Stigma and discrimination

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ لَا يَسۡخَرۡ قَوۡمࣱ مِّن قَوۡمٍ عَسَىٰٓ أَن يَكُونُواْ خَيۡرࣰ ا مِّنۡهُمۡ وَلَا نِسَآءࣱ مِّن نِّسَآءٍ عَسَىٰٓ أَن يَكُنَّ خَيۡرࣰ ا مِّنۡهُنَّۖ وَلَا تَلۡمِزُوٓاْ أَنفُسَكُمۡ وَلَا تَنَابَزُواْ بِٱلۡأَلۡقَٰبِۖ بِئۡسَ ٱلِٱسۡمُ ٱلۡفُسُوقُ بَعۡدَ ٱلۡإِيمَٰنِۚ وَمَن لَّمۡ يَتُبۡ فَأُوْلَٰٓئِكَ هُمُ ٱلظَّٰلِمُونَ

Believers, no one group of men should jeer at another, who may after all be better than them; no one group of women should jeer at another, who may after all be better than them; do not speak ill of one another; do not use offensive nicknames for one another. How bad it is to be called a mischief-maker after accepting faith! Those who do not repent of this behaviour are evildoers

إِنَّا كَفَيۡنَٰكَ ٱلۡمُسۡتَهۡزِءِينَ

We are enough for you against all those who ridicule your message

وَلَقَدِ ٱسۡتُهۡزِئَ بِرُسُلࣲ مِّن قَبۡلِكَ فَحَاقَ بِٱلَّذِينَ سَخِرُواْ مِنۡهُم مَّا كَانُواْ بِهِۦ يَسۡتَهۡزِءُونَ

Messengers before you [Muhammad] were also ridiculed, but those who mocked them were overwhelmed in the end by the very thing they had mocked

وَقَدۡ نَزَّلَ عَلَيۡكُمۡ فِي ٱلۡكِتَٰبِ أَنۡ إِذَا سَمِعۡتُمۡ ءَايَٰتِ ٱللَّهِ يُكۡفَرُ بِهَا وَيُسۡتَهۡزَأُ بِهَا فَلَا تَقۡعُدُواْ مَعَهُمۡ حَتَّىٰ يَخُوضُواْ فِي حَدِيثٍ غَيۡرِهِۦٓ إِنَّكُمۡ إِذࣰ ا مِّثۡلُهُمۡۗ إِنَّ ٱللَّهَ جَامِعُ ٱلۡمُنَٰفِقِينَ وَٱلۡكَٰفِرِينَ فِي جَهَنَّمَ جَمِيعًا

As He has already revealed to you [believers] in the Scripture, if you hear people denying and ridiculing God’s revelation, do not sit with them unless they start to talk of other things, or else you yourselves will become like them: God will gather all the hypocrites and disbelievers together into Hell

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ لَا تَتَّخِذُواْ ٱلَّذِينَ ٱتَّخَذُواْ دِينَكُمۡ هُزُوࣰ ا وَلَعِبࣰ ا مِّنَ ٱلَّذِينَ أُوتُواْ ٱلۡكِتَٰبَ مِن قَبۡلِكُمۡ وَٱلۡكُفَّارَ أَوۡلِيَآءَۚ وَٱتَّقُواْ ٱللَّهَ إِن كُنتُم مُّؤۡمِنِينَ

You who believe, do not take as allies those who ridicule your religion and make fun of it- whether people who were given the Scripture before you, or disbelievers- and be mindful of God if you are true believers

وَإِذَا نَادَيۡتُمۡ إِلَى ٱلصَّلَوٰةِ ٱتَّخَذُوهَا هُزُوࣰ ا وَلَعِبࣰ اۚ ذَٰلِكَ بِأَنَّهُمۡ قَوۡمࣱ لَّا يَعۡقِلُونَ

When you make the call to prayer, they ridicule it and make fun of it: this is because they are people who do not reason

(O ye who believe! Let not a folk deride a folk who may be better than they (are)�) [49:11]. This was revealed about Thabit ibn Qays ibn Shimas. The latter was hard of hearing and when he came to see the Messenger of Allah, Allah bless him and give him peace, the Companions made room for him in order for him to sit next to the Prophet so that he could hear him. He came one day when people were already seated and started stepping over people, saying: �Make room! Make room!� One man said to him: �You have found a place, so sit down!� Thabit sat down but he was angry. He tried to tease the man. He said: �Who are you?� The man said: �So-and-so�. Thabit exclaimed: �What, the son of so-and-so�, and he mentioned his mother about whom they used to taunt him in the pre-Islamic period. The man lowered his head out of embarrassment. Then, Allah, exalted is He, revealed this verse. (� not let women

O you who believe do not let any people that is any men among you deride yā ayyuhā’lladhīna āmanū lā yaskhar … to the end of the verse was revealed regarding the Banū Tamīm delegation when they derided the poor among the Muslims like ‘Ammār b. Yāsir and Suhayb al-Rūmī; al-sukhriya means ‘scorn’ and ‘disdain’ another people who may be better than they are in God’s sight; nor let any women from among you deride other women who may be better than they are. And do not defame one another do not cast aspersions on others and hence have aspersions cast on you that is let none among you denigrate another; nor insult one another by nicknames do not call another by a nickname which he detests such as ‘O degenerate one!’ or ‘O disbeliever!’. Evil is the name mentioned out of mockery derision and mutual reviling of immorality after faith! al-fusūqu ba‘da’l-īmāni substitutes for al-ismu ‘the name’ to

(O Ye who believe! Choose not for guardians such of those who received the Scripture before you, and of the disbelievers, as make a jest and sport of your religion) [5:57]. Said Ibn �Abbas: �Rifa�ah ibn Zayd and Suwayd ibn al-Harith were among those who displayed their faith in Islam but were hypocrites. Some Muslim men used to show affection to them, and so Allah, exalted is He, revealed this verse�.

