Erfarenheter av stigmatisering och diskriminering bland personer med psykisk sjukdom

Sammanfattning: The overall aim of this thesis is to 1) investigate the prevalence of stigmatizing experiences and beliefs of devaluation and discrimination among persons with mental illness, and 2) to investigate the relationship between beliefs of devalua¬tion/¬discrimination, rejection experiences and sociodemographic/clinical patient characteristics, social networks, self esteem, empowerment and subjective quality of life. The thesis comprises four papers. Part one of the study was designed as a cross-sectional study using a convenience sample of 200 consumers in current contact with mental health services or with earlier experiences of this. In order to reach subjects with different experiences of mental illness recruitment were made at inpatient and outpatient settings, rehabilitation units and among members of user organizations. This part of the study is presented in paper I-III. In the second part of the study 25 mental health user's who participated in the cross-sectional study were interviewed with regard to experiences of rejection related to their mental illness (Paper IV). Paper I investigates prevalence of rejection experiences and beliefs of devaluation and discrimination and the relationship to sociodemographic and clinical patient charac¬teristics. Except for a few areas, more than half of the participants believed that psychiatric patients might face severe devaluation and discrimination. Almost half of the participants reported that they avoided people, because they felt that they look down on people with mental illness. Paper II examines beliefs of devaluation/¬discrimination, actual rejection experiences, empowerment, social network and the relationship of these factors to subjective quality of life among 150 individuals with mental illness. Paper III compares subgroups with low and high levels of rejection experiences with regard to self-esteem, sense of coherence and empowerment. In summary this thesis shows moderate associations between more frequent rejection experiences and a lower degree of global functioning, a greater number of admissions to inpatient psychiatric care and with current contact with social services (Paper I). In Paper II the factors most prominently related to subjective quality of life were overall empowerment and overall social network. For a subgroup of subjects suffering from psychotic disorders there was a significant negative relationship between subjective quality of life and rejection experiences. Subjects suffering from psychotic disorders also reported more frequent rejection experiences than subjects with affective disorders or other disorders. The main finding in Paper III was that more rejection experiences were associated with lower level of sense of coherence and to a lesser extent, with lower level of empowerment and self-esteem. Paper IV showed that experiences of devaluation and discrimination can be found in many areas, and seemed to result in more constricted social networks, unemployment and reductions of life opportunities.