Psych · Professional — stigma, recovery and rights-based care
Stigma, recovery and rights-based care
Also known as Mental health stigma · Self-stigma and public stigma · Structural stigma · Personal recovery CHIME · Recovery-oriented practice · Rights-based mental health care · CRPD and psychiatry · Shared decision-making psychiatry · Supported decision-making · Anti-stigma interventions
Exam-exhaustive fellowship topic on mental health stigma (public, self, structural, courtesy), recovery models including CHIME, rights-based care and CRPD principles, shared decision-making, peer support, and anti-stigma strategy evidence. Legal frameworks stated as principles only; jurisdiction-specific statutes not invented. FRANZCP-primary, globally tagged.
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Red flags
- Using recovery language to justify under-treatment or premature discharge without partnership
- Claiming CRPD universally abolishes all involuntary treatment as settled single law
- Biogenetic 'illness like any other' messaging that increases social distance while reducing blame
- Pejorative documentation ('manipulative', 'attention-seeking') that follows the person permanently
- Token peer roles without pay equity, power, or clinical integration
- Confusing accurate risk communication with stigmatising stereotypes of violence
Meet the patient
A 24-year-old apprentice lives with his first episode of psychosis. He waited ten months to see anyone, because he was ashamed and his family hid the diagnosis. He refuses a long-acting injectable because, he says, he does not want to "look like a mental patient" at work — and he wants, more than anything, to get back to his trade.[5][7]
Every layer of that paragraph is stigma doing clinical work: the delayed help-seeking, the family concealment, the self-stigma driving a treatment refusal, and the recovery goal that the service has not yet asked about. This topic is the map of those forces, and the practice that moves a patient from "schizophrenia patient" back to apprentice.[1][9][11]
References16ShowHide
- [1]Corrigan PW, Watson AC Understanding the impact of stigma on people with mental illness World Psychiatry, 2002.PMID 16946807
- [2]Rüsch N, Angermeyer MC, Corrigan PW Mental illness stigma: concepts, consequences, and initiatives to reduce stigma Eur Psychiatry, 2005.PMID 16171984
- [3]Hatzenbuehler ML, Phelan JC, Link BG Stigma as a fundamental cause of population health inequalities Am J Public Health, 2013.PMID 23488505
- [4]Pescosolido BA, Martin JK, Long JS, et al. "A disease like any other"? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence Am J Psychiatry, 2010.PMID 20843872
- [5]Clement S, Schauman O, Graham T, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies Psychol Med, 2015.PMID 24569086
- [6]Thornicroft G, Mehta N, Clement S, et al. Evidence for effective interventions to reduce mental-health-related stigma and discrimination Lancet, 2016.PMID 26410341
- [7]Thornicroft G, Brohan E, Rose D, et al. Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey Lancet, 2009.PMID 19162314
- [8]Corrigan PW, Rao D On the self-stigma of mental illness: stages, disclosure, and strategies for change Can J Psychiatry, 2012.PMID 22854028
- [9]Leamy M, Bird V, Le Boutillier C, et al. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis Br J Psychiatry, 2011.PMID 22130746
- [10]Le Boutillier C, Leamy M, Bird VJ, et al. What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance Psychiatr Serv, 2011.PMID 22193795
- [11]Slade M, Amering M, Farkas M, et al. Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems World Psychiatry, 2014.PMID 24497237
- [12]Davidson L, Bellamy C, Guy K, et al. Peer support among persons with severe mental illnesses: a review of evidence and experience World Psychiatry, 2012.PMID 22654945
- [13]Elwyn G, Frosch D, Thomson R, et al. Shared decision making: a model for clinical practice J Gen Intern Med, 2012.PMID 22618581
- [14]Deegan PE, Drake RE Shared decision making and medication management in the recovery process Psychiatr Serv, 2006.PMID 17085613
- [15]Szmukler G, Daw R, Callard F Mental health law and the UN Convention on the rights of Persons with Disabilities Int J Law Psychiatry, 2014.PMID 24280316
- [16]Freeman MC, Kolappa K, de Almeida JM, et al. Reversing hard won victories in the name of human rights: a critique of the General Comment on Article 12 of the UN Convention on the Rights of Persons with Disabilities Lancet Psychiatry, 2015.PMID 26236004