Information
Stigmatization and Discrimination
Experiences of Persons with Mental Illness: Insights from a Qualitative Study
in Southern Ghana
Mavis
Dako-Gyeke / Emmanuel Sowah Asumang, University
of Ghana
1
Introduction
Globally, stigmatization and
discrimination against persons with mental illness is a matter of public health
concern. This is due to the fact that many people with mental illness are
challenged twice; on one hand, they struggle with the symptoms and disabilities
that result from the disease and on the other, they are stereotyped and
prejudiced due to misconceptions about mental illness (Corrigan &Watson,
2002). Persons with mental disorders represent a considerable proportion of the
world’s population (World Health Organization, WHO, 2010). It is estimated that
about one million people die due to suicide every year (WHO, 2009) and one in
four people worldwide will experience mental illness in her or his lifetime
(WHO, 2010).
In Ghana for instance, the World Health
Organization’s report (2007) on mental health indicated that out of the 21.6
million people living in Ghana, 650,000 were suffering from severe mental
disorders and 2,166, 000 were suffering from moderate to mild mental disorders.
While the burden of mental health care is a public health concern worldwide
(Prince et al., 2007), there is a significant gap between the level of mental
health needs and the availability of quality services to aptly address these
needs (Faydi et al., 2011). For low-income countries like Ghana, mental health
is often given the lowest health priority by authorities (Ofori-Atta, Read
& Lund, 2010) and this could deepen the stigma and discrimination faced by
this population.
In both low-income and middle-income
countries in Africa, it is estimated that between 76 percent and 99 percent of
people with serious mental disorders do not have access to the treatment they
need for their mental health problems (Faydi et al., 2011; World Health
Organization, 2008). Some scholars (e.g., Forster, 1962; Read, Adiibokah &
Nyame, 2009) have argued that political apathy towards mental health combined
with widespread stigma, hinders the progress of mental health care in Ghana.
The stigmatization of mental illness is a serious issue given that it adversely
affects patients and their relatives as well as institutions and health care
personnel working with persons with mental illness (Barke, Nyarko & Klecha,
2011). People who have or are perceived to have mental disorders may find it
difficult to access services due to stigma and discrimination and these
reactions obstruct prevention and treatment efforts and intensify the impact of
the mental health disabilities.
Across the world, people with mental
disorders, mental health services, mental health professionals and even the
very concept of mental health receive negative publicity and are stigmatized
and discriminated against in spite of growing evidence of the importance of
mental health for development (Sadik, Bradley, Al-Hasoon & Jenkins, 2010).
Mental health has an impact on varied development outcomes and is a basis for
social stability because it serves as a key determinant of well-being and
quality of life (WHO, 2010). Given that mental health is an important indicator
of human development, issues regarding stigmatization and discrimination
against persons with mental health disabilities cannot be ignored. The World
Health Organization for instance, has linked the stigma and discrimination
associated with mental illness to suffering, disability and poverty (Corrigan
& Watson, 2002; Crabb et al., 2012)
In his seminal
work on stigma, Goffman (1963) asserted that stigma is
a feature that is deeply discrediting and makes the person experiencing it
different from others and of a less pleasant kind. The unpleasant phenomenon is
often accompanied by stereotyping, rejection, status loss and discrimination
(Link & Phelan 2001). According to Byrne (2000) stigma is a sign of
disgrace or dishonor, separates a person from others. It could arise from a
number of factors such as superstition, ignorance, lack of knowledge, belief
systems and the fear and exclusion of people who are perceived as different
(Agbenyega, 2003; Avoke, 2002; Baffoe, 2013). Similarly, Crabb and colleagues
(2012) assert that the experience of stigma is characterized by shame, blame,
secrecy, labeling, isolation, social exclusion and discrimination. Since stigma
is often rooted in social attitudes, persons with mental illness in Ghana are
often disliked, rejected, shunned and could experience sanctions, harassment,
and even violence.
