Contemporary research posits that significant barriers exist in the delivery of mental health care as compared to physical healthcare According to Schomerus et al. (2012, 443), more than 70 percent of the individuals who have been diagnosed by some form of mental illness are not accorded mental health treatment. This occurrence may be attributed to discrimination and stigma which presents a multifaceted problem where access to care may be impeded at the institution, individual or community level. Epidemiological studies and descriptive surveys suggest that the factors that augment the possibilities of delay in care, treatment avoidance and discontinuation of service include prejudice against people with mental illness; lack of knowledge on the components and treatability of mental illness and general ignorance of resources associated with treatment interventions. According to a study by Corrigan et al. (2012, 970), the ideal approach for diminishing anticipated stigma among service users is through addressing the problem publicly as a means of championing for access to mental health care. Studies indicate that individual service users who were drawn from nations with higher rates of help-seeking behaviors and participation in treatment interventions demonstrated lower prevalence rates of perceived discrimination. Nonetheless, stigmatizing attitudes are known to persist in public and has been associated with averseness to seek help. The efficacy of psychological treatment interventions has also been called to question since services at the start of the treatment has created an influence on subsequent treatment behavior. This occurrence is significant in the sense that people only seek access to mental health services after the exacerbation of clinical symptoms impairment and stigma and these effects might be difficult to reverse.
According to Hansson et al. (2013, 50), the influence of stigma and discrimination on access to care may differ based on demographic factors and experiences of mental distress. Individuals who have diagnosed with psychotic disorders are highly susceptible to stigma while individuals with psychosis are often perceived as being unpredictable with tendencies of violence as compared to other people with mental illness. Accordingly, this phenomenon may culminate in augmented levels of anticipated discrimination in healthcare settings. Martensson, Jacobsson and Engstrom et al. (2014, 783) concurs that substance use is often associated with high rates of institutional and public stigma which may discourage such individuals from seeking health care due to fear of getting into contact with the authorities or poor treatment from healthcare providers. Specific subpopulations also experience unique challenges in attempts to access care. This may be attributed to the fact different ethnic groups have been subjected to different experiences and histories with healthcare systems thus some barriers are likely to be more prevalent amongst persons from different ethnic groups. This may be epitomized in studies where the negative experience of coercion in mental health care is more evident amongst ethnic minorities. It has been suggested that future research should pay more attention to the possible associations between subgroups and help-seeking attitudes towards mental illness.
Stigma is widely perceived as an intricate and multifaceted problem since solutions that would ultimately influence access to care positively is likely to be diverse. This characteristic has prompted the United Kingdom to develop a multidisciplinary national program dubbed "Time to Change" with the primary objective being reducing discrimination and stigma in England, Scotland and Wales (Henderson, Evans-Lacko & Thornicroft, 2013, 780). The model anti-stigma programs are comprised of multiple components that are directed towards specific target groups and the general public. Additionally, these programs are operated at multiple levels and the involvement of small community groups which are funded locally to conduct anti-stigma sensitization awareness. The Time to Change campaign was inaugurated in 2007 and studies conducted on its efficacy have revealed that mental health knowledge is essential in predicting the intentions to seek help for mental health challenges including the ease to disclose information to a patient's next of kin thus sensitizing on the need for mental health literacy.
Aims of the research project
The objective of this research project is to investigate:
1. The prevalence of stigma and discrimination among individuals with mental illness
2. The variation between stigma and discrimination of individuals with mental illness in sub populations comprising of ethnic minorities.
3. The influence of stigma and discrimination in a preventing access to mental health care.
4. The efficacy of anti-stigma national programs in creating public awareness and reducing negative perceptions towards individuals who have been diagnosed with some form of mental illness.
1. What is the prevalence rate of stigma and discrimination against the mentally ill?
2. Are there any variances of discrimination and stigma against ethnic minority groups?
3. How do stigma and discrimination prevent access to mental health care?
4. What is the effectiveness of anti-stigma national programs in creating awareness and reducing instances of stigma and discrimination?
A self-completion questionnaire was developed and sent out through emails to randomly selected students and staff members affiliated with the Faculty of Human Services.
