Mental Health Provider-Based Stigma: Understanding the Experience of Clients and Families

Abstract

That the general public commonly holds negative attitudes and beliefs toward persons living with mental illness is well-documented (Corrigan, Mueser, Bond, Drake, & Solomon, 2008 Corrigan, P.W., Mueser, K.T., Bond, G.R., Drake, R.E and Solomon, P. 2008. Principles and practice of psychiatric rehabilitation: An empirical approach, New York, NY: The Guilford Press. [Google Scholar]; Rusch, Angermeyer, & Corrigan, 2005 Rüsch, N., Angermeyer, M.C. and Corrigan, P.W. 2005. Mental illness stigma: Concepts, consequences, and initiative to reduce stigma. European Psychiatry, 20: 529–539. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Wahl, 1999 Wahl, O.F. 1999. Mental health consumers’ experience of stigma. Schizophrenia Bulletin, 25(3): 467–478. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). What is surprising is that some researchers have identified similar attitudes and beliefs held by mental health providers (Lauber, Anthony, Ajdacic-Gross, Rössler, 2004 Lauber, C., Anthony, M., Ajdacic-Gross and Rössler, W. 2004. What about psychiatrists’ attitude to mentally ill people?. European Psychiatry, 19: 423–427. doi:10.1016/j.eurpsy.2004.06.019[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Lauber, Nordt, Braunschweig, & Rössler, 2006 Lauber, C., Nordt, C., Braunschweig, C. and Rössler, W. 2006. Do mental health professionals stigmatize their patients?. Acta Psychiatrica Scandinavica, 113: 51–59. Suppl. 429doi:10.111/j.1600-0447.2005.00718.x[Crossref], [Web of Science ®] , [Google Scholar]; Nordt, Rössler, & Lauber, 2006 Lauber, C., Nordt, C., Braunschweig, C. and Rössler, W. 2006. Do mental health professionals stigmatize their patients?. Acta Psychiatrica Scandinavica, 113: 51–59. Suppl. 429doi:10.111/j.1600-0447.2005.00718.x[Crossref], [Web of Science ®] , [Google Scholar]). This less-understood phenomenon, provider stigma, is defined as the negative attitudes, beliefs, and behaviors that mental health providers possess and enact toward clients. The consequences of provider stigma are profound, yet efforts to address it must begin with intensive exploration of the concept and its experience. This article describes an ethnographic content analysis (ECA) of client- and family member–authored literature around the concept of provider stigma. The hope is that the outcome of analysis, a conceptual model involving five themes related to the lived experience of provider stigma, may be useful to social work practitioners, educators, and researchers: Sensitizing practitioners to actions and attitudes potentially perceived as less-than-helpful or harmful; to educators entrusted with preparing future mental health social workers; and for researchers further investigating the phenomenon, its consequences, measurement development, and intervention design.

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