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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

Stigma

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Main topics can be found within the left column; sub-topics and/or research reports can be found near the bottom of this page.  Thank you

 

 

 

Until we can define what we are dealing with when we talk of stigma and discrimination we may not be able to do anything very much. Below are some ideas put together as a result of the stigma discussion at the Jerusalem conference and other discussions about stigma we have If you have something to add that may help people in their creation of anti-stigma and anti-discrimination programs send us an email info@heart-intl.net

STEREOTYPING

  1. Grouping or categorizing persons under one heading and attributing characteristics to all the individuals under that heading
  2. Making generalizations about groups of people
  3. Making judgments based on how people look
  4. Being unable to see people as individuals with individual characteristics
  5. Using stereotypes on which to base film or TV suspense movie plots

REINFORCING THE STEREOTYPE

  1. Untreated people who are visible on our streets present an image that people respond to with fear and avoidance
  2. In some societies eccentricity is well accepted, in others people must conform for acceptance.

HISTORICAL ASSOCIATIONS

  1. The idea that psychiatric disorders have to do with the supernatural
  2. An almost innate feeling of fear among many members of society
  3. A fear of associating with anyone who has a mind disorder
  4. Society's recollection of the "madhouse" as demonstrated in films like "The Snake Pit" back in the 40s.
  5. A human being's distrust of the unpredictable

IGNORANCE

  1. The lack of knowledge and the public unawareness of how these disorders affect people
  2. Attributing logical and reasoned thought to the actions of people in psychosis
  3. A susceptibility to make fun of mental illness
  4. Government and societal discrimination against people with these disorders in matters of employment, travel (visas), etc..
  5. The mental health workforce is largely untrained and ignorant of current knowledge in the field

ABUSE

  1. Persons recovering from or unstable with illnesses of the mind are very vulnerable to unscrupulous individuals who would dupe or otherwise abuse them.
  2. Persons angered by the behaviour of people with illness may physically abuse them.
  3. Vulnerability to coercion by religious cults, drug users and dealers and others

LANGUAGE

  1. Using words that have unpleasant connotations
  2. Using words which are downright offensive e.g. schizo; psycho. (Extraordinarily enough a group of consumers have adopted for themselves the term "the crazies"
  3. Describing disorders using vivid adjectives e.g. "horrific; incurable"
  4. Finding suitable terms to describe experiences
  5. Using judgmental language
  6. The pejorative connotation of words that were originally ways to describe people's conditions e.g. mental illness
  7. Discounting anything someone with experience of schizophrenia says as delusional thinking or not to be considered.

THE BENEFITS OF LANGUAGE

  1. Finding more suitable expressions which put the hope back e.g. "treatable"
  2. Being able to ask those who have experience of mind disorders whether they can suggest better ways of using language
  3. Thinking before you speak. Putting yourself in the other persons position.
  4. Listening to and conversing with persons with experience of schizophrenia

VALUING PEOPLE WITH DISORDERS

  1. People should not be characterized by the disorders they suffer. There is more to a person than this.
  2. Searching out people's abilities is of more value than reinforcing notions about their disabilities

CHANGING THE EXPECTATIONS

  1. Better medications and better management indicate that today recovery is a very real hope.
  2. Better income provision for those with such disabilities may make them less vulnerable to discrimination.

ADDITIONAL ARTICLES:

Document Name & Link to Document

Description

File Size /pdf

Accelerating the Momentum in the Fight Against HIV/AIDS

HIV/AIDS related discrimination and stigma in South Asia: A violation of Human Rights

133 kb pdf

AIDS and the law

Health care workers in more than 25 U.S. states are now required to disclose the name and address of persons testing positive for HIV to state health departments and in some cases can legally compel a patient to list his or her known sexual contacts.

 

Annual Report-1999 from the Population Council

They seek to improve the wellbeing and reproductive health of current and future generations around the world and to help achieve a humane, equitable, and sustainable balance between people and resources

1,969 kb pdf

Aspects of Stigma

Until we can define what we are dealing with when we talk of stigma and discrimination we may not be able to do anything very much. Below are some ideas put together as a result of the stigma discussion at the Jerusalem conference and other discussions about stigma

 

Assessing Self-Efficacy for HIV Serostatus Disclosure Four studies were conducted to systematically develop scales for assessing self-efficacy to disclose HIV status to sex partners and negotiate safer sex practices among men and women living with HIV/AIDS Pdf 140 kb

BIO-TERRORISM AND HEPATITIS C: Is it feasible? 

