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Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong

Citation

Lee, S and Chiu, MY and Tsang, A and Chui, K and Kleinman, A, Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong, Social science & medicine, 62, (7) pp. 1685-1696. ISSN 0037-7856 (2006) [Refereed Article]

Copyright Statement

Copyright 2005 Elsevier Ltd.

DOI: doi:10.1016/j.socscimed.2005.08.016

Abstract

This research examines the experience of stigma associated with psychiatric treatment among Chinese patients with schizophrenia in Hong Kong. In focus groups patients described stigma experiences related to clinic visits and the side effects of antipsychotic medications. Additionally, they revealed various adverse treatment experiences during hospitalization which point to the presence of structural discrimination. Based on the focus group findings, a questionnaire was developed and completed by 320 and 160 patients with schizophrenia and diabetes mellitus, respectively. Results showed that patients with schizophrenia were more likely to anticipate stigma, conceal illness, and default on clinic visits than patients with diabetes. Medication-induced stigma occurred in 48% of patients with schizophrenia. It brought about the unwelcome disclosure of illness, workplace difficulties, family rejection, and treatment non-adherence. Adverse experiences during hospitalization were reported by 44% of patients with schizophrenia. They included negative staff attitudes, excessive physical/chemical restraints, inadequate information/complaint systems, and limited rights. We conclude that stigma, at both individual and structural levels, represents a central experience of the treatment of schizophrenia in Hong Kong. Because inequitable health policy, resource allocation, and service organization privilege service providers' control over users, treatment-related stigma may be a prime example of the social production of stigma and discrimination based on power difference between the stigmatizers and the stigmatized. To examine this critically we need to redirect stigma research to tractable clinical circumstances and structural mechanisms that produce and maintain stigmatizing and discriminatory psychiatric practice. Destigmatization programs must be evaluated not only by change in public attitudes but also by how much they reduce structural stigma and improve patients' lives.

Item Details

Item Type:Refereed Article
Keywords:Schizophrenia
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Mental health services
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Mental health
UTAS Author:Chui, K (Dr Helena Chui)
ID Code:131295
Year Published:2006
Web of Science® Times Cited:88
Deposited By:Psychology
Deposited On:2019-03-12
Last Modified:2019-07-31
Downloads:0

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