Prevalence of self-stigma and its association with self-esteem among patients in mental hospitals

psychiatric hospital

Stigma of Mental Illness

Stigma against mental disorders cuts across all age, religion, ethnic origin or socio-economic strata. In the same way, self-stigma among psychiatric patients admit in mental hospitals or in other IPD settings is also prevalent worldwide. The consequences of self-stigma are low self-confidence, increased severity of symptoms, low adherence to prescribed medication & treatment, increased suicide rate and an overall decreased quality of life.

Mental disorders are accompanied by reactions from the societies and communities of the suffering persons, that adds a dimension of suffering to the existent condition of the sufferer, which is called “second illness” or “stigma”.

Most studies highlight the existence of two dimensions of stigma namely, public stigma and self-stigma or internalized stigma. Public stigma is comprised of the negative attitudes held by members of the public about devalued people. On the other hand, self-stigma occurs when people internalize those public attitudes and suffer numerous negative consequences as a result.

Negative attitudes of people in general (hospital staffs, other people in society) towards them, during the process of admission into a mental hospital, may be an underlying cause for them to internalize such negative attitudes leading to self-stigma.

According to a study, prevalence of self- stigma among psychiatric patients is high: ranging from 22.5 to 97.4% in different countries: it is 36% in USA, 97.4% in Ethiopia, 22.5% in Nigeria, 49.5% in China and 50–66% in India.

In addition to this, self-stigma among psychiatric patients is associated with poor quality of life, low treatment adherence, decreased esteem, increased severity of symptoms, low self-efficacy and poor recovery. In extreme circumstances, self-stigma is associated with a higher rate of suicidality.

Self-stigma is strongly linked with low self-esteem that is directly related to the prognosis and impediment of the disease condition. On the other hand, positive self-esteem is basic characteristic of mental health that protects the people’s mental health from the impact of negative influences of mental illness. Furthermore, it promotes and facilitates effective coping with stressful situations, thus acting as a protective factor in mental health. This imperative element of mental health is vulnerable to self-stigma among psychiatric patients.

Implementation of awareness programs could help in reduction of self-stigma.

Furthermore, self-stigma and self-esteem have a strong negative relationship, which implies that as self-stigma increases, self-esteem decreases.

So in order to protect the self-esteem of psychiatric patients residing in mental hospitals or other such IPD settings, self-stigma must be reduced.

Different interventions and therapies being practiced at mental hospitals, which are focused on reduction and elimination of self-stigma like healthy self-concept, self-stigma reduction program, ending self-stigma, and cognitive therapy might help in reducing self-stigma. Self-esteem enhancement programs can also decrease self-stigma. A reduction in public stigma is also suggested here.

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