The Role of Neighborhood Factors and Community Stigma in Predicting Community Participation Among Persons With Psychiatric Disabilities

Gonzales, Lauren; Yanos, Philip T.; Stefancic, Ana; Alexander, Mary Jane; Harney-Delehanty, Brianna

doi:10.1176/appi.ps.201700165

Cited by 25 publications

(21 citation statements)

References 30 publications

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“…The preference for social distance from people with mental illness leads to social isolation, loneliness, impaired social networks [ 37 ], and reduced social capital [ 38 ] and community participation. This particularly affects people living with severe mental illness [ 39 , 40 ]. At the same time, people with severe mental illness are at risk of targeted violence and hostility, such as verbal and physical abuse, and sexual and financial exploitation [ 41 ].…”

Section: The Impacts Of Stigma and Discriminationmentioning

confidence: 99%

Mental Health Related Stigma as a ‘Wicked Problem’: The Need to Address Stigma and Consider the Consequences

Henderson

Gronholm

2018

IJERPH

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Recent reviews on the evidence base for mental health related stigma reduction show that under certain conditions interpersonal contact is effective in promoting more positive attitudes, reduced desire for social distance, and increased stigma related knowledge (knowledge which disconfirms beliefs based on stereotypes). Short-term interventions may have effects that are attenuated over time; longer term programmes may support sustained improvements, but research following up long-term interventions is scarce. However, the effectiveness of these interventions should not obscure the nature of stigma as a social problem. In this article we describe stigma as a ‘wicked problem’ to highlight some implications for intervening against stigma and evaluating these efforts. These include the risks of unintended consequences and the need to continually reformulate the concept of stigma, to ensure that tackling stigma at the structural, interpersonal, and intrapersonal levels become part of the core business of stakeholder organisations. We compare the main targets of anti-stigma programmes with what is known about the sources of stigma and discrimination and their impacts to identify targets for future intervention. In some cases, interventions have been directed at the interpersonal level when structural level intervention is also needed; in others, systematic reviews have not so far identified any interventions.

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Section: The Impacts Of Stigma and Discriminationmentioning

confidence: 99%

Mental Health Related Stigma as a ‘Wicked Problem’: The Need to Address Stigma and Consider the Consequences

Henderson

Gronholm

2018

IJERPH

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“…Six included empirical studies were qualitative in nature, using focus group (Gonzales et al ., 2015 a ; Peters et al ., 2016), one-to-one semi-structured interviews (Holley et al ., 2016 a ; McCue, 2016; Harper et al ., 2017) and analysis of free-text survey questions (Charles et al ., 2017). Four were cross-sectional surveys (Zurick, 2016; DeLuca et al ., 2017; DeLuca et al ., 2018; Gonzales et al ., 2018), with sample sizes from 222 to 951 participants. Four of these studies employed convenience sampling of the US public using online survey platforms.…”

Section: Resultsmentioning

confidence: 99%

“…The latter was used in three studies aiming to identify individual characteristics associated with endorsement of mental health microaggressions by the general public. Broadly, endorsement of microaggressions was positively associated with right-wing political views (DeLuca et al ., 2018), suburban values and socio-economic disadvantage (Gonzales et al ., 2018), authoritarianism (the attitude that people with serious mental illness cannot care for themselves and require coercion) and social restrictiveness (the belief that people with mental illness should be feared and excluded) (Zurick, 2016). Endorsement was negatively associated with benevolence (the belief that people with mental illness are innocent and naïve) (Zurick, 2016).…”

Section: Resultsmentioning

confidence: 99%

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Microaggressions towards people affected by mental health problems: a scoping review