Discrimination on the other hand, results
from stigma and occurs when people are treated on the basis of belonging, or
being perceived to belong to a particular group (Letamo, 2005). Goreczny,
Bender, Caruso and Feinstein (2011) describe discrimination as the way persons
are treated, intentionally or unintentionally, due to stigma. Discrimination
may lead to societal exclusion, bullying, aggression, ridicule and devaluation
of the self-worth of people and these could bring about oppression against such
persons in all areas of life including the ability to obtain housing, maintain
regular employment, access education, engage in meaningful relationships and
enjoy quality of life (Baffoe, 2013).
Compared to stigma, discrimination can be
recognized more often because it includes public restrictions and some forms of
punishment (Busza, 1999). However, not all acts of discrimination are obvious
because it may take a more subtle form, as in community members withholding
care and support for ailing individuals (Collymore, 2002). Discrimination and
stigma are devastating experiences for persons with mental health disabilities
in Ghana because in most communities, people tend to have strong views about
mental illness, which are often based on stereotypes and traditional beliefs.
Since many people have little knowledge
and understanding regarding mental health issues, they may not understand that
mental illness is a form of disability that could affect anyone in society.
Additionally, stigma research in general has been challenged for drawing on
theories and concepts that are uninformed by the lived experiences of the
people studied (Link & Phelan, 2001). In Ghana for example, persons experiencing
mental conditions are one of the most highly stigmatized and vulnerable groups,
for that reason they are usually seen by others in society as being violent,
dangerous and unpredictable. Moreover, even though some studies have examined
mental health issues in Ghana, a minimal number of empirical research studies
have explored stigmatization and discrimination among persons with mental
illness.
This study, which is part of a larger
research, however goes beyond extant literature by exploring the stigmatization
and discrimination experiences of persons with mental health disorders from
their own voices and the perspectives of key informants. Understanding their
experiences is important because stigmatization and discrimination experienced
by persons with mental illness could lead to restrictions in their lives.
Research has shown that persons with mental illness are usually prone to a
vicious cycle of social isolation, poverty, unemployment and homelessness,
among others. In this article the terms mental illness and mental disorder are
used interchangeably. The objectives of this study were:
1.
To find out how persons with mental illness are
stigmatized and discriminated against by their family members.
2.
To ascertain how persons with mental illness are
stigmatized and discriminated against by the public (friends and neighbors).
3.
To determine how persons with mental illness are
stigmatized and discriminated against by their employers and work colleagues.
The family, public, and workplace were
the focus of the study because as Alexander and Link (2003) asserted, they are
qualitatively different in how personal the relationships are and how
intentional the contacts may be. The relationship between persons with mental
disorders and their family members is usually more personal than their
relationship with friends, neighbors and work colleagues. Likewise, interaction
between persons with mental illness and the public and those in the workplace
are different in that public contact is not sought out, but work contact is
chosen (Alexander & Link, 2003).
2
Methodology
2.1
Research Design
A qualitative research approach,
specifically phenomenology was used to study the lived experiences of persons
with mental health disorders. Generally, reflection on the lived experiences is
recollective because it is a reflection on experience that had passed or lived
through (van Manen, 1990). The context of this study involved questions about
how social life was organized and ways in which individuals and groups made
sense of their lived experiences within a their society (Miller & Dingwall,
1997; Baffoe, 2013). Phenomenology was useful for this study because it allowed
participants to share their experiences regarding mental illness. As Schwandt
(2000) opined, the main concern of phenomenological analysis is to understand
how participants constitute their everyday, inter-subjective world.
2.2
Study Area
Ghana is a country located along the
coast of West Africa and is a typical hot and humid tropical country. There are
a lot of sub-cultures in the country because it consists of a large variety of ethnic groups (Ardayfio-Schandorf,
2005). This study was conducted in the Pantang community, which comprises of
people with different ethnic backgrounds. It is a community in Accra, the
capital city of the country. Pantang was deemed appropriate for the study
because of the existence of a psychiatric hospital in the community. The
Pantang Psychiatric Hospital is the largest of the three psychiatric hospitals
in Ghana with patients from all over Ghana and other West African countries
such as Togo, Benin, Nigeria, Burkina Faso, and Ivory Coast.