(And when ye call to prayer they take it for a jest and sport�) [5:58]. Said al-Kalbi: �When the caller to prayer, appointed by the Messenger of Allah, Allah bless him and give him peace, called to prayer, the Muslims stood up to perform it. Seeing this, the Jews used to comment: 'they stood up, may they never stand up! They prayed, may they never pray! They bowed down, may they never bow down!' They used to say this to mock the Muslims and make fun of them. And so Allah, exalted is He, revealed this verse�. Said al-Suddi: �This was revealed about a man from the helpers of Medina. Whenever he heard the caller to prayer say, 'I bear witness that Muhammad is the Messenger of Allah', he would say: 'May the liar be burnt!' One night, the servant of this man entered his house and brought some fire with him, while this man and his family were sleeping. A spark from this fire caused the whole h

It has been revealed read active nazzala ‘He has revealed’ or passive nuzzila ‘It has been revealed’ to you in the Book in the Qur’ān in sūrat al-An‘ām Q. 668 that an has been softened and its subject omitted in other words read it as annahu ‘When you hear God’s signs the Qur’ān being disbelieved in and mocked do not sit with them that is the disbelievers and the mockers until they engage in some other talk for otherwise you if you were to sit with them would surely be like them’ in sinfulness. God will gather the hypocrites and disbelievers all together into Hell just as they were gathered together in this world in unbelief and mockery.

Verily, those who believe, then disbelieve, then believe (again), and (again) disbelieve, and go on increasing in disbelief; Allah will not forgive them, nor guide them on the (right) way (137)Give to the hypocrites the tidings that there is for them a painful torment (138)Those who take disbelievers for friends instead of believers, do they seek honor with them? Verily, then to Allah belongs all honor (139)And it has already been revealed to you in the Book that when you hear the verses of Allah being denied and mocked at, then sit not with them, until they engage in talk other than that; certainly in that case you would be like them. Surely, Allah will collect the hypocrites and disbelievers all together in Hell (140) Characteristics of the Hypocrites and Their Destination Allah states that whoever embraces the faith, reverts from it, embraces it again, reverts from it and remains on

حَدَّثَنَا إِسْحَاقُ بْنُ إِبْرَاهِيمَ، أَخْبَرَنَا مُعَاذُ بْنُ هِشَامٍ، حَدَّثَنِي أَبِي، عَنْ قَتَادَةَ، عَنْ أَبِي الْمُتَوَكِّلِ النَّاجِيِّ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ ـ رضى الله عنه ـ عَنْ رَسُولِ اللَّهِ صلى الله عليه وسلم قَالَ ‏ "‏ إِذَا خَلَصَ الْمُؤْمِنُونَ مِنَ النَّارِ حُبِسُوا بِقَنْطَرَةٍ بَيْنَ الْجَنَّةِ وَالنَّارِ، فَيَتَقَاصُّونَ مَظَالِمَ كَانَتْ بَيْنَهُمْ فِي الدُّنْيَا، حَتَّى إِذَا نُقُّوا وَهُذِّبُوا أُذِنَ لَهُمْ بِدُخُولِ الْجَنَّةِ، فَوَالَّذِي نَفْسُ مُحَمَّدٍ صلى الله عليه وسلم بِيَدِهِ لأَحَدُهُمْ بِمَسْكَنِهِ فِي الْجَنَّةِ أَدَلُّ بِمَنْزِلِهِ كَانَ فِي الدُّنْيَا ‏"‏‏.‏ وَقَالَ يُونُسُ بْنُ مُحَمَّدٍ حَدَّثَنَا شَيْبَانُ عَنْ قَتَادَةَ حَدَّثَنَا أَبُو الْمُتَوَكِّلِ‏.‏

Narrated Abu Sa`id Al-Khudri:Allah's Messenger (ﷺ) said, "When the believers pass safely over (the bridge across) Hell, they will be stopped at a bridge in between Hell and Paradise where they will retaliate upon each other for the injustices done among them in the world, and when they get purified of all their sins, they will be admitted into Paradise. By Him in Whose Hands the life of Muhammad is everybody will recognize his dwelling in Paradise better than he recognizes his dwelling in this world

