronholm, 2018).This essay also projects the importance of stigma and discrimination on the people living with mental illness.

Impact of Stigma and Discrimination

The challenges faced by mentally ill persons have been doubled. On one side, they struggle with the symptoms and disabilities as a result of the disorder, however, on the other side, they are being challenged by discrimination and prejudice from society. The public stigma is faced by mentally ill persons in the form of derogatory attitudes and beliefs. Also, mentally ill people remain the target audience and suffer both verbal and physical abuse (Jennifer, 2011) in which sexual and financial exploitation are critical challenges experienced by mentally ill persons. Discrimination in terms of the community can be distinguished into three major forms and include education, housing, and employment. In terms of education, in Australia, students with mental illness often face unfavorable responses from peers, like teasing and loss of friendship resulting in loneliness and social exclusion (Nicola & Anthony, 2014). These adverse reactions from classmates significantly impact academic and career progression. Furthermore, some students have been excluded from educational institutions owing to decimation and prejudice against mental illness. Concerning housing, there is evidence of unsafe leasing for mentally ill persons. According to Jennifer (2011), mentally ill people find it difficulty in getting the house of their choice and therefore always find issues of the rental market for housing and inferior accommodation where they face problems of noise, overcrowding. It means the mental illness and associated discrimination have resulted in increased homelessness and the people also lack equal access to welfare, healthcare services, and employment. This might be the consequence of reduced mental abilities and forgetfulness among them. Moreover, the impact of stigma has also been faced by healthcare staff in the hospital, creating a barrier for effective care giving.

Stigma Leading to Social Isolation

Mental disorders account for a large part of non-fatal health disorders worldwide (González et al., 2011). Mental illness affects people of various cultural backgrounds irrespective of their age, caste, color, and socioeconomic status. According to a study by the Australian National Survey of Mental Health and Wellbeing, around one-third of the population suffering from mental illness are socially isolated and living alone (Harvey & Brophy, 2011). Moreover, the study also concluded that about 39% of mentally ill patients do not have a friend with whom they can share their inner thoughts and feelings. The stigma and discrimination associated with the mentally ill people in Australia is triggering various problems impacting their quality of life in which social isolation has become a serious issue.

Social isolation owing to mental illness can impact their relationships including family and friends in longer terms. These people experience restrictions from social engagements, employment, and education leading to the refutation of most basic rights. Stigma and discrimination towards mentally ill patients have become a serious issue resulting in reduced access to healthcare services, recovering from illness, and social interaction. Social isolation experienced by mentally ill persons impacts their day to day activities. The major reason for discrimination leading to isolation is the lack of education and society’s perception of mental health and associated illness. Consequently with this existing unawareness mentally ill people are stigmatized and socially excluded from society and these people even find it difficult to contribute to society as well. The government should create several interventions to exclude the existing stigma and discrimination for the safety and wellbeing of the people.

Social and Self-Stigma

Public stigma is the reaction of general people related to mental illness which results in prejudice and discrimination. However, self-stigma is a form of self-doubt experienced by mentally ill persons owing to public stigma (González et al., 2011). Stereotypes are considered social and efficient as they are commonly agreed by most of the social groups and they further conclude expectations and generate impressions of people belonging to a stereotyped group. Lack of education and unawareness regarding mental illness are two important factors triggering stigma and discrimination in society (Judd & Park,2014).However, stigmatizing attitudes do not only exist in the general population, but even well-educated people also from healthcare systems subscribe to stereotype regarding mental illness. The prevailing ideas about mental illness lead to exclusion of the patient from the community and as a result of fear from their illness. Also, authoritarianism is the other existing idea in a society that describes mentally ill persons are irresponsible and therefore lack the right to make decisions (Krueger, 2014). These ideas create barriers to exclude prejudice and discrimination from society, however, three major factors including education, protest, and contact create interventions for minimizing public stigma. These strategies will improve patient life quality and increase patient outcomes as well. The protest is an active way to lessen negative thoughts about mental illness (Krueger, 2014). Also, education programs proved effective for larger participants including college students, adolescents, residential communities, and even mentally ill persons. However, this intervention for reducing stigma and discrimination was not found satisfactory owing to existing unawareness regarding mental health.

