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Stigma in patients with schizophrenia receiving community mental health care: a review of qualitative studies

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Abstract

Purpose

The aim of this review is to identify consistent themes among the qualitative literature on stigma as experienced by patients with schizophrenia receiving community mental health care. With the treatment focus of schizophrenia nowadays shifting more and more towards community-based mental health care, professionals need to be aware of the increased vulnerability of their clients in their social environment as a result of stigma towards their disease. In-depth knowledge on stigma is critical in order to offer a dignifying community mental health care.

Methods

A systematic search of the qualitative literature in Web of Science, PubMed, PsycINFO and Francis was performed to review the subjective experiences and ideas on stigma in outpatients with schizophrenia.

Results

Three major themes were identified in 18 studies and need to be taken into consideration when implementing an adequate community mental health care: (i) the continuing existence of stigma inherent in the health care setting, (ii) the importance of relational aspects of stigma encounters in daily life and (iii) the significance of the behavioural aspects related to previous stigma experiences and beliefs among patients.

Conclusions

Despite much effort in community treatment, patients still experience stigma and discrimination. Community mental health care professionals should not only be aware of structural problems in mental health care, but should also pay considerable attention towards the relational and behavioural aspects in their clients’ life concerning stigma. Furthermore, they have the crucial role in the community to raise awareness about stigma in order to increase their clients’ acceptance in society.

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Acknowledgments

The research for this review was performed in the context of the Erasmus Mundus Master in Bioethics that was attended by A.M. with supporting scholarship of the European Commission. The authors would like to thank the participating universities of the EMMB programme for their valuable support in this research project; KU Leuven in Belgium, RU Nijmegen in The Netherlands and UNIPD Padova in Italy.

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Correspondence to Bart Hansen.

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Mestdagh, A., Hansen, B. Stigma in patients with schizophrenia receiving community mental health care: a review of qualitative studies. Soc Psychiatry Psychiatr Epidemiol 49, 79–87 (2014). https://doi.org/10.1007/s00127-013-0729-4

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  • DOI: https://doi.org/10.1007/s00127-013-0729-4

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