Thursday, January 22, 2009

People with schizophrenia say discrimination is a constant in their lives

From U.S. News & World Report:

People with schizophrenia often expect to be discriminated against, and are, in various aspects of their life, new research finds.

The study, which included 732 people with schizophrenia in the United States and 26 other countries, found that 47 percent reported discrimination in making or keeping friends, 43 percent from family members, and 27 percent in intimate or sexual relationships. Also, 29 percent of the participants said they experienced discrimination while trying to find or keep a job.

What the study referred to as positive discrimination was reported by less than 5 percent of the participants.

The researchers also found that 64 percent of the participants didn't bother applying for work, training or education because they expected to fail or to face discrimination, and 55 percent anticipated discrimination when seeking a close relationship. However, more than a third of participants who expected these types of discrimination did not actually experience it.

Most participants, 72 percent, also told the researchers that they felt they needed to conceal their diagnosis of schizophrenia.

The findings appear online and in an upcoming print issue of The Lancet.

"This study opens a new arena of research characterizing the nature and extent of discrimination against people with mental illness," study author Graham Thornicroft, a professor at the Institute of Psychiatry, King's College London, and his colleagues wrote in a news release issued by the journal. "Rates of both anticipated and experienced discrimination are consistently high across countries among people with mental illness. Measures such as disability discrimination laws might, therefore, not be effective without interventions to improve self-esteem of people with mental illness."

"Even allowing for the possible effect of anticipated discrimination influencing patients' views of their experiences, negative experienced discrimination in many domains of life might be related to prior coercive mental-health service intervention," the authors continued. "If confirmed by further studies, this finding might guide mental-health services to promote social inclusion and to rely less upon compulsory treatment in the future."

The study points to the kind of research required to improve understanding of stigma and discrimination, according to an accompanying editorial by Beate Schulze of the Research Unit for Clinical and Social Psychiatry at the Center for Disaster and Military Psychiatry in Zurich, Switzerland.

"By investigating actual discrimination and self-stigma, the study brings together the structural and cognitive perspectives that have not previously been combined," she wrote. "However, what remains to be done is to determine the effect of discrimination on health and social outcomes and translate these findings into effective public-health strategies."