Over the last five years our society has heard more and more about a liver disease called hepatitis C. The media has dubbed it the "silent killer" and the "silent epidemic" because it takes 20 to 30 years under normal conditions until it manifests serious damage to the liver and impacts the infected persons quality of life.

 

Concentration Camp Economics

The fast-paced growth of the U.S. prison industry, with its exorbitant incarceration rates, was originally advertised to the people as a necessary part of the "get tough on crime" movement. Though the public's fear of crime and violence has been stoked to inflammatory proportions as part of the sales campaign, the reality today is that what has become known as the prison/ industrial complex has more to do with the economic vitality of communities than it has with criminal justice.

 

Conceptualizing Stigma.

The stigma concept we construct has implications for understanding several core issues in stigma research, ranging from the definition of the concept to the reasons stigma sometimes represents a very persistent predicament in the lives of persons affected by it

213 kb pdf

Couples

A couple is composed of two persons in a committed sexual or romantic relationship, usually over a significant period of time. Couples may be opposite-sex or same-sex, married or unmarried, monogamous or nonmonogamous, and cohabitating or living apart and may or may not have children.

 

COUPLES' PERCEPTIONS OF WIVES' CFS SYMPTOMS, SYMPTOM CHANGE, AND IMPACT ON THE MARITAL RELATIONSHIP

The purpose of this descriptive correlational study was to describe the differences in couples' perceptions of wives' Chronic Fatigue Syndrome (CFS) symptoms and to describe the relationship between changing symptoms and the marital relationship.

 

Courts Perpetuating AIDS Stereotypes, Study Indicates The study, which examined the cumulative total of all AIDS-related litigation since the epidemic began in 1981, was released by the AIDS Litigation Project, which was established three years ago to help lawyers, health care providers and consumers understand the evolution of laws regarding the rights of people with AIDS or those infected with the human immunodeficiency virus. It is funded by the AIDS program office of the Department of Health and Human Services.  

Differences in Knowledge of Hepatitis B Among Vietnamese, African- American, Hispanic, and White Adolescents in Worcester, Massachusetts

Knowledge of hepatitis B was low overall. Vietnamese respondents were more likely than were other students to know that hepatitis B affects the liver. However, they were much less likely than were other students to correctly identify sex with an infected person as a risk factor for infection

 

Disability Awareness and Changing Attitudes

Public attitudes toward disability are often the greatest barrier for people with disabilities. Since the publication of the reference bibliography "Attitudes toward Handicapped People, Past and Present" in 1984, however, the emphasis in the literature on disability has been shifting from a focus on differentness and limitation to a focus on abilities and potential.

 

DISABILITY LAW AND HIV/AIDS

"Conditions in society which are not defined as a problem and for which alternatives are never proposed, never become policy issues. Government does nothing and conditions remain the same."

 

Disclosure of HIV Infection Among Asian/Pacific Islander American Women: Cultural Stigma and Support

Disclosure of HIV infection can lead to important social support that can mitigate the negative effects of stress. However, disclosure can also result in rejection, discrimination, and stigma, making the decision to disclose a dilemma for individuals infected with HIV. This decision may be particularly difficult for Asian/Pacific Islander (A/PI) women, owing to HIV's association with topics considered "taboo" in Asian cultures

 

Disclosure of HIV-Positive Status to Partners

Among patients who did not disclose, 57% used condoms less than all the time. In multiple logistic regression analysis, the odds that an individual with 1 sexual partner disclosed was 3.2 times the odds that a person with multiple sexual partners disclosed. The odds that an individual with high spousal support disclosed was 2.8 times the odds of individuals without high support, and the odds that whites or Latinos disclosed was 3.1 times the odds that blacks disclosed.