2.3
Participants
For this study, a purposive sampling
method was used to recruit twenty respondents. This sampling method allowed the
researchers to select individuals whose experiences were useful for the purpose
of the study (Patton, 2002). The participants comprised of ten persons with
mental illness, six relatives of persons with mental illness and four residents
of the Pantang community. According to Marshall (1996), the number of
participants for a qualitative study becomes clear when new categories, themes
or explanations stop emerging from the data that are being collected. In this
study, the researchers settled on the sample size of twenty when not much new
information emerged from the data being gathered.
Persons with mental illness included in
the study accessed psychiatric services at the out-patient department (OPD) of
the Pantang hospital and the relatives were persons who were principal caretakers
of the mentally ill persons. With assistance from officials of the Pantang
Psychiatric Hospital, persons with mental illness were recruited from the OPD
because they were medication compliant and functioning well in society.
Additionally, the other key informants were included in the study due to their
in-depth knowledge about the experiences of persons with mental health
disabilities as a result of their direct and regular interactions with them.
The respondents were 18 years and above
with an average age of thirty years. In relation to marital status, eight of
the persons with mental illness had never married and the other two indicated
that they were married prior to their illness but were divorcees at the time of
the study. While many relatives of persons with mental disorders and persons in
the community included in this study were self-employed, the participants with
mental illness were unemployed. The majority of respondents was Christians and
belonged to different ethnic groups.
2.4
Data Collection Procedures
Data for this study was collected from
respondents through in-depth interviews using unstructured open-ended questions
and a voice recorder. Permission to use the voice recorder was sought from
respondents. The open-ended questions allowed respondents to express themselves
freely and enabled the researchers and participants to discuss emerging issues
in much more detail. Furthermore, the data collection method allowed the
researchers to probe participants’ responses for clarification and to explore
key issues mentioned, which were useful for the study. The consent of
respondents was sought before the interviews were conducted. Participation in
the study was voluntary and respondents were assured of anonymity and
confidentiality regarding information they provided.
2.5
Data Analysis
The interviews were recorded after
participants’ consent was sought. The interviews were played and listened to
several times to accurately capture the data and then transcribed. The data
gathered was analyzed inductively because it enabled dominant or significant
themes to emerge devoid of the restraints imposed by structured methodologies
(Thomas, 2003). The researchers analyzed specific statements and looked for
possible ideas that made the information more meaningful (Creswell, 1998).
Significant themes that emerged from the in-depth interviews were used in
analyzing and understanding the study. The most illustrative quotations were
extracted and discussed.
3
Findings and Discussions
The study aimed at exploring
stigmatization and discrimination experienced by persons with mental illness.
The findings revealed that in their daily lives, persons with mental illness
who were medication complaint and functioning well in society experienced
stigma and discrimination from various groups of people. The themes generated
from the data were: interaction with family members, association with friends
and community members, contact with employers and work colleagues.
3.1
Interaction with Family Members
This theme centered on stigmatization and
discrimination experiences of persons with mental illness regarding their
interactions with family members. As Stier and Hinshaw (2007) asserted, stigma
leads to poorer individual and family functioning. Most often, negative
perceptions by family members of mental disorders result in stigmatization and
discrimination against persons with mental illness. During the in-depth
interviews some respondents said:
“. . . things have
changed since I was discharged from the psychiatric hospital . . . we used to
share things together as a family, we talk about issues . . . I shared the same
bed with my brother, my sister and I had meals together and dined from the same
plate but now I have been given a separate room, my own plate and drinking cup
. . . don’t do things together anymore . . .”
“My ex-
husband beat me up, accused me of being the cause of my illness and deserted
me . . . it wasn’t my fault to be mentally ill”.
“We
were a happy family but things changed when I got sick, my husband deserted me
and went for another woman accusing me of being a witch . . . he took our two children
with him and I hardly see them . . . I don’t have a choice, do I?”
“My son
and I have been rejected by my relatives because of his illness but it is not
my fault that he has mental illness . . .”
“. . .
he is unpredictable and violent sometimes so I have to protect my other
children from danger; he is the cause of his own illness by associating
with bad friends who use hard drugs”.
