Electronic Letters to:
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eLetters: Electronic letters published:
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Attitude of medics
- Jinesh Shah (28 March 2007)
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Stigma: Managing the challenge
- Meetiksha Malhotra, Swapnil Palod, North East London Mental Health Trust (18 April 2007)
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Jinesh Shah, Senior House Officer in Airedale-Bradford rotation.
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drjinesh{at}gmail.com Jinesh Shah
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I read with interest Thornicroft et al’s editorial on Stigma. Stigma faced by the people suffering from Schizophrenia from general public is very common place. People suffering from other mental disorders, like depression, anxiety, also face a lot of stigma. The medical staff stigmatises them. The GP trainees are placed in Psychiatry placements and their awareness of mental health problems is good, generally. However, the awareness in other hospital specialities is lacking. Recently, I was referred a patient from a medical ward. When I went there and had a word with the medical doctor, she said something to the effect- “ this patient already has a history of depression in the past, so, I guess, when she came in the medical ward, she was not 100% normal.” The way she said was as if people who have had a history of mental health problems in the past are lesser mortals than others. Also, the psychiatrist faces stigma in the world of medicine. I was once admitted for surgery. I accidentally heard that my request to change rooms was joked about, with comments like “is this psychiatrist nuts”. Although these are individual scenarios, the experience of lack of understanding towards our patients and ourselves from medics and surgeons is not so uncommon. |
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Meetiksha Malhotra, Senior House Officer Wathwood RSU, Sheffield Care Trust, Swapnil Palod, North East London Mental Health Trust
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drmeetiksha{at}rediffmail.com Meetiksha Malhotra, et al.
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We agree with Thornicroft et al, that the main challenge that lies ahead, is to identify the interventions, which will produce behaviour changes to decrease discrimination against people with mental illness. The Department of Health initiated “Action on stigma - promoting mental health, ending discrimination at work”, (1) as a step in this direction. It provides guidance for employers to encourage a culture of respect and dignity by making them more aware of mental illness, encouraging measures which would help to recognise symptoms early and hence, seeking help appropriately. It is suggested that employment must not be refused on grounds of mental illness or disability. Appropriate adjustments to work environment, for people with mental health illness, are recommended, to encourage them to work. Some organisations already participating are BT, Royal Mail, Oxleas NHS Foundation Trust, BP, and Astra Zeneca. The Royal College of Psychiatrists' campaign on “Changing minds”(2) further emphasises that the interventions to improve public knowledge about mental health illness can be effective. The results (3) of this campaign, showed a reduction in the negative opinions expressed by people about mental health illness. Fewer people endorsed the statement that people with mental health illness “feel different from us”. This is important as it reflects empathy (lack of empathy is considered an important aspect of stigma). The most stigmatised disorders were drug addiction, alcoholism and schizophrenia, however only 6% people believed that schizophrenics were to be blamed for their illness. Byrne, P. (4) suggested methods for practical management of stigma. These include acknowledging stigma as the first step, implementing effective psychological interventions for the patients, developing advocacy services involving patients, peers, families, carers, community groups, civil rights activists with a view to utilize their valuable experience to develop better tools to deal with problems they may have faced due to stigma. To summarise, there is positive evidence supporting that there are efforts being put in, to change peoples behaviour as a means of minimising discrimination. Proactive measures need to be developed in this regard. Effective tools and policies to evaluate the result of these interventions would prove beneficial. References: 1)Department of Health (DoH), Action on Stigma: Promoting Mental Health, ending discrimination at work (Best Practising Guidance, Oct. 2006). 2)Royal College of Psychiatrists campaign, “Changing minds”(1998- 2003), http://www.rcpsych.ac.uk/campaigns.aspx 3)Crisp, A., Gelder,M., Goddard, E., Meltzer, H.,(2005) Stigmatisation of people with mental illnesses: a follow-up study within the Changing Minds campaign of the Royal College of Psychiatrists. Research Report. World Psychiatry 4:2-June 2005. 4)Byrne, P. (2000) Stigma of mental illness and ways of diminishing it. Advances in Psychiatric Treatment, 6,65-72. |
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