حَدَّثَنَا مُوسَى بْنُ إِسْمَاعِيلَ، حَدَّثَنَا هَمَّامٌ، قَالَ أَخْبَرَنِي قَتَادَةُ، عَنْ صَفْوَانَ بْنِ مُحْرِزٍ الْمَازِنِيِّ، قَالَ بَيْنَمَا أَنَا أَمْشِي، مَعَ ابْنِ عُمَرَ ـ رضى الله عنهما ـ آخِذٌ بِيَدِهِ إِذْ عَرَضَ رَجُلٌ، فَقَالَ كَيْفَ سَمِعْتَ رَسُولَ اللَّهِ صلى الله عليه وسلم فِي النَّجْوَى فَقَالَ سَمِعْتُ رَسُولَ اللَّهِ صلى الله عليه وسلم يَقُولُ ‏ "‏ إِنَّ اللَّهَ يُدْنِي الْمُؤْمِنَ فَيَضَعُ عَلَيْهِ كَنَفَهُ، وَيَسْتُرُهُ فَيَقُولُ أَتَعْرِفُ ذَنْبَ كَذَا أَتَعْرِفُ ذَنْبَ كَذَا فَيَقُولُ نَعَمْ أَىْ رَبِّ‏.‏ حَتَّى إِذَا قَرَّرَهُ بِذُنُوبِهِ وَرَأَى فِي نَفْسِهِ أَنَّهُ هَلَكَ قَالَ سَتَرْتُهَا عَلَيْكَ فِي الدُّنْيَا، وَأَنَا أَغْفِرُهَا لَكَ الْيَوْمَ‏.‏ فَيُعْطَى كِتَابَ حَسَنَاتِهِ، وَأَمَّا الْكَافِرُ وَالْمُنَافِقُونَ فَيَقُولُ الأَشْهَادُ هَؤُلاَءِ الَّذِينَ كَذَبُوا عَلَى رَبِّهِمْ، أَلاَ لَعْنَةُ اللَّهِ عَلَى الظَّالِمِينَ ‏"‏‏.‏

Narrated Safwan bin Muhriz Al-Mazini:While I was walking with Ibn `Umar holding his hand, a man came in front of us and asked, "What have you heard from Allah's Messenger (ﷺ) about An-Najwa?" Ibn `Umar said, "I heard Allah's Messenger (ﷺ) saying, 'Allah will bring a believer near Him and shelter him with His Screen and ask him: Did you commit such-and-such sins? He will say: Yes, my Lord. Allah will keep on asking him till he will confess all his sins and will think that he is ruined. Allah will say: 'I did screen your sins in the world and I forgive them for you today', and then he will be given the book of his good deeds. Regarding infidels and hypocrites (their evil acts will be exposed publicly) and the witnesses will say: These are the people who lied against their Lord. Behold! The Curse of Allah is upon the wrongdoers

حَدَّثَنَا قُتَيْبَةُ، حَدَّثَنَا مُحَمَّدُ بْنُ مُوسَى الْمَخْزُومِيُّ الْمَدَنِيُّ، عَنْ سَعِيدِ بْنِ أَبِي سَعِيدٍ الْمَقْبُرِيِّ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ لِلْمُؤْمِنِ عَلَى الْمُؤْمِنِ سِتُّ خِصَالٍ يَعُودُهُ إِذَا مَرِضَ وَيَشْهَدُهُ إِذَا مَاتَ وَيُجِيبُهُ إِذَا دَعَاهُ وَيُسَلِّمُ عَلَيْهِ إِذَا لَقِيَهُ وَيُشَمِّتُهُ إِذَا عَطَسَ وَيَنْصَحُ لَهُ إِذَا غَابَ أَوْ شَهِدَ ‏"‏ ‏.‏ قَالَ هَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏ وَمُحَمَّدُ بْنُ مُوسَى الْمَخْزُومِيُّ الْمَدَنِيُّ ثِقَةٌ رَوَى عَنْهُ عَبْدُ الْعَزِيزِ بْنُ مُحَمَّدٍ وَابْنُ أَبِي فُدَيْكٍ ‏.‏

Narrated Abu Hurairah:that the Messenger of Allah (ﷺ) said: "There are six things due from the believer to another believer: Visiting him when he is ill, attending (his funeral) to him when he dies, accepting his invitation when he invites, giving him Salam when he meets him, replying to him when he sneezes, and wishing him well when he is absent and when he is present

حَدَّثَنَا حُمَيْدُ بْنُ مَسْعَدَةَ، حَدَّثَنَا زِيَادُ بْنُ الرَّبِيعِ، حَدَّثَنَا حَضْرَمِيٌّ، مَوْلَى آلِ الْجَارُودِ عَنْ نَافِعٍ، أَنَّ رَجُلاً، عَطَسَ إِلَى جَنْبِ ابْنِ عُمَرَ فَقَالَ الْحَمْدُ لِلَّهِ وَالسَّلاَمُ عَلَى رَسُولِ اللَّهِ ‏.‏ قَالَ ابْنُ عُمَرَ وَأَنَا أَقُولُ الْحَمْدُ لِلَّهِ وَالسَّلاَمُ عَلَى رَسُولِ اللَّهِ وَلَيْسَ هَكَذَا عَلَّمَنَا رَسُولُ اللَّهِ صلى الله عليه وسلم عَلَّمَنَا أَنْ نَقُولَ الْحَمْدُ لِلَّهِ عَلَى كُلِّ حَالٍ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ غَرِيبٌ لاَ نَعْرِفُهُ إِلاَّ مِنْ حَدِيثِ زِيَادِ بْنِ الرَّبِيعِ ‏.‏