“My
father is no more living with us, I didn’t know why he left and my mother
didn’t tell me either, he ignores my calls . . . didn’t understand why
because we were very close . . . now I know it is because of my mental
illness”.
“. . .
before I got ill, I used to be invited by the welfare committee of my family to
deliberate on family issues but now I am no longer invited . . . when I attend
family meetings and contribute to discussions some family members laugh at
me whenever I talk . . .”
“My
ex-husband and his family members have neglected us since my daughter’s mental
illness, they said the illness is from my family lineage but I don’t know or haven’t
seen anyone in my family with mental illness”.
“Sometimes,
he becomes violent and usually doesn’t make sense in his conversations . .
. issues that aren’t funny are funny to him and vice-versa so it is frustrating
to have a meaningful conversation with him”.
The above responses from participants of
this study clearly indicate that persons with mental illness are stigmatized
and discriminated against in various forms by their family members. Mental
illness affected family relationships where family members distanced themselves
from a relative who had experienced a mental disorder. Most people are likely
to withdraw from personal relationships with people with mental illness such as
living together (Bhugra, 1989; World Psychiatric Association, 2005).
Consequently, people with mental illness face social isolation, social distance
and low self-esteem (Al-Naggar, 2013; Barke et al., 2011).
Additionally, Al-Naggar (2013) argues
that the multiple consequences that result from negative perceptions of mental
illnesses could prevent persons with mental illness from fully living and could
serve as a barrier to proper care. In this study, it was found that some family
members perceived mental ill persons as dangerous and incapable of engaging in
daily activities. Our finding corroborates research findings which suggest that
people’s attitudes towards persons with mental illness often include beliefs
that they are dangerous and less capable when compared with the general
population (Al-Naggar, 2013; Angermeyer & Matschinger, 2003; Coker, 2005;
Gureje, Lasebikan, Ephraim-Oluwanuga, Olley, & Kola, 2005). However, it is
important to mention that there could be people in the general population who
are dangerous and incapable though may not have been diagnosed with mental
illness.
While in most societies the family is
regarded as a safe haven for family members, it is rather unfortunate that
persons with mental illness in this study were stigmatized and discriminated
against by close family members like parents and spouses. Such attitudes and
behaviours are not surprising, given that the majority of Ghanaians have poor
knowledge regarding causation of mental illness as well as the efficacy of
orthodox psychiatric medications. Compounding this issue is that stigmatizing
views about mental illness are not limited to uninformed members of the general
public; some trained professionals from most mental health disciplines
subscribe to stereotypes about mental illness as well (Corrigan & Watson,
2002; Lyons & Ziviani, 1995). In their study on attitudes towards mental
illness in Malawi, Crabb et al (2012) found that their respondents were not
willing to consent to a social intimacy with persons who had experienced mental
illness. This finding according to Crabb and colleagues was influenced by
respondents’ belief that genetic factors were the cause of mental illness and
therefore could be passed on to their future children.
Additionally, since the adverse impact of
stigma of mental illness extends beyond individuals who have been with mental
illness to their family members (Barke et al., 2011; Corrigan & Watson,
2002; Ohaeri & Fido, 2001; Stier & Hinshaw, 2007; Wahl, 1999; Wahl
& Harman, 1989) family relations are likely to distance themselves from
their relatives who are mentally ill. This could heighten the stigma and discrimination
experienced by persons with mental disorders. Based on studies conducted in
Ethiopia, Shibre and colleagues (2001) asserted that the experience of stigma
by people with mental illness may be widespread since about three quarters of
family members of individuals with mental disorders experience stigma, as well.
3.2
Association with Friends and Community Members
In view of the fact that persons with
mental illness live in communities, it was vital to explore stigma and
discrimination they experienced from friends and people in the Pantang
community. Due misconceptions about mental illness, persons with mental illness
are robbed of the opportunities that define quality life, which include
affiliation with friends and community members (Corrigan & Watson, 2002).
Below are some responses from participants:
“I have
lost my friends after I was diagnosed with mental illness, we were hanging
around most of the time but it is not the same anymore . . . ignore me these days
. . .”
