Discrimination Attributed to Mental Illness or Race-Ethnicity by Users of Community Psychiatric Services

Jheanell Gabbidon · Simone E. Farrelly · Stephani L. Hatch · Claire Henderson · Paul R Williams · Dinesh Bhugra +3 more

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Mental Health Treatment and Access Racial and Ethnic Identity Research Cultural Competency in Health Care

Abstract

OBJECTIVE: This study assessed participants' experienced discrimination and their causal attributions, particularly to mental illness or race-ethnicity. METHODS: In a cross-sectional study, 202 service users with severe mental illnesses were interviewed to assess their reported experiences of discrimination. The Major Experiences of Discrimination Scale assessed major experiences of discrimination and their recency and frequency across 12 life domains and perceived reasons (attributions). The Everyday Experiences of Discrimination Scale assessed ten types of everyday discrimination and attributions for these experiences. RESULTS: Most participants (88%) reported discrimination in at least one life domain, and 94% reported ever experiencing everyday discrimination. The most common areas of major discrimination were mental health care (44%), neighbors (42%), police (33%), employment (31%), and general medical care (31%). The most common attributions for major discrimination were mental illness (57%), race-ethnicity (24%), education or income (20%), or appearance (19%). Almost half (47%) attributed experiences of major discrimination to two or more causes. No differences were found between racial-ethnic groups in overall experienced discrimination or in main attributions to mental illness. However, compared with the mixed and white groups, participants in the black group were most likely to endorse race-ethnicity as a main attribution (p<.001). CONCLUSIONS: Mental illness-related discrimination was found to be a common issue across racial-ethnic groups, and discrimination based on race-ethnicity was prevalent for the mixed and black groups. There is a need for antidiscrimination strategies that combine efforts to reduce the experience of discrimination attributed to mental illness and to race-ethnicity for racial-ethnic minority groups.

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References

1997Racial Differences in Physical and Mental Health 1999The Prevalence, Distribution, and Mental Health Correlates of Perceived Discrimination in the United States 2005Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health 2009Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey 1995The Wage Effects of Sexual Orientation Discrimination 2012Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey 2008Perceived discrimination, race and health in South Africa 2000Unfair Treatment, Neighborhood Effects, and Mental Health in the Detroit Metropolitan Area

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