Narrated Hadrami, the freed slave of the family of Al-Jarud:from Nafi: "A man sneezed beside Ibn 'Umar and said: 'Al-Hamdulillah Was-Salamu 'Ala Rasulillah. (All praise is due to Allah, and peace upon the Messenger of Allah)'. So Ibn 'Umar said: 'I too say Al-Hamdulillah Was-Salamu 'Ala Rasulillah, but this is not what the Messenger of Allah (ﷺ) taught us. He taught us to say: "Al-Hamdulillah 'Ala Kulli Hal (All praise is due to Allah in every circumstance)

^ يا أيها الذين آمنوا لا يسخر قوم من قوم عسى أن يكونوا خيرا منهم ولا نساء من نسآء عسى أن يكن خيرا منهن ولا تلمزوا أنفسكم ولا تنابزوا بالألقاب بئس الاسم الفسوق بعد الإيمان ومن لم يتب فأولئك هم الظالمون ^ الحجرات وقال تعالى ^ ويل لكل همزة لمزة ^ الهمزة

وهذا محرم مهما كان مؤذيا كما قال تعالى يا أيها الذين آمنوا لا يسخر قوم من قوم عسى أن يكونوا خيرا منهم ولا نساء من نساء عسى أن يكن خيرا منهن ومعنى السخرية الاستهانة والتحقير والتنبيه على العيوب والنقائص على وجه يضحك منه وقد يكون ذلك بالمحاكاة في الفعل والقول وقد يكون بالإشارة والإيماء وإذا كان بحضرة المستهزأ به لم يسم ذلك غيبة وفيه معنى الغيبة قالت عائشة رضي الله عنها حاكيت إنسانا فقال لي النبي صلى الله عليه وسلم والله ما أحب أني حاكيت إنسانا ولي كذا وكذا + حديث عائشة حكيت إنسانا فقال لي النبي صلى الله عليه وسلم ما يسرني أني حاكيت إنسانا ولي كذا وكذا أخرجه أبو داود والترمذي وصححه + وقال ابن عباس في قوله تعالى يا ويلتنا ما لهذا الكتاب لا يغادر صغيرة ولا كبيرة إلا أحصاها إن الصغيرة التبسم بالاستهزاء بالمؤمن والكبيرة القهقهة بذلك وهذا إشارة إلى أن الضحك على الناس من جملة الذنوب والكبائر وعن عبد الله بن زمعة أنه قال سمعت رسول الله صلى الله عليه وسلم وهو يخطب فوعظهم في ضحكهم من الضرطة فقال علا

الثامن السخرية والاستهزاء استحقارا له فإن ذلك قد يجري في الحضور ويجري أيضا في الغيبة ومنشؤه التكبر واستصغار المستهزأ به

الآفة السادسة: السخرية والاستهزاء، ومعنى السخرية: الاحتقار والاستهانة، والتنبيه على العيوب والنقائص على وجه يضحك منه، وقد يكون ذلك بالمحاكاة في الفعل والقول، وقد يكون بالشارة والإيماء، وكله ممنوع منه في الشرع، ورد النهى عنه في الكتاب والسنة.

وأما سوء الظن فهو امتلاء قلبه بالظنون السيئة بالناس حتى يطفح على لسانه وجوارحه فهم معه أبدا في الهمز واللمز والطعن والعيب والبغض ببغضهم ويبغضونه ويلعنهم ويلعنونه ويحذرهم ويحذرون منه فالأول يخالطهم ويحترز منهم والثاني يتجنبهم ويلحقه أذاهم الأول داخل فيهم بالنصيحة والإحسان مع الاحتراز والثاني خارج منهم مع الغش والدغل والبغض

وهذا إنما يحرم في حق من يتأذى به فأما من جعل نفسه مسخرة وربما فرح من أن يسخر به كانت السخرية في حقه من جملة المزاح وقد سبق ما يذم منه وما يمدح وإنما المحرم استصغار يتأذى به المستهزأ به لما فيه من التحقير والتهاون وذلك تارة بأن يضحك على كلامه إذا تخبط فيه ولم ينتظم أو على أفعاله إذا كنت مشوشة كالضحك على خطه وعلى صنعته أو على صورته وخلقته إذا كان قصيرا أو ناقصا لعيب من العيوب فالضحك من جميع ذلك داخل في السخرية المنهى عنها الآفة الثانية عشر إفشاء السر

Mass media interventions for reducing mental health-related stigma.: Background: Mental health-related stigma is widespread and has major adverse effects on the lives of people with mental health problems. Its two major components are discrimination (being treated unfairly) and prejudice (stigmatising attitudes). Anti-stigma initiatives often include mass media interventions, and such interventions can be expensive. It is important to know if mass media interventions are effective. Objectives: To assess the effects of mass media interventions on reducing stigma (

Challenging the public stigma of mental illness: a meta-analysis of outcome studies.: Objective: Public stigma and discrimination have pernicious effects on the lives of people with serious mental illnesses. Given a plethora of research on changing the stigma of mental illness, this article reports on a meta-analysis that examined the effects of antistigma approaches that included protest or social activism, education of the public, and contact with persons with mental illness. Methods: The investigators heeded published guidelines for systematic literature reviews in health care

