Stigma towards people with mental disorders: perceptions of devaluation and discrimination in a sample of Chilean workers

María Teresa Solis-Soto, María Soledad Burrone, Gabriel Reginatto, Jaime C. Sapag, Rubén Alvarado

DOI: https://doi.org/10.17711/SM.0185-3325.2019.027

Abstract


Introduction. Mental disorders represent one of the main causes of disease burden in the adult population. Negative public attitudes and behaviors toward people with mental disorders negatively affect the treatment, recovery, and social inclusion of those affected. Chile laks surveys on workers that address this issue.

Objective. To describe the perceptions of devaluation and discrimination towards people with mental disorders in a sample of Chilean workers.

Method. A cross-sectional study was carried out with 1 516 workers in the formal sector of four regions of Chile (Metropolitan Region [RM], Bío Bio [VIII], Valparaíso [V] and Coquimbo [IV]). The perception of discrimination and devaluation was explored through a modified version of the The perceived Devaluation-Discrimination Scale (PDD) comprising 15 questions. The relationship of each question with sociodemographic variables (age, sex, years of study, and region) and type of economic activity was assessed.

Results. The study found a high percentage of perceptions of devaluation and discrimination in most aspects considered, particularly those related to hiring a person who has been hospitalized due to a mental illness (85%), feeling sorry for people with severe mental illnesses (80%), and the unwillingness to marry a person with a mental illness (78%). Significant differences were observed in the opinions by sociodemographic variables and region of residence.

Discussion and conclusion. The perception of Chilean workers has high levels of stigma towards people living with mental disorders. It is necessary and urgent to develop effective anti-stigma public policies to promote a more inclusive, tolerant society.

Keywords


Estigma social; trastornos mentales; trabajadores; Chile

Full Text:

HTML Pdf ePub

References


Angermeyer, M. C., Buyantugs, L., Kenzine, D. V., & Matschinger, H. (2004). Effects of labelling on public attitudes towards people with schizophrenia: Are there cultural differences?. Acta Psychiatrica Scandinavica, 109(6), 420-425. doi: 10.1111/j.1600-0047.2004.00310.x

Boyd, J. E., Adler, E. P., Otilingam, P. G., & Peters, T. (2014). Internalized Stigma of Mental Illness (ISMI) scale: a multinational review. Comprehensive Psychiatry, 55(1), 221-231. doi: 10.1016/j.comppsych.2013.06.005

Chuaqui, J. (2005). El estigma en la esquizofrenia. Ciencias sociales Online, 2(1), 45-66

Corrigan, P. W. (2016). Lessons learned from unintended consequences about erasing the stigma of mental illness. World Psychiatry, 15(1), 67-73. doi: 10.1002/wps.20295

Hanisch, S. E., Birner, U. W., Oberhauser, C., Nowak, D., & Sabariego, C. (2017). Development and evaluation of digital game-based training for managers to promote employee mental health and reduce mental illness stigma at work: Quasi-experimental study of program effectiveness. JMIR Mental Health, 4(3), e31. doi: 10.2196/mental.7600

Hanisch, S. E., Twomey, C. D., Szeto, A. C. H., Birner, U. W., Nowak, D., & Sabariego, C. (2016). The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review. BMC Psychiatry, 16(1), 1. doi: 10.1186/s12888-015-0706-4

Koschorke, M., Evans-Lacko, S., Sartorius, N., & Thornicroft, G. (2017). Stigma in different cultures. In Gaebel, W., Rössler, W., & Sartorius, N. (Eds.). The Stigma of Mental Illness-End of the Story? (pp. 67-82). Heidelberg, Germany: Springer. doi: 10.1007/978-3-319-27839-1

Lau, A. S., Guo, S., Tsai, W., Nguyen, D. J., Nguyen, H. T., Ngo, V., & Weiss, B. (2016). Adolescents’ stigma attitudes toward internalizing and externalizing disorders: Cultural influences and implications for distress manifestations. Clinical Psychological Science, 4(4), 704-717. doi: 10.1177/2167702616646314