Justification for Method
A self-completion questionnaire is deemed to be ideal especially for the sensitive topic that touches on mental health. The widespread assumption is that the provision of anonymity presents and advantage for both the respondents and researcher. Participants are more likely to give reliable responses since a self-completion questionnaire does not necessarily reveal the identifying information. Additionally, the researcher may not influence the respondents' responses using his voice or facial expressions as is the case with interviewer-based questionnaires thus limiting the possibilities of research bias. Self-completion surveys are also deemed to be cost-effective as compared to interviewer-based questionnaires as it is essential in diminishing wastage of resources such as time and finances.
A total of 11 questions were formulated of which 7 were closed questions which are answerable by yes/no while the remaining for questions were open questions. Closed questions are beneficial in comparing responses to the same question over a large sample of participants. While the research questions were designed for the purpose of obtaining information on attitudes to compare attitudes between those who had or still suffer from mental illness with those who had no such experience; they did not give comprehensive reasons for the advent of such attitudes. Hence, the remaining four questions are aimed at providing a platform where the participants explicate the reasons for their beliefs and attitudes which provides richer data. Demographic data such as the age and gender of the respondents was also collected.
Ethical Issues and Integrity
Research Integrity may be defined as the devotion and subscription to the professional standards and ethical principles that define the process of research. The researcher will seek permission from all relevant bodies before embarking on data collection. These include; the chairman of the faculty for Human Services and the Academic Registrar. The study objectives will be discussed with each respondent for understanding before consenting. The researcher will endeavor to ensure accuracy of each data in order to achieve the required outputs. The participant will be educated and will be handled with at most care to ensure that they have informed consent and they know their rights during and after the study. Subject protection programs require ongoing performance evaluation thorough the utilization of feedback and monitoring mechanisms. Moreover, the information embedded within the questionnaires will be sourced from randomly selected participants who will not be required to provide personal identifier information. Hence, the data collected would be confidential and free of any bias.
Validity and Reliability
The self-completion questionnaire is designed to be completed without the interference of the researcher and is unedited by the research providers. The validity and reliability of the responses of the participants to the questionnaire were tested statistically and nearly 95 percent of the respondents were able to offer accurate responses. Additionally, the participants averaged 15 minutes to complete the questionnaire. The test-retest reliability by the participants' responses to the questionnaire was 93 percent.
A sample of 30 respondents comprising of randomly selected students and staff members from the Faculty of Human Services responded to the questionnaire. Of these, 13 (43.3%) were aged 18-25; 8 (26.7%) participants were aged between 26-35 years; 6 were aged between 36-45 years (20%) and 3 (10%) participants were aged 46 and over. 55 percent were students while the staff members accounted for 45 percent of all selected participants. An analysis of staff members indicated that 30 percent worked in administration, 25 percent worked in student services while 35 percent were members of the teaching staff.
Findings and Analysis of Data
Most of the participants (75%) claimed that they had made contact with individuals who have been subjected to instances of discrimination by virtue of being diagnosed with some form of mental illness. Moreover, 95 percent agreed that discrimination and stigma was a national issue that needed to be addressed as prejudice against people with mental illness only serves to infringe on their rights. Nonetheless, attitudes towards mental illness demonstrated mixed reactions with respect to whether the participants would be willing to work together with individuals with mental illness. A smaller percentage of the respondents, most of who were aged 46 and over, claimed that they would be willing to work with persons experiencing mental challenges. Perhaps the logical explanation for this occurrence is the unpredictable nature or the fear of the unknown when dealing with individuals with some form of mental illness. Moreover, most of the participants (70%) implied that they would shun away from employing individuals with mental illness while most respondents would be seemingly unwilling to discuss the provisions for accommodating individuals in the workplace setting who may be suffering from mental illness. On the other hand, most of the participants (60 %) appeared to empathetic and claimed that they would still be friends with people who have been diagnosed with some form of mental illness. Additionally, such individuals would be willing to live to individuals with mental difficulties as their neighbors.
Fig.1: Bar graph illustrating the perceived prevalence rates if stigma against individuals with mental illness.
Recent research indicates that the mental health of workers is an essential determinant of the overall hea...
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