The stigma associated with psychiatric illness and mental health care may inhibit people from seeking treatment, which may prevent an improvement in their condition and even lead to a deterioration. Stigma has a destructive effect on the lives of people with psychiatric illnesses and on their rehabilitation and integration into society.
This is one in a series of studies conducted jointly with the Mental Health Services at the Ministry of Health to suggest directions for interventions to reduce stigma with regard to objectives, intervention methods, and target sub-populations. The study described in this report, examines the cognitive, emotional, and behavioral facets of stigma against “mental illness,” people with psychiatric problems, and mental health care. The study is based on a sample representative of Israel’s entire adult population (N=1,583) and special samples of the ultra-Orthodox Jewish sector and Arab localities (2,100 interviews in all). Concurrently, a study on people attending public mental health clinics and a preliminary study of parents of people with psychiatric illnesses were also conducted. Selected findings of the current study:
The public is open, in principle, to seeking psychiatric treatment, but half of the respondents believe the negative attitude of people around them to be justification for not doing so. About a third do not know whether there is a mental health clinic in their area.
If psychiatric hospitalization is required, people would prefer to be admitted to a psychiatric ward in a general hospital rather than a psychiatric hospital. In contrast, when it comes to ambulatory treatment, there is a slight preference for clinics dedicated solely to mental health care.
The public perceives the “mentally ill” to be characterized by abnormal or unexpected behavior and violence. The perception of violence is reflected in fear of the “mentally ill” and of people with schizophrenia. In contrast, people with depression are perceived more as “guilty” of their condition and more anger was expressed against them.
An examination of the public’s willingness to have contact with people with psychiatric illnesses revealed that 52% of the respondents would not hire a person with a psychiatric illness, 35% were not willing to work with one, and 31% were not prepared to have one as a neighbor. These findings are probably an underestimate of the barriers facing persons trying to rehabilitate themselves and integrate into society.
The report discusses objectives and possible methods of intervention: reduce the stigma associated with psychiatric hospitalization; decrease the perception that people with psychiatric illnesses are violent and reduce the fear of them; reduce the blame for their condition and the anger directed at them; inform the public about the existence of medications for schizophrenia and about the chemical basis of depression and the treatments available. The report discusses differential interventions for different target populations, including the ultra-Orthodox and Arabs. It also discusses the importance of presenting a multi-dimensional picture stressing that people with psychiatric illnesses have normative aspects, without ignoring the “ill” aspects; the positive and negative implications of providing information about the illness and the etiology; and issues relating to increasing exposure to, and contact with, people with psychiatric illnesses. With regard to seeking mental health treatment, the study discusses informing the public about mental health clinics and their location, reducing the stigma of seeking treatment, and interventions with family doctors.
The findings of the study have been submitted to the heads of the Mental Health Services at the Ministry of Health and to the National Council for the Rehabilitation of the Mentally Disabled in the Community and presented before the Council plenum. The study was funded with the help of by the National Institute for Health Services and Health Policy Research.
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