Li, J., Zhang, M. M., Zhao, L., Li, W. Q., Mu, J. L., & Zhang, Z. H. (2018). Evaluation of attitudes and knowledge toward mental disorders in a sample of the Chinese population using a web-based approach. BMC Psychiatry, 18(1), 367. doi: 10.1186/s12888-018-1949-7

Link, B. G. (1987). Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. American Sociological Review, 52(1), 96-112. doi: 10.2307/2095395

Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363-385. doi: 10.1146/annurev.soc.27.1.363

Link, B. G., Cullen, F. T., Struening, E. L., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54(3), 400-423. doi: 10.2307/2095613

Lundberg, B., Hansson, L., Wentz, E., & Bjorkman, T. (2007). Sociodemographic and clinical factors related to devaluation/discrimination and rejection experiences among users of mental health services. Social Psychiatry and Psychiatric Epidemiology, 42(4), 295-300. doi: 10.1007/s00127-007-0160-9

Martinez-Zambrano, F., Pizzimenti, M., Barbeito, S., Vila-Badia, R., Comellas, G., Escandell, M. J., ... Ochoa, S. (2016). Spanish version of the Link’s Perceived Devaluation and Discrimination scale. Psicothema, 28(2), 201-206. doi: 10.7334/psicothema2015.89

Mascayano, F., Armijo, J. E., & Yang, L. H. (2015). Addressing stigma relating to mental illness in low- and middle-income countries. Frontiers in Psychiatry, 6, 38. doi: 10.3389/fpsyt.2015.00038

Mascayano, F., Toso-Salman, J., Ruiz, B., Warman, K., Jofre Escalona, A., Alvarado Muñoz, R., ... Yang, L. H. (2016). What matters most’: stigma towards severe mental disorders in Chile, a theory-driven, qualitative approach. Revista de la Facultad de Ciencias Médicas, 72(4), 250-260. PMID:27107276

Ministerio de Salud. (2008). Estudio de Carga de Enfermedad y Carga Atribuible, Chile, 2007. In Estudios AUGE Santiago de Chile. Retrieved from http://www.cienciasdelasalud-udla.cl/portales/tp76246caadc23/uploadImg/File/Informe-final-carga-Enf-2007.pdf

Ministerio de Salud. (2017). Plan Nacional de Salud Mental 2017 - 2025. Santiago, Chile. Retrieved from http://www.minsal.cl/wp-content/uploads/2017/12/PDF-PLAN-NACIONAL-SALUD-MENTAL-2017-A-2025.-7-dic-2017.pdf

Ministerio de Salud. (2018). Modelo de Gestión Red Temática de Salud Mental en la Red General de Salud. Retrieved from http://www.minsal.cl/wp-content/uploads/2015/09/2018.05.02_Modelo-de-Gesti%C3%B3n-de-la-Red-Tem%C3%A1tica-de-Salud-Mental_digital.pdf

Minoletti, A., & Zaccaria, A. (2005). Plan Nacional de Salud Mental en Chile: 10 años de experiencia. Revista Panamericana de Salud Pública, 18(4-5), 346-358.

Mora-Rios, J., Bautista-Aguilar, N., Natera, G., & Pedersen, D. (2013). Adaptación cultural de instrumentos de medida sobre estigma y enfermedad mental en la Ciudad de México. Salud Mental, 36(1), 9-18.

