Labelling of mental illness in a paediatric emergency department and its implications for stigma reduction education

Abstract

IntroductionStigmatizing attitudes and behaviours towards patients with mental illness have negative consequences on their health. Despite research regarding educational and social contact-based interventions to reduce stigma, there are limitations to the success of these interventions for individuals with deeply held stigmatizing beliefs. Our study sought to better understand the process of implicit mental illness stigma in the setting of a paediatric emergency department to inform the design of future educational interventions.MethodsWe conducted a qualitative exploration of mental illness stigma with interviews including physician, nurse, service user, caregiver and administrative staff participants (n = 24). We utilized the implicit association test as a discussion prompt to explore stigma outside of conscious awareness. We conducted our study utilizing constructivist grounded theory methodology, including purposeful theoretical sampling and constant comparative analysis.ResultsOur study found that the confluence of socio-cultural, cognitive and emotional forces results in labelling of patients with mental illness as time-consuming, unpredictable and/or unfixable. These labels lead to unintentional avoidance behaviours from staff which are perceived as prejudicial and discriminatory by patients and caregivers. Participants emphasized education as the most useful intervention to reduce stigma, suggesting that educational interventions should focus on patient-provider relationships to foster humanizing labels for individuals with mental illness and by promoting provider empathy and engagement.DiscussionOur results suggest that educational interventions that target negative attributions, consider socio-cultural contexts and facilitate positive emotions in healthcare providers may be useful. Our findings may inform further research and interventions to reduce stereotypes towards marginalized groups in healthcare settings.

Health care providers and people with mental illness: An integrative review on anti-stigma interventions

“…An interesting aspect identified in a study (Sukhera et al, 2020) was related to the need to develop strategies that address implicit stigma, since stigmatizing attitudes and behaviors often manifest outside of consciousness (Sukhera et al, 2017). Despite the best intentions of educational strategies to combat stigma, implicit stigma may persist due to the limited reach of educational programs (Ashburn-Nardo, 2010; Gershan, 2013).…”

The risk of blood-borne infections in Poland – opportunities and threats to public health, nationwide qualitative research

“…This makes it possible to carry out information and prevention activities without the risk of generating negative social attitudes which could have a negative impact on the situation of infected people; there is no need to break the negative prejudices. Negative attitudes and even escalation can be observed in the case of public communication also concerning other problems [36,37].…”

Hekimlerin Bipolar Afektif Bozukluğa Karşı Damgalayıcı Tutumların Değerlendirilmesi

“…Studies on stigmatization and stigmatizing attitudes towards mental illnesses have been conducted on different samples. These samples include emergency personnel (11), university students (12), pre-clinical and post-clinical medical students (13), psychiatrists (14), and non-psychiatrist specialist doctors (15). Social distance can be defined as the degree in which people accept the involvement of people with mental illness in their social relationships (16).…”