Barber

Gronholm

Ahuja

et al. 2019

Epidemiol Psychiatr Sci

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Aims This review aims to understand the scope of the literature regarding mental health-related microaggressions towards people affected by mental health problems. Methods A scoping review was conducted to explore this question. Four electronic health-oriented databases were searched alongside Google Scholar. As per scoping review principles, the inclusion criteria were developed iteratively. The results of included studies were synthesised using a basic narrative synthesis approach, utilising principles of thematic analysis and thematic synthesis where appropriate. Results A total of 1196 records were identified, of which 17 met inclusion criteria. Of these, 12 were peer-reviewed journal articles, three were research degree theses and two were book chapters. Six included empirical studies were qualitative, four were quantitative and two employed a mixed-methods design. Within these, five qualitative studies aimed to describe the nature of mental health microaggressions experienced by people with mental health problems. Themes identified in a thematic synthesis of these five studies included stereotypes about mental illness, invalidating peoples' experience and blaming people with mental illness for their condition. The included publications informed on the perpetration of mental health microaggressions by family, friends, health professionals and social workers. In addition, two studies created scales, which were then used in cross-sectional surveys of the general public and community members to assess characteristics, such as right-wing political views, associated with endorsement of mental health microaggressions. A consensus definition of microaggressions emerged from the included studies: microaggressions are brief, everyday slights, snubs or insults, that may be subtle or ambiguous, but communicate a negative message to a target person based on their membership of a marginalised group, in this case, people affected by mental illness. Conclusions The study of mental health microaggressions is an emerging, heterogeneous field, embedded in the wider stigma and discrimination literature. It has been influenced by earlier work on racial microaggressions. Both can be ambiguous and contradictory, which creates difficulty defining the boundaries of the concept, but also underpins the key theoretical basis for the negative impact of microaggressions. Mental illness is a more concealable potential type of identity, so it follows that the reported perpetrators of microaggressions are largely friends, family and professionals. This has implications for intervening to reduce the impact of microaggressions. There are several challenges facing research in this area, and further work is needed to understand the impact of mental health microaggressions on people affected by mental health problems.

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“…It is also possible that other area characteristics, not measured in the current study, could account for the associations we observed. For example, research suggests geographic variation exists in gender norms, beliefs which condone domestic violence, [33][34][35] and stigmatising attitudes towards people with mental illness; 36,37 neighbourhood patterns in violence towards people with mental illness observed in this study could reflect regional differences in attitudes. Material deprivation in neighbourhoods is associated with the experience of violence, across a range of indicators, including intimate partner violence, 38 homicide 39 and use of hospital care for assault.…”

Section: Explanation Of Findingsmentioning

confidence: 88%

The association between neighbourhood characteristics and physical victimisation in men and women with mental disorders

et al. 2020

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Background How neighbourhood characteristics affect the physical safety of people with mental illness is unclear. Aims To examine neighbourhood effects on physical victimisation towards people using mental health services. Method We developed and evaluated a machine-learning-derived free-text-based natural language processing (NLP) algorithm to ascertain clinical text referring to physical victimisation. This was applied to records on all patients attending National Health Service mental health services in Southeast London. Sociodemographic and clinical data, and diagnostic information on use of acute hospital care (from Hospital Episode Statistics, linked to Clinical Record Interactive Search), were collected in this group, defined as ‘cases’ and concurrently sampled controls. Multilevel logistic regression models estimated associations (odds ratios, ORs) between neighbourhood-level fragmentation, crime, income deprivation, and population density and physical victimisation. Results Based on a human-rated gold standard, the NLP algorithm had a positive predictive value of 0.92 and sensitivity of 0.98 for (clinically recorded) physical victimisation. A 1 s.d. increase in neighbourhood crime was accompanied by a 7% increase in odds of physical victimisation in women and an 13% increase in men (adjusted OR (aOR) for women: 1.07, 95% CI 1.01–1.14, aOR for men: 1.13, 95% CI 1.06–1.21, P for gender interaction, 0.218). Although small, adjusted associations for neighbourhood fragmentation appeared greater in magnitude for women (aOR = 1.05, 95% CI 1.01–1.11) than men, where this association was not statistically significant (aOR = 1.00, 95% CI 0.95–1.04, P for gender interaction, 0.096). Neighbourhood income deprivation was associated with victimisation in men and women with similar magnitudes of association. Conclusions Neighbourhood factors influencing safety, as well as individual characteristics including gender, may be relevant to understanding pathways to physical victimisation towards people with mental illness.

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The Role of Neighborhood Factors and Community Stigma in Predicting Community Participation Among Persons With Psychiatric Disabilities

Abstract: Findings suggest that effects of neighborhood characteristics and community stigma on people with psychiatric disabilities are complex and are partly conditioned by housing context.

Cited by 25 publications

References 30 publications

Mental Health Related Stigma as a ‘Wicked Problem’: The Need to Address Stigma and Consider the Consequences

Mental Health Related Stigma as a ‘Wicked Problem’: The Need to Address Stigma and Consider the Consequences

Microaggressions towards people affected by mental health problems: a scoping review

The association between neighbourhood characteristics and physical victimisation in men and women with mental disorders

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