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The uplift ideology of French Muslim leaders directly impacts the ways in which they respond to stigmatization. In the wake of rising Islamophobia, leaders of the UOIF encourage their coreligionists to react politely to stigma, stressing the value of nonconfrontational responses. For them, the destigmatization of Islam is best achieved through strict policing of Muslims’ conduct and constant attention to self-discipline. This anti-racist repertoire is aligned with color-blind republicanism, in a society where the social reality of Islamophobia is regularly denied and which regards group-based claims-making with suspicion. Correspondingly, UOIF leaders tend to distance themselves from contentious means of action, such as legal action or direct protest, and chastise what they consider a victim mentality. Once again, their approach is primarily guided by pious considerations. Practicing the Prophetic model of patience and perseverance (ṣabr) is part of their effort to fashion pious subjectivities. However, this approach remains costly. Constant self-regulation exacts a psychological toll on individuals while the promotion of behavioral exemplariness tends to obscure power structures, teaching worshippers to police their behavior rather than question postcolonial hierarchies.
Social contact refers to the facilitation of connection and interactions between people with and without mental health conditions. It can be achieved, for example, through people sharing their lived experience of mental health conditions, which is an effective strategy for stigma reduction. Meaningful involvement of people with lived experience (PWLE) in leading and co-leading anti-stigma interventions can/may promote autonomy and resilience. Our paper aimed to explore how PWLE have been involved in research and anti-stigma interventions to improve effective means of involving PWLE in stigma reduction activities in LMICs. A qualitative collective case study design was adopted. Case studies from four LMICs (China, Ethiopia, India and Nepal) are summarized, briefly reflecting on the background of the work, alongside anticipated and experienced challenges, strategies to overcome these, and recommendations for future work. We found that the involvement of PWLEs in stigma reduction is commonly a new concept in LMIC. Experienced and anticipated challenges were similar, such as identifying suitable persons to engage in the work and sustaining their involvement. Such an approach can be difficult because PWLE might be apprehensive about the negative consequences of disclosure. In many case studies, we found that long-standing professional connectedness, continued encouragement, information sharing, debriefing and support helped the participants’ involvement. We recommend that confidentiality of the individual, cultural norms and family concerns be prioritized and respected during the implementation. Taking into account socio-cultural contextual factors, it is possible to directly involve PWLEs in social contact-based anti-stigma interventions.
Stigma is significantly impacted by cultural and contextual value systems. People with mental health conditions frequently have to deal with the condition itself and the associated stigma and discrimination. Contextual understanding is essential to design measures and interventions.
Objective
This study aimed to explore the experiences and perceptions of people with mental health conditions, their families and key stakeholders.
Method
A qualitative method used to understand mental health-related stigma and its local contexts. Sixteen participants, including service users, caregivers, service providers and health service administrators, were interviewed.
Result
People with mental health conditions and their caregivers experienced various forms of stigmatization which is linked to attributions about the causality of the illness, overt manifestations of mental health condition leading to easy identification and functional impairments that adversely affect participation. Social contact, lived experiences sharing and training of service providers are relevant intervention strategy to address stigma.
Implication
Stigma and exclusion are prominent in the experiences of people with mental health conditions and their caregivers in this rural Ethiopian setting. Measurement of stigma and the development of interventions should consider how stigma is socially constructed. Anti-stigma interventions need to be implemented alongside expanded local access to mental healthcare.
Reading Lowell’s depictions of madness in poems from The Mills of the Kavanaughs to Day by Day, this chapter follows Lowell’s negotiation of literary conventions to arrive at a notion of diverse mental states that, in life, cannot entirely be controlled. It is argued that he effectively contributes to the reduction of stigmatization by slowly working through conventions of representing madness, such as the gothic, or othering mad persons through race and gender. He arrives at finally owning his mental state as a derangement of his senses, especially his vision, and foregrounds art and humor as coping mechanisms when facing the fragility and suffering of human life.