The different faces of mental illness stigma: Systematic variation of stereotypes, prejudice and discrimination by type of illness.: Mental illness (MI) stigma has been characterized as multi-dimensional including problems of knowledge (stereotypes), attitudes (prejudice) and behavior (discrimination); however, most research practice is predominantly applying unidimensional behavioral measures such as social distance scales. Moreover, specific types of MIs and different forms of discriminatory behaviors are not being differentiated. The Stereotype Content Model predicts that group stereotypes (warmth, competence) are linked w

Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review.: Background: Most research on interventions to counter stigma and discrimination has focused on short-term outcomes and has been conducted in high-income settings. Aims: To synthesise what is known globally about effective interventions to reduce mental illness-based stigma and discrimination, in relation first to effectiveness in the medium and long term (minimum 4 weeks), and second to interventions in low- and middle-income countries (LMICs). Method: We searched six databases from 1980 to 2013

Women's and girls' experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis.: Background: Attention to women's and girls' menstrual needs is critical for global health and gender equality. The importance of this neglected experience has been elucidated by a growing body of qualitative research, which we systematically reviewed and synthesised. Methods and findings: We undertook systematic searching to identify qualitative studies of women's and girls' experiences of menstruation in low- and middle-income countries (LMICs). Of 6,892 citations screened, 76 studies reported

Continuum beliefs and mental illness stigma: a systematic review and meta-analysis of correlation and intervention studies.: Background: Promulgating a continuum model of mental health and mental illness has been proposed as a way to reduce stigma by decreasing notions of differentness. This systematic review and meta-analysis examines whether continuum beliefs are associated with lower stigma, and whether continuum interventions reduce stigma. Methods: Following a pre-defined protocol (PROSPERO: CRD42019123606), we searched three electronic databases (PubMed, Web of Science, and PsycINFO) yielding 6726 studies. After

The social and economic impacts of epilepsy on women in Nigeria.

Background: Persons with epilepsy in sub-Saharan Africa experience stigma and social marginalization. There is paucity of data on the social and economic impacts of epilepsy in these patients and in particular, groups like women. We sought to determine the social and economic impacts of epilepsy on Nigerian women and especially how it affects their treatment and outcomes. Methods: We carried out a cross-sectional survey of 63 women with epilepsy (WWE) and 69 controls matched for age, social status and site of care. A structured questionnaire was used to document information on demographic characteristics, education, employment status, economic status, health care use, personal safety and perceived stigma. The data were collated and analyzed with SPSS version 15. Results: Unemployment, fewer years of formal education, lower marriage rates and higher stigma scores were more frequent among …

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Internalized stigma among patients with schizophrenia in Ethiopia: a cross-sectional facility-based study.

Background: Despite the potential impact on treatment adherence and recovery, there is a dearth of data on the extent and correlates of internalized stigma in patients with schizophrenia in low income countries. We conducted a study to determine the extent, domains and correlates of internalized stigma amongst outpatients with schizophrenia in Ethiopia. Methods: The study was a cross-sectional facility-based survey conducted at a specialist psychiatric hospital in Addis Ababa, Ethiopia. Consecutive consenting individuals with a diagnosis of schizophrenia were recruited and assessed using an Amharic version of the Internalized Stigma of Mental Illness (ISMI) scale. Results: Data were collected from 212 individuals, who were mostly single (71.2%), unemployed (70.3%) and male (65.1%). Nearly all participants (97.4%) expressed agreement to at least one stigma item contained in the ISMI; 46.7…

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Stigma resistance in patients with schizophrenia.

Background: An individual's capacity to counteract the stigma of mental illness, stigma resistance (SR), is considered as playing a crucial role in fighting stigma. However, little is known about SR and its correlates in patients with schizophrenia or schizoaffective disorder. Aim: Exploring SR in patients with schizophrenia or schizoaffective disorder. Method: One hundred fifty-seven participants completed the "Internalized Stigma of Mental Illness" (ISMI) Scale including its subscale on SR. Measures of perceived devaluation and discrimination, depression, self-esteem, empowerment, quality of life, and demographic and clinical variables were obtained. Results: Two-thirds of all patients showed high SR. SR correlated positively with self-esteem, empowerment, and quality of life and negatively with stigma measures and depression. A social network with a sufficient number of friends, being…

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Mental Health Burden Among Impoverished HIV-Positive Patients in Peru.

HIV and poor mental health are intricately related. In settings of poverty, both are often rooted in structural factors related to material and social deprivation. We performed a qualitative analysis to understand factors contributing to poor emotional health and its impact among impoverished Peruvian HIV-infected individuals. We conducted focus group discussions with patients and providers consisting of semistructured, open-ended questions. Qualitative analysis provided insight into the profound impact of depression, isolation, stigma, and lack of social support among these patients. Living with HIV contributed significantly to mental health problems experienced by HIV-positive individuals; furthermore, long-standing stressors-such as economic hardship, fragmented family relationships, and substance use-shaped patients' outlooks, and may have contributed not only to current emotional ha…

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Recognition of mental disorders and beliefs about treatment and outcome: findings from an Australian national survey of mental health literacy and stigma.