Naciones Unidas. (2005). Clasificación Industrial Internacional Uniforme de todas las Actividades Económicas (CIIU). Revisión 3.1. Nueva York. ISBN 92-1-361213-3. Retrieved from https://unstats.un.org/unsd/publication/SeriesM/seriesm_4rev3_1s.pdf

Organización Mundial de la Salud. (2013). Plan de acciόn sobre salud mental 2013-2020. Ginebra, Suiza. ISBN 9789243506029. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/97488/9789243506029_spa.pdf;jsessionid=39B9B80C9E8741D7596133D5D61EDB7D?sequence=1

República de Chile. (2000). Plan Nacional de Salud Mental y Psiquiatría. Documento técnico MINSAL, Santiago de Chile, p 230. Retrieved from https://diprece.minsal.cl/wrdprss_minsal/wp-content/uploads/2016/02/MINSAL_2001_Plan-Nacional-de-Salud-Mental.pdf

Resnik, D. B., & Shamoo, A. E. (2011). The singapore statement on research integrity. Accountability in Research, 18(2), 71-75. doi: 10.1080/08989621.2011.557296

Sanz Perez, C. (2016). Validación del instrumento Perceived Devaluation and Discrimination Scale en pacientes con esquizofrenia y trastornos mentales afines, en Chile. (Magíster en Salud Pública), Universidad de Chile, Santiago. Retrieved from http://bibliodigital.saludpublica.uchile.cl:8080/dspace/bitstream/handle/123456789/468/Tesis_Carla%20Sanz.pdf?sequence=1&isAllowed=y

Schomerus, G., Matschinger, H., Kenzin, D., Breier, P., & Angermeyer, M. C. (2006). Public attitudes towards mental patients: A comparison between Novosibirsk, Bratislava and German cities. European Psychiatry, 21(7), 436-441. doi: 10.1016/j.eurpsy.2006.01.009

Semrau, M., Evans-Lacko, S., Koschorke, M., Ashenafi, L., & Thornicroft, G. (2015). Stigma and discrimination related to mental illness in low- and middle-income countries. Epidemiology and Psychiatric Sciences, 24(5), 382-394. doi: 10.1017/S2045796015000359

Stuart, H. (2016). Reducing the stigma of mental illness. Global Mental Health (Cambridge, England), 3, e17. doi: 10.1017/gmh.2016.11

Superintendencia de Salud. (2018). Estadísticas Consolidadas de Licencias Médicas Curativas de Origen Común y SIL 2016 - FONASA e ISAPRES. Retrieved from http://www.supersalud.gob.cl/documentacion/666/w3-article-16504.html

Thornicroft, G., Brohan, E., Rose, D., Sartorius, N., & Leese, M. (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: A cross-sectional survey. The Lancet, 373(9661), 408-415. doi: 10.1016/s0140-6736(08)61817-6

Van Boekel, L. C., Brouwers, E. P., Van Weeghel, J., & Garretsen, H. F. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: Systematic review. Drug and Alcohol Dependence, 131(1-2), 23-35. doi: 10.1016/j.drugalcdep.2013.02.018

Vivanco, M. (2005). Muestreo estadístico. Diseño y aplicaciones. Santiago, Chile: Editorial Universitaria. ISBN 956-11-1803-3

World Health Organization. (2005). Hacia un marco conceptual que permita analizar y actuar sobre los determinantes sociales de la salud. Documento de trabajo de la Comisión sobre Determinantes Sociales de la Salud, 5. Retrieved from https://cursos.campusvirtualsp.org/pluginfile.php/3229/mod_page/content/1/determinantes/bibliocomplementaria/unidad_2.2bc/ud22bc-marco-conceptual-ddsOMS.pdf

World Health Organization. (2007). Breaking the vicious cycle between mental ill-health and poverty. Geneva: Mental health core to development information sheet. Retrieved from https://www.who.int/mental_health/policy/development/MHPB1.pdf

Zieger, A., Mungee, A., Schomerus, G., Ta, T. M., Dettling, M., Angermeyer, M. C., & Hahn, E. (2016). Perceived stigma of mental illness: A comparison between two metropolitan cities in India. Indian Jornual of Psychiatry, 58(4), 432-437. doi: 10.4103/0019-5545.196706