Stress is a challenge among non-specialist health workers worldwide, particularly in low-resource settings. Understanding and targeting stress is critical for supporting non-specialists and their patients, as stress negatively affects patient care. Further, stigma toward mental health and substance use conditions also impacts patient care. However, there is little information on the intersection of these factors. This sub-analysis aims to explore how substance use and mental health stigma intersect with provider stress and resource constraints to influence the care of people with HIV/TB. We conducted semi-structured interviews (N=30) with patients (n=15) and providers (n=15, non-specialist health workers) within a low-resource community in Cape Town, South Africa. Data were analyzed using thematic analysis. Three key themes were identified: (1) resource constraints negatively affect patient care and contribute to non-specialist stress; (2) in the context of stress, non-specialists are hesitant to work with patients with mental health or substance use concerns, who they view as more demanding and (3) stress contributes to provider stigma, which negatively impacts patient care. Findings highlight the need for multilevel interventions targeting both provider stress and stigma toward people with mental health and substance use concerns, especially within the context of non-specialist-delivered mental health services in low-resource settings.
This chapter examines how precarity affects the experiences of low skilled dirty workers – a group characterised by stigma and devaluation. Utilising Axel Honneth’s ideas of mutual recognition and the normative significance of work for identity, we explore how precarious working conditions affect self-understanding at the intersection of class and gender. Drawing on ethnographic data from street cleaners and refuse workers across four London boroughs, our findings demonstrate lack of secure employment has resulted in experiences of self-doubt and diminished sense of self-worth. Additionally, our findings highlight how secure employment and the ability to provide for one’s family is imperative to these workers, due to the heavy reliance on working class masculinity norms for affirming identity. Thus, we argue the centrality of work for a positive sense of self remains classed and gendered. We also show how the increasingly precarious nature of work is perpetuating feelings of vulnerability and therefore undermining opportunities for class solidarity through collective action in the face of moral injury for working class men.
Parkinson’s disease (PD) is a neurodegenerative movement disorder that impairs emotional expression in older adults. Parkinson's disease decreases a person’s ability to express their emotions in the face, body, and voice. Due to this decrease in emotional expression, people with PD are often perceived with a bias by both medical professionals and lay observers. These misperceptions can lead to people with PD experiencing stigmatization, decreased quality of life, and decreased satisfaction in their social relationships. Following a review of how PD affects the perceptions of people with PD at both the encoder and decoder level, this chapter will present possible compensatory strategies for increasing accuracy in perceptions with health-related expressivity deficits such as increased engagement in valued activities and using deliberate expressions to show emotions in high stakes social situations.
This chapter begins the book’s comparative ethnographic enquiry. While the scholarship has advanced several explanations for the post-authoritarian deactivation of the underprivileged across Latin American cities, little is known about the trajectories by which mobilization survives in some neighborhoods and not in others. This chapter focuses on the case of Nuevo Amanecer to better grasp the mechanisms that led to the demise of collective action in post-dictatorial urban Chile. It describes how party activists belonging to the Alianza Democrática developed a managerial leadership style in many underprivileged neighborhoods when coordinating anti-dictatorial protests in the 1980s. The relationships these moderate political activists fostered with neighborhood dwellers throughout the decade often evolved into networks of political loyalty after the democratic transition. These networks are current and ongoing. To feed their political loyalty networks, community leaders learn to insistently monopolize political capital at the grassroots level. This dynamic has further prevented mobilizational citizenship from developing. It also fragments población spaces, deactivates local initiatives of governance, and depoliticizes the youth.
In Chapter 9, we unfold subthemes within the superordinate theme of relationships. When our participants constructed their narrative identities, they emphasized how mental illness had strained and ruptured relationships, that others did not understand or stigmatized them, and how they withdrew and felt lonely. These subthemes carry toxic identity conclusions, including “I am a burden” and “I am alone” and capture narrative identity processes involved in social alienation and self-stigmatization. Although rarer, storylines of positive impact included empathy with others in difficult circumstances and growth of relationships with adaptive identity conclusions including “I can help others in pain,” which may propel individuals to engage in peer support, one aspect of personal recovery. When our participants narrated well-being into their identities, they expanded on subthemes where other people were depicted as supportive, understanding, and helping. They shared stories about acceptance, feeling valued, togetherness, safety and stability, the possibility of giving to others, and love. These subthemes can give rise to positive identity conclusions, encompassing “I can love, and others can love me” and “I can help and support others,” narrative underpinnings of connectedness and positive identity, which are central to personal recovery.
