What explains these differences in quality of care and life expectancy? Among the elements explaining these disparities, we find stigma and discrimination, present in society in general and in nursing care, which will be the subject of this article.
We will explain the concepts related to stigma and discrimination in mental health and then identify factors that may contribute to it. We will propose actions that nurses can take to combat stigma and improve the quality of care.
Learning Objectives
After reading this article, you will be able to:
- To explain concepts related to stigma and discrimination in mental health.
- To recognize factors in nursing practice and care settings that contribute to stigmatization and discrimination of people living or having lived with a mental health disorder.
- To name nursing actions to combat stigma and discrimination in mental health and improve the quality of care.
The International Council of Nurses (ICN) (2008), the Order of Nurses of Quebec (OIIQ) (2009, 2016) and the Canadian Nurses Association (CNA) (2012) all state that the reduction of stigma is one of the nursing responsibilities. Let us emphasize that stigma and discrimination will not be treated as the result of bad intentions or incompetence, but rather as the undesirable results of supposedly useful actions.
Concepts related to stigma and discrimination in mental health
Most nurses have a positive attitude towards people living with mental disorders. They want to help them and say they are empathetic to their situation (Ihalainen-Tamlander et al., 2016). However, it is noted on a global scale that many health professionals adhere to negative stereotypes, adopt attitudes that can be harmful and behave inappropriately towards people with mental disorders (Dell et al., 2021; Deng et al. , 2022). Since these people also receive treatment for various health conditions, in establishments other than those dedicated exclusively to mental health care, this subject concerns all nurses (Raj, 2022).
Thus, it is estimated that 13.7% of nurses, 28.3% of general practitioners and 26.1% of psychiatrists adopt negative attitudes towards people living with mental disorders (Mental Health Council of Australia, 2011). According to studies, the proportion of those who have ever felt stigmatized in a health network varies greatly, ranging from 32% (Kirby and Keon, 2006) to 90% (Corker et al., 2013). Among the stereotypes mentioned by nurses, note those according to which people living with mental disorders are incapable of making decisions about their own lives (Svediene et al., 2009), that they are not responsible enough to make care of themselves (Ahmead et al., 2010) and that it is necessary to use coercive approaches to administer treatment (Ihalainen-Tamlander et al., 2016).