 

Doctors' & Nurses' Knowledge & Attitudes

This report presents responses to AIDS-related questions from a national sample of 958 physicians and 1,520 registered nurses in 1990-91. Questions included willingness to treat AIDS patients and whether they believe that they were professionally obligated and should be legally required to do so, attitudes toward homosexual men and intravenous drug users, knowledge about HIV (human immunodeficiency virus) transmission, perceptions of the risk of HIV contagion, precautionary practices, trust in HIV authorities, career plans, and attitudes toward mandatory testing and mandatory reporting. Physicians' and nurses' responses were compared nationally.

 

Early Effects of a School-Based Human Immunodeficiency Virus Infection and Sexual Risk

Preintervention data indicated that the study population was involved in sexual activity and other risk behaviors at rates comparable to those of other urban adolescent populations. Examination of 3 outcome constructs as dependent variables (knowledge, sexual self-efficacy, and safe behavior intention) revealed that the health educators and peer educators increased students' knowledge significantly more than did the control condition for both middle (females, P<.01; males, P<.01) and high (females, P<.001; males, P<.001) school. Comparisons of self-efficacy changes across intervention groups did not reach statistical significance, and safe behavior intention changes differed significantly by intervention group for high school but not for middle school students. For all analyses, the preintervention scores for each outcome variable were the most powerful predictors of postintervention scores, and analysis of variance models predicted substantial overall variance.

 

Effect of HIV Reporting by Name on Use of HIV Testing in Publicly Funded Counseling and Testing Programs

No significant declines in the total number of HIV tests provided at counseling and testing sites in the months immediately after implementation of HIV reporting occurred in any state, other than those expected from trends present before HIV reporting.

 

Effect of Training Program on Physicians' Attitudes towards knowledge and Practice Patterns Related to Assessment and Screening of Clients with HIV/AIDS

The study also examines physicians' practice patterns related to the screening and testing of Hispanic patients at risk for the disease. A one on one educational program was taken to the physician's office at a time convenient to the physician. A pre- and post-test design is used with questionnaires developed for the study that assess self-reported data related to physicians' attitudes, knowledge and practice patterns

 

Endnotes-Stigma

Breakdown of and list of reference concerning AIDS

53 kb pdf

Epidemic Ravages Caregivers; Thousands die from diseases contracted through needle sticks

Instead, OSHA said it would develop tough new workplace regulations to protect health care workers -- a process that would involve sending notices to 600,000 employers, gathering comments and holding public hearings. The process would be lengthy, but health care workers were optimistic that the agency was at last paying attention to the needle stick epidemic

 

EXAMPLES OF DISCRIMINATION IN EMPLOYMENT Impairment in pre-work, Race discrimination in work, Pregnancy discrimination and victimization at work, Prospective employee asked age at interview, Race discrimination,  Young worker harassed at work, Sex discrimination and sexual harassment Pdf 285 kb

EXPECTATIONS AND SOCIAL INTERACTIONS OF CHILDREN WITH AND WITHOUT MENTAL RETARDATION

Mentally retarded and nonretarded perceiver children (n = 40) conversed by telephone with a child who was described as a special or regular education student. Perceivers reported that special and regular education telephone partners behaved differently during the conversation even though observers who were unaware of how telephone partners had been described did not detect behavioral differences between them. These same observers did detect differences in stereotype related social behaviors of mentally retarded and nonretarded perceivers, but only when perceivers thought they were speaking to a regular education student. Observer ratings also suggested that nonretarded perceivers "talked down" to special education telephone partners.

 

Fear of dying and HIV infection vs hepatitis B Infection

Fear of certain death seems to account for the greater concern about exposure to HIV than to Hepatitis B.

 

Help us Win the Fight!ing Stigma

There are myths that have become part of American "folklore" that contribute to this stigma. The main ones are (1 ) that people with mental illness are violent and (2) that people with mental illness don't recover. So, to fight stigma, the two major messages to communicate are that these myths are false -- that (1) statistics show that "mental disorders ... account for a minuscule portion of the violence that afflicts American society," according to a statement issued by the National Stigma Clearinghouse; and that (2) people with mental illness do recover, and return to their communities to lead productive lives.

 

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