BPD are often characterized by dependence, affectability, unpredictability, impulsivity and self-destructiveness. Paradoxically, the symptoms associated with BPD are the same behaviors that makes them difficult to accommodate by health professionals. They constitute the most excluded and stigmatized patient group.
Objectives
To gain knowledge on how BPD patients felt acknowledged when they experienced the need for professional help.
Methods
We conducted semi-structured interviews with six BPD-women, aged between 18 to 46, all inpatient at different psychiatric units in the Capital Region of Denmark. The data were analyzed and interpreted through meaning condensation. We entered the philosophical hermeneutic framework of Hans-Georg Gadamer.
Results
We found that the women experienced that; the diagnosis was a filter, in which they were always viewed and judged through as “just another BPD-patient” and not a unique individual. their cry for help was expected to be verbalized in a certain manner and therefore was often not understood nor heard, but instead they experienced to be scolded by health professionels. the emergency plan became a legitimate way for the health care professionals to avoid spending to many resources, rather than a helpful tool. the psychiatry as a unit was largely characterized by stigmatization and a distrustful attitude towards them. Therefore they felt deeply dependent on meeting that one special health professional who were experienced to have a genuine interest and desire to help them.
Conclusions
Findings correspond with the findings of existing research. Hence, there also seems to be significant barriers nationally for patients with BPD to experience being acknowledged and helped, when in need of professional help.
Mental health professionals are one of the major sources of stigma for persons with schizophrenia and their families. The stereotype of incompetence is central in this stigmatization, whereas valuing skills is a fundamental aspect of mental health care and recovery.
Objectives
The aim of this study is to identify the domains of competence stigmatized in schizophrenia by mental health professionals and the factors associated with this stigmatization.
Methods
An online survey was conducted with a specific measure of the stereotype of incompetence and these associated factors. Participants were to be mental health professionals who work or have worked with persons with schizophrenia. These participants were recruited through professional social networks.
Results
Responses of 164 participants were analyzed. The results reported four highly stigmatized skill domains: ability to relate well socially, ability to be effective in their work, ability to make decisions about their health, and ability to control their emotions. Intelligence was found to be less stigmatized than the other dimensions. Recovery beliefs, categorical beliefs, and perceived similarities were factors associated with the stereotype of incompetence.
Conclusions
Responses of 164 participants were analyzed. The results reported four highly stigmatized skill domains: ability to relate well socially, ability to be effective in their work, ability to make decisions about their health, and ability to control their emotions. Intelligence was found to be less stigmatized than the other dimensions. Recovery beliefs, categorical beliefs, and perceived similarities were factors associated with the stereotype of incompetence.
Mental health care is considered to be one of the main sources of mental illness stigmatization. Detailed information about these stigmatization experiences is needed to reduce stigma in mental health practices.
Objectives
The study aimed i) to identify the most relevant stigmatizing situations in mental health care encountered by users and families, ii) to characterize the relative importance of these situations in terms of frequency, experienced stigmatization and suffering, and iii) to identify individual and contextual factors associated with these experiences.
Methods
In a focus group, users were asked to select the 15 most relevant stigmatization situations among those they elicited and those that were taken from the literature. An online survey was then conducted among users and family members to characterize these situations and identify predictors.
Results
A total of 235 participants were included: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses and 80 family members. The results revealed 15 situations with different levels of frequency, stigmatization and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization and with a higher frequency. Moreover, factors such as recovery-oriented practices and measures without consent were the best predictors of experienced stigmatization.
Conclusions
These original stigmatization situations could be targeted to reduce stigmatization and associated suffering in mental health practices. Results strongly suggest that recovery-oriented practice should be fostered to fight stigma in mental health care.