Objective: The aim of the study was to carry out a national survey in order to assess recognition and beliefs about treatment for affective disorders, anxiety disorders and schizophrenia/psychosis. Method: In 2011, telephone interviews were carried out with 6019 Australians aged 15 or over. Participants were presented with a case vignette describing either depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder (PTSD). Questions were asked about what was wrong with the person, the likely helpfulness of a broad range of interventions and the likely outcomes for the person with and without appropriate treatment. Results: Rates of recognition of depression were relatively high, with almost 75% of respondents using the correct label. Rates of recognition for the schizophrenia vignettes and PTSD were similar, w…

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Suicide from the perspectives of older men who experience depression: a gender analysis.

Depression can be a pathway to older men's suicide, yet the mechanisms by which this can occur are poorly understood. A qualitative study of 22 older men who self-identified or were formally diagnosed with depression was conducted to describe the connections between masculinity, depression, and suicide. Analyses of individual interviews revealed that cumulative losses around social bonds were central to older men's depression, apathy for living, and thoughts about suicide. Prominent were men's self-assessments of failing to fulfill breadwinner roles, judgments that led participants to ruminate on their shortcomings amid recognizing their older age as limiting opportunities for redemption. Stigma featured as a barrier for men acting on their suicidal thoughts, and guilt about the pain their suicide would evoke on family and friends was a strong deterrent for men's self-harm. Overall, part…

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Stigma and treatment for alcohol disorders in the United States.

Among a nationally representative sample of adults with an alcohol use disorder, the authors tested whether perceived stigmatization of alcoholism was associated with a lower likelihood of receiving alcohol-related services. Data were drawn from a face-to-face epidemiologic survey of 34,653 adults interviewed in 2004-2005 who were aged 20 years or older and residing in households and group quarters in the United States. Alcohol abuse/dependence was diagnosed by using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, version (AUDADIS-IV). The stigma measure used was the Perceived Devaluation-Discrimination Scale. The main outcome was lifetime intervention including professional services and 12-step groups for alcohol disorders. Individuals with a lifetime diagnosis of an alcohol use disorder were …

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Loneliness and HIV-related stigma explain depression among older HIV-positive adults.

Advances in the treatment of HIV have resulted in a large growing population of older adults with HIV. These aging adults face added social, psychological, and physical challenges associated with the aging process. Correlations between depression, loneliness, health, and HIV/AIDS-related stigma have been studied, but there is little evaluation of these associations among HIV-positive adults over the age of 50. Data for these analyses were taken from the Research on Older Adults with HIV study of 914 New York City-based HIV-positive men and women over the age of 50. In total, 39.1% of participants exhibited symptoms of major depression (CES-D > 23). Multivariate modeling successfully explained 42% of the variance in depression which was significantly related to increased HIV-associated stigma, increased loneliness, decreased cognitive functioning, reduced levels of energy, and being young…

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The public's stigmatizing attitudes towards people with mental disorders: how important are biomedical conceptualizations?

Objective: This study examined hypotheses that stigmatizing attitudes are increased by use of psychiatric labels, by conceptualization of symptoms as a medical illness and by belief in genetic causes. Method: A survey of 3998 Australian adults asked questions about one of four vignettes: early schizophrenia, chronic schizophrenia, depression and depression with suicidal thoughts. Attitudes were measured by a social distance scale and a question about likely dangerousness. Results: Social distance was unrelated to the hypothesized factors. For schizophrenia (but not depression), belief in dangerousness was predicted by medical illness conceptualizations and genetic causal attribution. However, more important factors were the behaviours in the vignette and the belief that they are because of weakness of character. Conclusion: Biomedical conceptualizations are not the major cause of stigma,…

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Different faces of discrimination: perceived discrimination among homeless adults with mental illness in healthcare settings.

Background: Research on discrimination in healthcare settings has primarily focused on health implications of race-based discrimination among ethno-racial minority groups. Little is known about discrimination experiences of other marginalized populations, particularly groups facing multiple disadvantages who may be subjected to other/multiple forms of discrimination. Objectives: (1) To examine the prevalence of perceived discrimination due to homelessness/poverty, mental illness/alcohol/drug related problems, and race/ethnicity/skin color while seeking healthcare in the past year among racially diverse homeless adults with mental illness; (2) To identify whether perceiving certain types of discrimination is associated with increased likelihood of perceiving other kinds of discrimination; and (3) To examine association of these perceived discrimination experiences with socio-demographic c…

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Employment barriers for persons with psychiatric disabilities: update of a report for the President's Commission.

A major public policy problem is the extremely low labor force participation of people with severe mental illness coupled with their overrepresentation on the public disability rolls. This situation is especially troubling given the existence of evidence-based practices designed to return them to the labor force. This article reviews research from the fields of disability, economics, health care, and labor studies to describe the nature of barriers to paid work and economic security for people with disabling mental disorders. These barriers include low educational attainment, unfavorable labor market dynamics, low productivity, lack of appropriate vocational and clinical services, labor force discrimination, failure of protective legislation, work disincentives caused by state and federal policies, poverty-level income, linkage of health care access to disability beneficiary status, and …

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Perceptions of barriers and benefits to physical activity among outpatients in psychiatric rehabilitation.

