Study of understanding the internalized stigma of schizophrenia in psychiatric nurses in Japan

Abstract

Aim: ‘Internalized stigma’ is a construct that reflects the degree to which a person accepts beliefs endorsed by society about mental illness. Among people with schizophrenia spectrum disorders, internalized stigma has been found to moderate the associations between insight and social function, hope, and self‐esteem. Among families of patients with schizophrenia, internalized stigma may not only hinder help‐seeking but also result in the families attempting to provide care themselves, without assistance from mental health services. Little is known about internalized stigma among service providers, especially psychiatric nurses in Japan. Therefore, we investigated the correlation between internalized stigma and ‘beliefs about the most appropriate form of hospitalization’ among psychiatric nurses. Methods: The subjects were 215 psychiatric nurses employed in psychiatric hospitals who completed the personal stigma scale, perceived stigma scales, and Difficulty of Community Living Scale (DCLS) with respect to a chronic schizophrenia case vignette. Results: Internalized stigma was positively correlated with greater ‘beliefs about the most appropriate form of hospitalization’ among psychiatric nurses. We also showed that stronger ‘beliefs about the social disadvantages of schizophrenia patients in the community’ was positively correlated with stronger ‘beliefs about the most appropriate form of hospitalization’. Conclusion: The present findings suggest that the psychiatric nurses employed at Japanese psychiatric hospitals have a pessimistic view of the community living of people with schizophrenia and their families. And these psychiatric nurses' beliefs were related to their understanding of the deeply dependent relationship between patients and families, and was related to the Confucian ideal.

Cancer in patients with schizophrenia: What is the next step?

“…Many people suffer from the stigma of mental illness; thus, they tend to conceal mental health problems and refuse medical help . For example, in the families of patients with schizophrenia, internalized stigma may not only discourage help‐seeking but may also result in families who attempt to provide care themselves without assistance from mental health services . Moreover, concealing mental illness can seriously affect the prognosis of patients with mental illness and the effective treatment of cancer.…”

“…Finally, incorrect public (including physicians’) beliefs concerning the causes of schizophrenia or psychosis should be challenged continuously through education, and the internalized stigma of schizophrenia should be understood by professionals (i.e., psychiatric nurses) to help their patients …”

Living with schizophrenia in rural communities in north‐east Thailand

“…Stigma raises doubts even among professional caregivers whether people with schizophrenia could/should live in the community (Hanzawa et al . ).…”

“…Discrimination and other negative selfperceptions have been documented across multiple European countries (Brohan et al 2010) and in Thailand (Wong-Anuchit et al 2016), particularly Thai rural areas (Burnard et al 2006). Stigma raises doubts even among professional caregivers whether people with schizophrenia could/should live in the community (Hanzawa et al 2012).…”

Revision of road traffic law in Japan and mental health stigma

“…We recruited new nursing students before clinical practice, for two reasons: (i) nurses are key players in providing care to people with mental illness; and (ii) nursing students before clinical practice have little clinical experience that could affect stigma . Their schools were located in Aichi, Toyama, and Shizuoka prefectures.…”