Importance of Anti-Stigma Interventions

All Australians, including those with mental illness, have the right to participate in community ceremonies without stigma and social exclusion (Judd & Park, 2014). Education, literacy surveys, and contact are some of the effective anti-stigma interventions. Education aims to correct misinformation and negative beliefs and attitude from society. The educational campaigns can be used at a larger scale from local to national bodies, which focus on education which acts as an important and evident anti-stigma tactic(Francis et al.,2014). The education programs are based on strategies like mindfulness and acceptance along with behavior change and commitment strategies (Francis et al., 2014). For example, the See Me campaign aimed to correct inaccurate information to normalize the people to mental health and related illness (Judd &Park, 2014). The study also stated that adolescents showed significant change regarding their attitudes and beliefs of mental illness. They also showed a significant response to the education program as compared to the adult population. National Mental Health Literacy surveys have been conducted by the Australian Government to keep a track of stigma and its associated harm which helps the researchers to monitor the trends in public behavior regarding mental health (Loncar et al., 2014). The survey included a set of a questionnaire regarding taking antidepressants, having psychotherapy, and social exclusions (Loncar et al., 2014). The survey concludes that around 87% of the Australian population in some territories of Australia were aware of mental illnesses like depression and anxiety. Another initiative called Beyondblue, a National Depression Initiative was organized by the Australian government which aimed to increase the skills and knowledge of primary healthcare workers to resolve the mental health issue (Lucie et al., 2013). The program was started in 2005 and was funded by the Australian government along with some other non-profitable organizations for creating sustainable impact. Various media platforms were involved in the program including radio, television, and internet to spread awareness about mental illness.

Adopting anti-discrimination policies related to mental illness is an important way to reduce structural discrimination. In most countries, people with mental disabilities are covered under the special disability category and the policies are being evaluated at local, state, and national levels to ensure the services will meet their needs. Mental health promotion programs aim to cope with the problemas sociated with mental illness like stress and support the communities to reduce the stigma and associated discrimination (Thornicroft et al., 2017). At the structural level discrimination can be reduced by ensuring inclusion and equity to healthcare services by providing access to the right care at right time (Brockington et al., 2014).The healthcare systems have been a focus of the National Mental Health Strategy to provide equal and quality care services to people with mental illness which has now become an important part of every healthcare organization (Loncar et al., 2014). The Australian guidelines for healthcare professionals direct them to protect the rights of every patient by providing equal and advance care for safety and care. In Australia, a Mental Health First Aid program was organized by Betty Kitchener which focuses on mental health awareness and has now been initiated by different nations worldwide (Thornicroft et al.,2017). These programs are also funded by the government to encourage the successful outcomes of these initiatives by educating the general population. Several chapters based on mental health are being incorporated into regular lessons that aim to promote mental illness by reducing discrimination and prejudice (Loncar et al., 2014).These initiatives aim to educate the general population regarding mental illness by excluding discrimination and prejudice at individual and community levels as well.

Role of Social Workers

In the context of social workers, the Australian Association of Social Workers (AASW) is a group that acts on improving individual mental health by considering the external factor and the processes triggering mental illness (Practice Standards for Mental Health Social Workers 2014). It also focuses on the internal factors that can impact resilience and vulnerability which include family functioning, culture, ethnicity, and gender. concerns also include the impact of extended social issues promoting discrimination like economic wellbeing, housing, and employment (AASW, 2014). In Australia, Practice Standards uphold rights that support a person experiencing discrimination and prejudice owing to their mental illness. The social workers have established their roles for working with people facing mental illness and related problems in the public and community health systems (Paloma & Robert, 2014). They are mental illness experts who work on improving mental health using evident-based interventions and include cognitive behavior therapy, skill improvement (stress management, social skills, anger management), relaxation therapy. Apart from these therapies, psycho-education based on motivational interviews followed by discussions promotes mental health awareness (Paloma&Robert,2014). AASW focuses on guiding the social workers which form the foundation for decision making and ethical reflection, they will support improving the mental health of the whole nation including Indigenous persons, older and young people without discrimination on basis of culture and community (Wilson, 2011).The AASW also works to bridge the gap of mental education between nurses and general practitioners for patient safety and wellbeing.