“. . .
if a tragedy happens to you in life, you will know the true colours of your
friends . . . my friends have distanced themselves from me since I was
discharged from the psychiatric hospital”.
“My
fiancée was my best friend, we dated for almost five years living together in
an apartment, we had no secrets . . . he deserted me when I became
mentally ill . . . made all efforts to contact him now that I am
well but to no avail . . .”
“. . .
people in our neighbourhood ridicule my daughter when we go out so I make sure
she doesn’t go out alone . . .”
“. . .
my friends changed their attitudes towards me when they became aware of my son’s
mental illness, some have stopped visiting me for fear of being attacked by my son”.
“. . .
some neighbours, especially the teenagers ridicule and point fingers at me wheneverI
go out, I don’t like going out, I prefer being at home . . .”
“Every
time I come out of my room, people in my house look at me in a funny way . . . even
their visitors do same, it is quite frustrating . . .”
“I
can’t be a friend to someone who is crazy because you wouldn’t know when he or
she will strike, madness knows no friend . . .”
“I will
not be comfortable around someone who is crazy due to their unpredictable and
violent behaviours . . .”
“. . .
will consider friendship with someone with mental illness depending on the severity
of the illness . . . be extremely careful in order not to be in danger of being
harmed”.
“I am
scared of someone whose brain does not function well or is crazy; it will be
very difficult to establish friendship with such a person . . .”
“I was
a member of a keep fit club in my neighbourhood but they cancelled my membership
when I became mentally ill, I am well now but they don’t associate with me
anymore . . .”
“I was
part of the neighbourhood watch committee but members don’t care about me anymore,
they have rejected me . . . no one comes to my house to visit me”
“I was
a member of a football team in my community . . . stopped playing because the
team members treated me badly after I was diagnosed with mental illness . . .”
As the responses indicate, due to their
diagnosis, some persons with mental illness lost their friends and others were
scoffed at by community members. Research studies on community attitudes have
been done in West Africa and have showed widespread negative views towards
mental illness and the belief that persons with mental illness are not suitable
for normal social contact (Gureje et al., 2005). Similar perceptions were held
by community members included in this study. These negative perceptions are
likely to account for the social distancing and isolation that people with
mental disorders experience and could also make people unfamiliar with the
realities of sufferer’s experiences and illness (Crisp, Gelder, Rix, Meltzer
& Rowlands, 2000).
In many African countries, including
Ghana, people’s attitudes towards mental illness are influenced strongly by
social and traditional norms that are in turn informed by historical, cultural
and symbolic practices such as beliefs in supernatural causes (Gureje &
Alem, 2000; Read et al., 2009). Many Ghanaians view persons with mental illness
as dangerous, violent and unpredictable because the majority of persons with
mental health problems do not use formal health institutions, are labeled with
derogatory language such as crazy or lunatics and are often seen roaming the
streets of urban centers begging for food or money, sometimes chasing
pedestrians and either naked or wearing torn dirty clothes. This is usually due
to one or a combination of the following factors; inadequate mental health
resources, lack of money and stigma associated with mental illness and
psychiatric treatment (Barke et al., 2011; Asenso-Okyere, 1998; Roberts, 2001;
Rosenberg, 2002).
Although the majority of persons with
mental illness in the Pantang community functioned well on psychiatric
medications, as the findings of this study showed, community members still had
negative perceptions and attitudes towards them. The findings are consistent
with that of Schulze and Angermeyer’s (2003) study in Germany. They found that
as soon as contact with mental health services became known to their social
environment, most people with mental illness experienced negative reactions,
which included reduction of their person to being crazy, not trusted, carefully
watched over, and every detail of their behavior ascribed to the illness.
Kapungwe et al (2010) noted that the stigmatization and discrimination against
persons suffering from mental disorders hinders their ability to integrate into
society and recover from the illness, due to frequent personal harassment,
isolation and exclusion they experience.
Moreover, many Ghanaians do not have
confidence in orthodox psychiatric services since they are more familiar with
unorthodox medication and services (herbal preparations and spiritual
incantations and invocations) offered by traditional and spiritual healers.