Purpose: To explore perceived barriers and benefits to physical activity in people with serious and persistent mental illness (SPMI) who were enrolled in community-based psychiatric rehabilitation. Design and methods: Four focus groups, two for men and two for women, were held with a total of 34 outpatients from two program sites. The investigators used a semistructured interview guide to facilitate the discussions. Audiotapes of the discussions were transcribed and analyzed for concepts and themes. Findings: Significant barriers to physical activity were: mental illness symptoms, medications, weight gain from medications, fear of discrimination, and safety concerns. Being in a psychiatric rehabilitation program offered comfort and belonging, but it also had the effect of leaving activity initiation up to the program staff, which some participants perceived was part of required program c…

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Structural distress: experiences of moral distress related to structural stigma during the COVID-19 pandemic.

Introduction: The COVID-19 pandemic has taken a significant toll on the health of structurally vulnerable patient populations as well as healthcare workers. The concepts of structural stigma and moral distress are important and interrelated, yet rarely explored or researched in medical education. Structural stigma refers to how discrimination towards certain groups is enacted through policy and practice. Moral distress describes the tension and conflict that health workers experience when they are unable to fulfil their duties due to circumstances outside of their control. In this study, the authors explored how resident physicians perceive moral distress in relation to structural stigma. An improved understanding of such experiences may provide insights into how to prepare future physicians to improve health equity. Methods: Utilizing constructivist grounded theory methodology, 22 parti…

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'It's my inner strength': spirituality, religion and HIV in the lives of young African American men who have sex with men.

Young black men who have sex with men account for 48% of 13-29-year-old HIV-positive men who have sex with men in the USA. It is important to develop an effective HIV prevention approach that is grounded in the context of young men's lives. Towards this goal, we conducted 31 interviews with 18-30-year-old men who have sex with men in the San Francisco-Oakland Bay Area. This paper examines the roles of religion and spirituality in men who have sex with men's lives, which is central in the lives of many African Americans. Six prominent themes emerged: (1) childhood participation in formal religious institutions, (2) the continued importance of spirituality among men who have sex with men, (3) homophobia and stigmatisation in traditional black churches, (4) tension between being a man who has sex with men and being a Christian, (5) religion and spirituality's impact on men's sense of person…

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Public health implications of same-sex marriage.

Significantly compromised health care delivery and adverse health outcomes are well documented for the lesbian, gay, bisexual, and transgender (LGBT) community in the United States compared with the population at large. LGBT individuals subject to societal prejudice in a heterosexist world also suffer from the phenomenon known as "minority stress," with its attendant negative mental and physical health effects. Reports in the medical and social science literature suggest that legal and social recognition of same-sex marriage has had positive effects on the health status of this at-risk community. Improved outcomes are to be expected because of the improved access to health care conferred by marriage benefits under federal or state law and as a result of attenuating the effects of institutionalized stigma on a sexual minority group.

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Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: the GAMIAN-Europe study.

Background: There is little information on the degree to which self-stigma is experienced by individuals with a diagnosis of bipolar disorder or depression across Europe. This study describes the levels of self-stigma, stigma resistance, empowerment and perceived discrimination reported in these groups. Methods: Data were collected from 1182 people with bipolar disorder or depression using a mail survey with members of national mental health non-governmental organisations. Results: Over one fifth of the participants (21.7%) reported moderate or high levels of self-stigma, 59.7% moderate or high stigma resistance, 63% moderate or high empowerment, and 71.6% moderate or high perceived discrimination. In a reduced multivariate model 27% of the variance in self-stigma scores, among people with a diagnosis of bipolar disorder or depression, was accounted for by levels of empowerment, perceive…

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Mental health disparities research: the impact of within and between group analyses on tests of social stress hypotheses.

Social stress models are the predominant theoretical frame for studies of the relationship between social statuses and mental health (Dressler, Oths, & Gravlee, 2005; Horwitz, 1999). These models propose that prejudice, discrimination and related social ills exert an added burden on socially disadvantaged populations (populations subjected to stigma, prejudice and discrimination) that can generate mental health problems. Researchers have used a variety of methodological approaches to study this hypothesis. In this paper we argue that researchers have not paid sufficient attention to the implications of this methodological variability, particularly the distinction between studies of within-group and studies of between-groups variation, in interpreting empirical tests of social stress theory. To fully evaluate the evidence, we need to carefully consider the convergence and divergence of re…

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Barriers to treatment and culturally endorsed coping strategies among depressed African-American older adults.

Objective: Older adults are particularly vulnerable to the effects of depression, however, they are less likely to seek and engage in mental health treatment. African-American older adults are even less likely than their White counterparts to seek and engage in mental health treatment. This qualitative study examined the experience of being depressed among African-American elders and their perceptions of barriers confronted when contemplating seeking mental health services. In addition, we examined how coping strategies are utilized by African-American elders who choose not to seek professional mental health services. Method: A total of 37 interviews were conducted with African-American elders endorsing at least mild symptoms of depression. Interviews were audiotaped and subsequently transcribed. Content analysis was utilized to analyze the qualitative data. Results: Thematic analysis of…

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Depression, stigma, and suicidal ideation in medical students.

