Interlocking oppressions: the effect of a comorbid physical disability on perceived stigma and discrimination among mental health consumers in Canada

Abstract

People living with mental health problems often face stigma and discrimination; however, there is a lack of research that examines how comorbid conditions affect this perceived stigma. This study sought to determine whether people who have a comorbid physical and psychiatric disability experience more stigma than those with only a psychiatric disability. It also looked at how perceived stigma and discrimination affect physical and mental health. A secondary analysis on data from interviews with 336 former and current clients of the mental health system in a mid-size Canadian city in 2005 was performed. Of these, 203 (60.4%) reported they had a psychiatric disability, 112 (33.0%) reported that they had a physical disability, with 74 reporting both a psychiatric and a physical disability. People with a self-reported psychiatric disability and a self-reported comorbid physical disability faced more overall perceived discrimination/stigma (P = 0.04), than those with a psychiatric disability alone. Perceived discrimination/stigma was positively correlated with psychiatric problem severity (P = 0.02), and negatively correlated with self-rated general health (P < 0.001), physical condition (P < 0.001), emotional well-being (P < 0.001) and life satisfaction (P < 0.001). These results bring to light the aggravating effect of a physical disability on the perceived stigma for those living with a mental illness, and also strengthen the knowledge that stigma and discrimination have a negative impact on health. Healthcare providers should recognise this negative impact and screen for these comorbid conditions. Policy-makers should take measures such as improving access to housing and employment services to help reduce stigma and discrimination against this particularly vulnerable group.

Discrimination and Health of Male and Female Canadian Immigrant

“…Moreover, though previous research has focused mainly on race-or ethnic-based discrimination, our study showed that these forms of discrimination have a somewhat weaker effect on health than other types of discrimination such as that based on disability, religion, sex, and sexual orientation for immigrant women. The findings on the importance of non-racial and non-ethnic sources of discrimination substantiate previous research on the negative effect of discrimination on health due to language (Spencer and Chen 2004;Yoo et al 2009), religion (see Armstrong and Trento 2007;Kundnani 2007), age (Yip et al 2008), sex (Finch et al 2001;Borrell et al 2006), sexual orientation (Almeida et al 2007;Ortiz-Hernandez et al 2009;McLaughlin et al 2010), and disability (Bahm and Farchuk 2008).…”

Functional impairment, illness burden, and depressive symptoms in older adults: does type of social relationship matter?

“…Older adults with functional impairment, however, may not be willing or able to engage in frequent social interactions, because of decreased mobility and embarrassment or stigma regarding their impairment (Bahm and Forchuk, ). In this case, interventions must be focused on either enhancing quality of support, perhaps from caregivers, or assisting the patient in ascribing meaning to the care they receive.…”

“…Participation in psychoeducational or self-help groups (Laitinen et al, 2006), or engagement in both leisure and productive social activities, such as physical exercise or attending a senior citizens center (Herzog et al, 1998), may help ill or impaired older adults develop a sense of competency and capability that, in turn, may reduce depressive symptoms. Older adults with functional impairment, however, may not be willing or able to engage in frequent social interactions, because of decreased mobility and embarrassment or stigma regarding their impairment (Bahm and Forchuk, 2009). In this case, interventions must be focused on either enhancing quality of support, perhaps from caregivers, or assisting the patient in ascribing meaning to the care they receive.…”

A Comparison of Work Value Preferences of Individuals With Disabilities and Individuals Without Disabilities

“…Similarly, Ben-Shem and Avi-Itzhak (1991) found that students pursuing careers in helping professions attributed greater importance to altruism than independence or creativity when compared to students pursuing other careers. Edwards and Cable (2009) found that the reason value congruence was related to positive outcomes (job satisfaction, identification with the employer, and intent to remain an employee) was associated with the trust employees had in the employer, improved communication within the employer, and friendship among workers.…”