Most often, in order to get rid of the supposed demons causing the mental
illness, individuals are chained, flogged, or incarcerated in shrines or
spiritual prayer camps (Fournier, 2011; Commonwealth Human Rights Initiative
Africa, 2008; Read et al., 2009). This maltreatment of persons with mental
disorders is sometimes exposed through the media and often leads to unhelpful
or health-damaging reactions to mental illness (Gureje & Alem, 2000). Once
people perceive that mental illness is caused by demons, they have a tendency
to believe that it can only be treated spiritually and therefore cannot be
cured by orthodox psychiatric medications.
3.3
Contact with Employers and Work Colleagues
The stigmatization and discrimination
experiences of persons with mental disorders were explored with regard to their
contact with employers and work colleagues. If people, especially employers
perceive mental disorders as stable, permanent conditions that are unresponsive
to treatment (Stier & Hinshaw, 2007), it is likely they would not offer
persons with mental illness jobs. Commenting on this issue, respondents disclosed
the following:
“. . .
before I was diagnosed with mental illness, I was in the building construction business
with my own workers, now they are all gone because of my illness. . . I do not get
jobs anymore”
“When
I came home from the psychiatric hospital, I went back to my workplace but my
manager said I was sick and that he cannot afford to lose customers because of
me . . .”
“I went
back to my job after I was discharged from the psychiatric hospital but most of
my colleagues started behaving funny towards me, I wasn’t
feeling comfortable so I left and has since not looked for a job”.
“I was
a driver before my mental illness, I went back to the car owner after I was discharged
from the psychiatric hospital, but she refused to offer me a job on grounds that
I was ill and cannot drive well . . . I have tried to convince her on several occasions
without success . . . tried other car owners but none of them is willing to offer
me a job”.
“I was
a fisherman but have lost my job after my mental illness, my fishing colleagues
refused to have me on board although I am feeling better now, they told me
they cannot guarantee my safety because I am not fit to go for fishing
on the high seas . . .”
“I knew
from the time he became ill that he will lose his job because of the way we treat
people with mental illness in our society. . .”
“I will
never be comfortable working with someone suffering from mental illness or with
a history of mental illness, I will always be nervous”.
“. . .
it would be a waste of time and resources to employ persons with mental
illness, how will they function effectively on the job? . . . cannot
guarantee the safety of other workers and customers . . .”
“It is
rather unfortunate she was not given a second chance to continue her work, she
is functioning very well on medication but here we are in a society where
even the normal people are not getting jobs so how much more those regarded
as crazy . . ”
“I was
working in a bakery prior the mental illness, although I am feeling better on medication,
my manager fired me because most of the workers threatened to quit because of
me . . .”
“I am a
dressmaker but have stopped sewing . . . lost my customers after was diagnosed
with mental illness . . . opened my shop a couple of times but nobody came around,
even my apprentices refused to come to work”.
“It was
a disturbing issue for me when she was diagnosed with the mental illness, Ghanaians
refer to people with mental illness as crazy and because of that people are not
willing to offer a job to a person with mental illness . . .”
The findings showed that persons with
mental disorders were unemployed since they were unable to find or keep their
jobs although they were functioning well on psychiatric medications. Some
employers shunned persons with mental disorders because they perceived them as
incapable of working and other employers felt they would lose customers if they
hired persons with mental illness. In the seminal study of Farina and Felner
(1973), it was found that employers were significantly less likely to offer
jobs to individuals believed to have a mental illness. As a result, in most
work places, people who have been labeled with mental illness report a wide
range of discriminatory experiences in occupational settings such as being
turned down for jobs for which they are qualified (Alexander & Link, 2003).
Consequently, people with mental illness are deprived of opportunities to earn
income, which adversely affects total national output (Corrigan & Watson,
2002; Fournier, 2011).
Employers do not want persons with mental
illness nearby so they do not hire them (Corrigan & Penn, 1999; Manning
& White, 1995). Even if hired, people who have been patients of psychiatric
hospitals are likely to be underemployed and earn less income compared to
people with similar psychiatric problems who have not been labeled as mentally
sick (Link, 1987). In addition to employers, persons with mental disorders in
this study experienced stigma and discrimination from their colleagues at work.
