About Stigma And Schizophrenia

People with schizophrenia were once kept away from the rest of civilized society, sometimes even locked up, often in poor conditions, with little or no say in running their lives. In primitive cultures, they were just as isolated and feared because of their strange behavior and the powers believed to control them. Stigma, or negative attitudes, still lock them out, depriving schizophrenics of opportunities and self-esteem.

Prevalence

An international survey of 732 schizophrenic subjects in 27 countries was conducted by researchers from King's College London in the United Kingdom. Results found that up to 47 percent experienced discrimination in relationships with friends and family, 27 percent experienced discrimination with significant others and 29 percent experienced employment or workplace discrimination. The findings were published in the January 31, 2009, issue of the journal Lancet. Graham Thornicroft, who led the study, suggested that anti-discrimination legislation needs to be applied to people with mental as well as physical disabilities.

Significance

Discrimination in the Lancet study was measured with a tool called the discrimination and stigma scale (DISC), which rates three areas: positive discrimination, negative discrimination and anticipated discrimination. In the survey of schizophrenics, positive discrimination was rare. Researchers also noted that more than a third of subjects anticipated discrimination in work, training, education and relationships. Of the 732 participants, 526 felt the need to hide their diagnosis. Researchers concluded that stigma increases social marginalization and decreases quality of life for schizophrenics.

Effects

Norman Sartorius, president of the World Psychiatric Association (WPA), and Nadia Kadri, Moroccan local coordinator of the WPA Global Program against Stigma and Discrimination Because of Schizophrenia, have said the stigma attached to schizophrenia is the greatest obstacle to improving the lives of patients and their families. Kadri and Sartorius, in their article published in July 2005, say stigma results in a low priority for mental health services, problems attracting and hiring competent staff, and poor quality of care for physical illnesses in those diagnosed as having psychiatric disorders.

Prevention/Solution

The WPA program provides information about schizophrenia through meetings, books, websites and newspapers in participating areas of the world. Training is offered to target groups such as health care professionals, law enforcement and teachers. Mental health services receive support, and cultural artistic activities are funded. Sartorius and Kadri say it takes time to change attitudes and behaviors and that continuing financial support for programs is needed.

Other Efforts

In her article published in the February 2006 issue of the journal World Psychiatry, Mitsumoto Sato of the Department of Psychiatry at Tohoku Fukushi University in Japan explains the reasons for her country's 2002 renaming of the disease of schizophrenia. Formerly called "mind-split disease," the Japanese Society of Psychiatry and Neurology replaced the former name with one that means "integration disorder." According to Sato, the aim of the new term is to ease the stigma of negative perceptions relating to disease outcome for patient and families. Sato relates that psychiatrists hesitated to inform patients of their diagnosis using the earlier term, which implied life-long disability.