The consequences of schizophrenia stigma are numerous and highly damaging to individuals, their families, the health care system and society. Mental health professionals (MHP) are considered to be one of the main sources of stigmatization.
Objectives
To identify the characteristics of MHP stigma in schizophrenia in comparison with other psychiatric disorders, the specificities of MHP compared with other social groups, and associated factors.
Methods
Following PRISMA guidelines, we systematically searched multiple electronic databases for articles: (i) reporting original data published in English in peer-reviewed journals, (ii) reporting quantitative data with statistical analysis, (iii) assessing stigma in a broad sense, and (iv) including samples composed only of MHP.
Results
A total of 38 articles published from 1999 to 2019 and involving 10926 MHP fulfilled our inclusion criteria. Studies showed that schizophrenia is the most stigmatized mental illnesses in MHP, despite recent results suggesting that borderline personality disorder and substance abuse may be more stigmatized. In comparison with other social groups, MHP reported less dangerousness beliefs and more positive beliefs regarding pharmacological treatment. Nevertheless, results were less consistent regarding prognosis and desire for social distance. Age, education level, type of mental health profession, or length of practice were associated factors that showed inconsistent relations with stigma. Work setting and biological causal beliefs were more clearly associated with MHP stigma.
Conclusions
These findings provide strong support for the need to conduct specific research on schizophrenia stigma in MHP and the importance of controlling for several variables to identify predictors of stigma.
The consequences of schizophrenia stigma are numerous and highly damaging to individuals, their families, the health care system and society. Mental health professionals (MHP) are considered to be one of the main sources of schizophrenia stigmatization.
Objectives
The aim of the study was to identify individual and contextual factors associated with stigmatization in MHP in its three dimensions.
Methods
An online survey was conducted with specific measures of MHP stigmatization (stereotypes, prejudices and discrimination). Four categories of potential associated factors were also measured: sociodemographic information, contextual characteristics (e.g. work setting), individual characteristics (e.g. profession, recovery-oriented practices) and theoretical beliefs (e.g. biological beliefs, perceived similarities, continuum beliefs). Models of prediction were computed when applicable.
Results
Responses of 357 MHP were analysed. The main factors associated with stigmatization (stereotypes, prejudice) in MHP are of two types: i) individual beliefs (about mental illness: biological etiological beliefs, categorical beliefs; or about MHP themselves: professional utility beliefs, similarity beliefs) and ii) characteristics of practices (recovery oriented practice, work setting, profession).
Conclusions
These original results suggest new strategies for reducing stigma in mental health practices such as focusing on individual beliefs and fostering recovery-oriented practice and professional utility beliefs.
Chapter 1 examines the moralization of work and stigmatization of laziness in the works of the late nineteenth- and early twentieth-century Ottoman moralists between the first and the second constitutional period (the 1870s to 1908). At the center of this chapter are Ottoman morality texts, a genre, yet to be fully explored, reconfigured in the nineteenth century. These texts articulated many emerging discourses and anxieties of the Ottoman reform period on a normative level. After an overview of the question of laziness in Ottoman thinking, attention is drawn to how a novel kind of knowledge was produced in the field of morality, expressing a new subjectivity in relation to modern citizenship; the normative nature of morality texts and the way these texts moralized, nationalized, and even Islamized productivity is then studied. Ottoman moralists identified certain beliefs and practices as handicaps for productivity and declared them un-Islamic and antithetical to progress. This chapter rethinks the construction of morality and Islamic knowledge in modern times, by examining deontological discourses on work that later produced the neologism of the “Islamic work ethic.”
The context of stigma, in which many homosexuals live, exposes them to discrimination/stigmatization and promotes the internalization of negative attitudes about sexuality. Battle feelings of rejection and isolation may lead to the development of internalized homophobia (IH).
Objectives
To elucidate the risk factors of IH and how the latter affects mental health.
Methods
Literature review (PubMed).