As indicated in the responses, some employers and work colleagues were not
comfortable working with persons with mental illness due to the likely
occurrence of the disease while on the job. Stier and Hinshaw (2007) have
argued that using potential future episodes of mental illness as a hiring
practice is discriminatory, which is similar to employers’ avoidance of hiring
females because they might become pregnant and be less productive.
Of more concern is the likelihood that
persons with mental illness may not disclose their disease to employers and
work colleagues due to fear of not being hired or losing their jobs. Thara and
Srinivasan (2000) found in their study in India that the need to conceal mental
illness from others was stigmatizing. Thus, concealment of mental illness in
order to procure a job cannot be overlooked (Loganathan & Murthy, 2008)
because it has implications for the health of sufferers as well as
productivity. For fear of being ridiculed or fired from their jobs, persons
with mental illness may not access mental health services and this could
adversely affect their job performance and interactions with people in the work
environment.
4
Conclusions and Implications
While globally, persons with mental
illness face a plethora of challenges in their daily lives, issues relating to
stigmatization and discrimination cannot be over emphasized. This is due to the
fact that a growing number of voices including this study are recognizing the
negative effects of stigma and discrimination on persons with mental illness,
their families, communities and nations (Corrigan & Kleinlen, 2005;
Hinshaw, 2006; Link & Phelan, 2001; Stier & Hinshaw, 2007). Clearly,
the findings of this study provide a picture of the prevailing stigma and
discrimination perpetuated by family, friends, work colleagues and neighbors
towards persons suffering from mental illnesses in the Pantang community.
Certainly, the findings suggest the need
for societies to take a critical look at the ways of seeing and interacting
with persons with mental illness and how they could support and empathize with
these persons. In order to reduce the stigma and discrimination experienced by
persons with mental disorders, it is suggested that societies join and develop
a multilevel response to the phenomenon. Given that in many countries in
Africa, including Ghana, the family remains an important resource for the
support and care of patients with mental disorders (Giel et al., 1983; Gureje
& Alem, 2000), family members need to be supported financially and
counseled to understand the causes, effects, and medical responses to mental
illness. This is essential because family members must often cope with burdens
related to care giving, stigmatization and discrimination (Corrigan &
Miller, 2004; Martens & Addington, 2001; Stier & Hinshaw, 2007).
Without assistance, it is likely family
members would become overwhelmed and distance themselves from their mentally
ill relatives. This could worsen the plight of persons with mental disorders
who need love, care and support from family should the public abandon them. As
found in this study, the majority of persons with mental disorders lost their
friends and jobs when their mental illness became publicly known. Once people
associate disclosing mental illness with negative consequences, they are likely
to conceal their mental illness from people, which could have an adverse effect
on their professional help seeking behavior and ultimately affect their health
and positive adjustment in society. As argued by Stier and Hinshaw (2007),
attempting to hide one’s illness may come at the cost of intimacy, friendship,
support, and likeability, which may further increase the symptoms a person with
mental disorder is trying to conceal.
Stigma and discrimination against persons
with mental illness are often fueled by societal attitudes and practices,
discriminatory policies, tendencies toward concealment and silence, and
structural processes that hinder the seeking or funding of adequate treatment
(Corrigan, 2005; Hinshaw, 2006; Stier & Hinshaw, 2007). It is therefore
important for mental health professionals such as clinical social workers and
psychologists to understand the stigma and discrimination against persons with
mental illness. Based on their understanding, they should be funded by
governmental and non-governmental organizations to develop and provide
appropriate mental health awareness campaigns in communities to improve
people’s knowledge about and acceptability of the illness.
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Author´s
Address:
Mavis Dako-Gyeke, Ph.D. / Emmanuel Sowah Asumang
University of Ghana, Legon, Accra
Department of Social Work
Ghana, West-Africa
Email: mavisdako@yahoo.com
Mavis Dako-Gyeke, Ph.D. / Emmanuel Sowah Asumang
University of Ghana, Legon, Accra
Department of Social Work
Ghana, West-Africa
Email: mavisdako@yahoo.com
