Stigma, Discrimination, Social Exclusion, and Mental Health

A Public Health Perspective

Authored by: Nicolas Rüsch , Sara Evans-Lacko , Sarah Clement , Graham Thornicroft

Routledge Handbook of Global Public Health

Print publication date:  December  2010
Online publication date:  December  2010

Print ISBN: 9780415778480
eBook ISBN: 9780203832721
Adobe ISBN: 9781136838330


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People with mental illness face a twofold problem. In addition to experiencing symptoms such as mood swings, hallucinations, or anxiety, they often encounter stigma and discrimination, which can present a greater burden than the illness itself. Mental illness stigma is pervasive in developing and developed countries alike (Thornicroft et al. 2009), and typically leads to social exclusion in various life domains such as personal relationships, work, housing, or access to care. Given that stigma affects all areas of life, it is a major public health concern. There is a rich and growing literature on mental illness stigma in particular (Corrigan 2005; Hinshaw 2007; Thornicroft 2006), and on the concepts of stigma and discrimination in general (Link and Phelan 2001; Major and O’Brien 2005; Nelson 2009). In this chapter, we will first briefly define three domains in which stigma and discrimination can operate: public stigma, self-stigma, and structural discrimination. We will then discuss the daily life consequences of these three types of stigma for people with mental illness. Finally, we will outline some ongoing initiatives, for example from Scotland and New Zealand, meant to reduce stigma and discrimination.

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