Perceived stigma and community integration among clients of assertive community treatment.

Abstract

Facilitating the integration of persons with psychiatric disabilities is an important goal of community programs. In addition to limitations such as inadequate housing, poverty, and unemployment, a common barrier to community adjustment identified by people with psychiatric disabilities is their perception of being stigmatized. This study examined the relationships between perceived stigma and community integration in 95 clients of assertive community treatment (ACT) teams, using sequential multiple regression procedures. Findings indicate that despite their physical presence in the community and the intensive support they receive, ACT clients believe other community members will reject them. Moreover, this perception appears to interfere with their sense of belonging, particularly among those who also perceive less social support and who have greater psychosocial skill deficits. In the context of the present study, global self-esteem did not mediate this relationship. In addition to community focused antistigma campaigns, stigma-related issues should also be addressed with ACT clients themselves.

How Evidence-Based Practices Contribute to Community Integration

“…Not all areas of community life are adequately covered by the established EBPs. Social integration, involving reciprocal relationships between consumers and others in society, has not been adequately achieved (Angell, 2003;Prince & Prince, 2002). Certainly, more work also is needed in the areas of jail diversion, treatment for medical conditions, and treatment for trauma and co-occurring post-traumatic stress disorder.…”

“…In their contacts with mental health centers, consumers often experience ''spirit-breaking'' messages reflecting low expectations regarding their potential to realize their dreams (Prince & Prince, 2002). Mirroring prejudices of the general community, many practitioners believe that independent living is beyond the ability of many consumers.…”

Stigmatisation. Leçons tirées des programmes visant sa diminution

“…Autrement, la stigmatisation peut faire obstacle à l'intégra-tion sociale, interférer avec la performance des rôles sociaux, réduire les attentes de vie et diminuer la qualité de vie. Les conséquences de la stigmatisation -manque de travail, absence de logement, faible estime de soi et peu de soutien social -peuvent être des obstacles majeurs au rétablissement, avoir un impact sur le pronostic à long terme, et pousser à l'incapacité (Link et al, 1991 ;Markowitz, 1998 ;Wahl, 1999 ;Prince et Prince, 2002). La stigmatisation peut aussi produire de graves bouleversements dans les relations familiales et, en raison d'un désir de secret, réduire les interactions sociales normales (Wahl et Harman, 1989).…”

Locating community among people with schizophrenia living in a diverse urban environment

“…Yanos et al (2007) found little association between community participation and type of neighbourhood (degree of stability of residence, concentration of immigrants, level of economic disadvantage), though Segal, Baumohl and Moyles (1980) found greater degrees of acceptance associated with liberal, non-traditional and working class neighbourhoods. Perceptions of community would also seem important as demonstrated by Prince and Prince (2002), who found that higher levels of perceived stigma were associated with lower community activity levels, and by Kloos and Townley (2011), who found that the perceptions of a better neighbourhood social climate has an inverse relationship with psychological distress.…”