Conclusion on Stigma and Discrimination Against People

The stigma and discrimination have been considered wicked problems existing in society and attention should be paid to evaluate the consequences of social stigma on mental health. The intervention to reduce stigma must include all the possible factors not only in the health sector but also in multiple service sectors. Attention should also be made to incorporate effective interventions in the educational systems to achieve a sustained result. The educational campaigns can be used at a larger scale from local and national, explain education based interventions are important and evident anti-stigma tactic. Adopting anti-discrimination policies is an important way to reduce the structural discrimination existing in society. Reducing stigma has now become an integral part of all local, national, and international stakeholders for the success of anti-stigma interventions. Healthcare systems have been a focus of mental health strategy to provide equal and quality care services to mentally ill persons. The interventions by social workers also focus on the internal and external factors that can impact the resilience and vulnerability of mentally ill persons. These interventions aim to reduce discrimination and stigma prevailing in the society for the safety and wellbeing of the community.

References for Stigma and Discrimination Against People

AASW. (2014). Practice standards for mental health social workers. Retrieved from https://www.aasw.asn.au/document/item/6739

Brockington, I., Hall, P., & Levings, J. (2014).The community's tolerance of the mentally ill.British Journal of Psychiatry, 162,93–99.

Francis, C., Pirkis, J., Dunt., & David, D. (2014). Improving mental health literacy: A review of the literature. International Journal of Environmental Research in Public Health, 9(8), 1-12.

González, M.A., Oraa, R., & Arístegui, M. (2011). Stigma and discrimination towards people with schizophrenia and their family members. Social Psychiatry and Psychiatric Epidemiology 42, 14–23.

Harvey, C., &Brophy, L. (2011).Social isolation in people with mental illness. Retrieved from https://medicinetoday.com.au/2011/october/regular-series/social-isolation-people-mental-illness

Henderson, C., & Gronholm P. (2018) Mental health-related stigma as a ‘wicked problem’: The need to address stigma and consider the consequences, International Journal of Environmental Research in Public Health, 15(6), 1-13.

Jennifer, M. (2011) Stigma and mental health in higher education. Higher Education Research & Development, 29, 259 274.

Judd, C., & Park, B. (2014).Definition and assessment of accuracy in stereotypes. Psychology Review, 100(4),109–128.

Krueger J. (2014). Personal beliefs and cultural stereotypes about racial characteristics. Journal of Personal Social Psychology, 71,536–548.

Loncar, C., Definis, M., Dodig, G., Jakovljevic, M., Franic, T., Marcinko, D., & Mihanovic, M. (2014).War, mental disorder, and suicide. Collegium Antropologicum, 28, 377–384.

Lucie, N., Nawka, A., & Adamkova, T. (2013). The picture of mental health/illness in the printed media in three central European countries. Journal of Health and Community, 17(1), 22–40.

Nicola, R.,& Anthony, J. (2011). Depression stigma in Australian high school students. Youth Studies Australia, 33(40), 1-12.

Paloma, C., & Robert, K. (2014).Social workers' beliefs about the interventions for schizophrenia and depression: a comparison with the public and other health professionals--an Australian analysis British. Journal of Social Work, 45, 1750-1770.

Pescosolido, B.A., Martin, J.K. (2015). The stigma complex. Annual Review of Sociology, 41, 87–116.

Ramiah, A., & Hewstone, M. (2013). Intergroup contact as a tool for reducing, resolving, and preventing intergroupconflict: Evidence, limitations, and potential. American Psychologist Journal, 68, 527–542.

Thornicroft G., Chatterji S., Evans-Lacko S., Gruber M., Sampson N., Aguilar-Gaxiola S., Al-Hamzawi A., Alonso J., Andrade L., &Borges G.(2017). Undertreatment of people with major depressive disorder in 21 countries. British. Journal of.Psychiatry.210, 119–124.

Wilson, L. (2011) ‘Developing a model for the measurement of social inclusion and social capital in regional Australia’. Social Indicators Research, 75(3), 335 – 60.

Practice Standards for Mental Health Social Workers (2014). Retrieved from https://www.aasw.asn.au/document/item/6739

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