Results
IH has been associated with lower levels of emotional stability, rejection sensitivity, impairments in emotion regulation and a tendency to turn against the self. Studies have connected IH to depression, poor self/relationship wellbeing, sexual discrimination, addictions, shame, body dissatisfaction, suicidal ideation, binge eating/drinking, partner violence and victimization. Higher levels of attachment anxiety and avoidance, outness, religiosity and internalized stigma were correlated with higher IH levels. The key factors relating to suicide include lack of acceptance by family and/or self, negative feelings about sexuality/gender and appearance dissatisfaction. In traditional/religious societies, heterosexual orientation is a strong norm and homosexuality is considered unacceptable leading LGBT individuals to report higher depressive symptoms and increased levels of IH. Due to heterosexist ideals, IH is a predictor for heterosexual marital intention, protests against LGBT and use of masculinity as a compensatory strategy.
Conclusions
Policies in support of individuals who have recently come out should be improved to reduce the development/effects of IH and take the social and sexual environments of rural gay men into account considering ways to increase service accessibility (e.g internet). Future research is needed to further understand the association between IH and mental health, social and cognitive mechanisms.
Leprosy, cutaneous leishmaniasis (CL) and Chagas disease (CD) are neglected tropical diseases (NTDs) with a high psychosocial burden in Norte de Santander and Arauca in Colombia. This study provides insights into affected persons' feelings, perceptions and experiences to better understand the nature of this burden.
Methods
In 2018, 34 leprosy, CD and CL patients participated in four focus groups discussing the influence of the disease on mental well-being, social participation and stigma. Additionally, 13 leprosy patients participated in semi-structured interviews to further explore the health-related stigma related to this disease. Audio recordings were transcribed verbatim, and open coding was used to identify the most relevant categories and themes.
Results
Persons suffering from CD reported that their mental distress was mainly caused by impairments and stress related to the progressive and incurable nature of the disease. Persons affected by CL perceived the treatment for the disease as having the most impact on their psychosocial well-being. Persons affected by leprosy reported suffering most from anticipated and experienced stigma.
Conclusions
The findings indicate that these diseases are likely to impose a significant psychosocial burden on patients in the studied regions, even though these vary per condition. Consistent data collection on the psychosocial burden and the sharing of knowledge of effective interventions can contribute to the holistic approach needed to win the fight against NTDs.
Civil society organizations and proponents of disarmament feel they are on the right side of history and morality in advocating for the elimination of nuclear weapons. They see growing support on a global scale to ban the testing and use of nuclear weapons or explosive devices under any circumstances. As this movement gains traction, supporters of the TPNW are mobilizing to hasten the pace of nuclear abolition in an absolutist form. They are actively working to change how individuals and states view nuclear weapons with the ultimate goal of universal disarmament through an active campaign of stigmatization and delegitimization.
The TPNW represents an unprecedented departure from current practice in that it is the first multilateral treaty to ban nuclear weapons. It is supported by 122 nations, representing a sizable contingent of the world’s population spanning various geographical divides. Although not celebrated by all nations, and vehemently opposed by nuclear-weapon states, its adoption at the UN General Assembly in July 2017 marks a fundamental departure from the status quo regarding armament matters. The primary purpose of this book was to examine the TPNW within the broader legal, diplomatic and political context in relation to the existing nuclear nonproliferation and disarmament framework in international law, exploring the influence of the Treaty from various perspectives and its potential impact on the nuclear architecture as it stands today.
The Treaty on the Prohibition of Nuclear Weapons 2017 marks an important development in nuclear arms control law, diplomacy and relations between states. Adopted by the UN General Assembly on July 7, 2017, it was supported by 122 nations, representing a potential disruptor to the nuclear status quo. It is the first treaty to ban nuclear weapons outright, taking a clear humanitarian approach to disarmament. Despite its success in coming to fruition, however, it is not celebrated by all nations. The permanent members of the UN Security Council neither participated in its negotiations, nor adopted the final text. No state with nuclear weapons endorses the Treaty and indeed they openly oppose its very existence.