Context: There is a concerning prevalence of depression and suicidal ideation among medical students, a group that may experience poor mental health care due to stigmatization. Objective: To characterize the perceptions of depressed and nondepressed medical students regarding stigma associated with depression. Design, setting, and participants: Cross-sectional Web-based survey conducted in September-November 2009 among all students enrolled at the University of Michigan Medical School (N = 769). Main outcome measures: Prevalence of self-reported moderate to severe depression and suicidal ideation and the association of stigma perceptions with clinical and demographic variables. Results: Survey response rate was 65.7% (505 of 769). Prevalence of moderate to severe depression was 14.3% (95% confidence interval [CI], 11.3%-17.3%). Women were more likely than men to have moderate to severe d…

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"We fear the police, and the police fear us": structural and individual barriers and facilitators to HIV medication adherence among injection drug users in Kiev, Ukraine.

Ukraine has one of the most severe HIV/AIDS epidemics in Europe, with an estimated 1.63% of the population living with HIV/AIDS in 2007. Injection drug use (IDU) remains the predominant mode of transmission in Kiev - the capital and largest city. Prior reports suggest that the HIV infection rate among IDUs in Kiev reaches 33%, and many have poor and inequitable access to highly active antiretroviral therapy (HAART). Among those with access to HAART, little is understood about barriers and facilitators to HAART medication adherence. In May 2009, two semi-structured focus groups were conducted with HIV-infected IDUs seeking treatment at the City AIDS Center, Kiev. The goal was to use this information to adapt and tailor, to Ukrainian culture, an evidence-based intervention for improving adherence to HAART. All 16 participants attributed HIV infection to IDU. Their average age was 31.6 (SD=…

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Female circumcision: toward an inclusive practice of care.

Female circumcision is a cultural tradition that includes cutting of female genitals without medical necessity. Over 130 million girls and women have been circumcised globally. This article reports on partial findings from a qualitative study that examined the lives of Somali Muslim women who were circumcised. A reoccurring theme of resentment toward North American health care practitioners who condemn the women for having experienced the practice of circumcision in their birth country was found. Discussion will include the physical and social stigma, the complex legal aspects, and ways to deal with female circumcision in a culturally competent manner.

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"Why doesn't she seek help for partner abuse?" An exploratory study with South Asian immigrant women.

This study explores why South Asian immigrant women with experiences of partner abuse delay seeking help from professionals. Three focus groups were conducted in Hindi language with South Asian immigrant women in Toronto. Twenty-two women participated with a mean age of 46 years (range 29-68 years). Thematic analysis was conducted on the transcribed data using constant comparison techniques within and across the groups. We found that three major themes emerged from the discussions: reasons for delayed help-seeking, turning points and talking to professionals. Women expressed delaying help-seeking to the point when "Pani sar se guzar jata he" (water crosses over your head). Their dominant reasons for delayed help-seeking were social stigma, rigid gender roles, marriage obligations, expected silence, loss of social support after migration and limited knowledge about available resources and…

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Public knowledge and assessment of child mental health problems: findings from the National Stigma Study-Children.

Objective: Child and adolescent psychiatry confronts help-seeking delays and low treatment use and adherence. Although lack of knowledge has been cited as an underlying reason, we aim to provide data on public recognition of, and beliefs about, problems and sources of help. Method: The National Stigma Study-Children is the first nationally representative study of public response to child mental health problems. A face-to-face survey of 1,393 adults (response rate 70.1%, margin of error +/-3.5%) used vignettes consistent with diagnoses of attention-deficit/hyperactivity disorder (ADHD) and depression. Descriptive and multivariate analyses provide estimates of the levels and correlates of recognition, labeling, and treatment recommendations. Results: Respondents do differentiate "daily troubles" from mental health problems. For the cases that meet diagnostic criteria, 58.5% correctly ident…

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Rethinking theoretical approaches to stigma: a Framework Integrating Normative Influences on Stigma (FINIS).

A resurgence of research and policy efforts on stigma both facilitates and forces a reconsideration of the levels and types of factors that shape reactions to persons with conditions that engender prejudice and discrimination. Focusing on the case of mental illness but drawing from theories and studies of stigma across the social sciences, we propose a framework that brings together theoretical insights from micro, meso and macro level research: Framework Integrating Normative Influences on Stigma (FINIS) starts with Goffman's notion that understanding stigma requires a language of social relationships, but acknowledges that individuals do not come to social interaction devoid of affect and motivation. Further, all social interactions take place in a context in which organizations, media and larger cultures structure normative expectations which create the possibility of marking "differe…

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Church ladies, good girls, and locas: stigma and the intersection of gender, ethnicity, mental illness, and sexuality in relation to HIV risk.

Inner city women with severe mental illness may carry multiple stigmatized statuses. In some contexts these include having a mental illness, being a member of an ethnic minority group, being an immigrant, being poor, and being a woman who does not live up to gendered expectations. These potentially stigmatizing identities influence both the way women's sexuality is viewed and their risk for HIV infection. This qualitative study applies the concept of intersectionality to facilitate understanding of how these multiple identities intersect to influence women's sexuality and HIV risk. We report the firsthand accounts of 24 Latina women living with severe mental illness in New York City. In examining the interlocking domains of these women's sexual lives, we find that the women seek identities that define them in opposition to the stigmatizing label of "loca" (Spanish for crazy) and bestow r…

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