From the Guidelines
Associative stigma in psychiatry is a significant concern that affects not only individuals with mental illness but also those connected to them, including family members, caregivers, and mental health professionals, leading to negative attitudes, prejudice, and discrimination. This phenomenon is characterized by the transfer of stigma from the person with mental illness to those associated with them through a process of "courtesy stigma" or "stigma by association" 1. The consequences of associative stigma can be severe, including social rejection, stereotyping, and diminished opportunities, which can lead to significant psychological distress, such as feelings of shame, isolation, and burnout.
Some key points to consider about associative stigma in psychiatry include:
- It affects not only family members and caregivers but also mental health professionals, who may experience diminished career satisfaction and personal well-being due to negative attitudes towards patients with behavioral health needs 1.
- The stigma associated with mental illness can exacerbate feelings of hopelessness, loneliness, and distress among patients and their families, leading to discrimination in housing, education, and employment 1.
- Mental health professionals, including psychiatrists and primary care providers, may hold pessimistic views about treatment outcomes and be less likely to provide evidence-based care to patients with schizophrenia due to unsupported perceptions about patient adherence to treatment 1.
- Public education efforts, fighting mental health discrimination, recovery-focused interventions, and messaging are among the recommended solutions to combat the stigma associated with behavioral health 1.
Overall, addressing associative stigma in psychiatry requires a comprehensive approach that recognizes the impact on the entire support network of those with mental illness, not just the diagnosed individuals themselves. By acknowledging and addressing associative stigma, we can work towards reducing the negative consequences of mental illness and promoting a more supportive and inclusive environment for all individuals affected.
From the Research
Definition of Associative Stigma
Associative stigma refers to the prejudice and discrimination experienced by individuals through their associations with relatives who have mental illness [(2,3,4,5,6)]. This type of stigma can have a negative impact on family members and relatives of individuals with mental illness.
Forms of Associative Stigma
The forms of associative stigma experienced by family members include:
- Social exclusion [(2,4,6)]
- Being blamed 2
- Not being taken seriously 2
- Time-consuming caregiving activities 2
- Exhaustion 2
- Guilt 6
- Shame 6
- Hiding the illness of their family member from others 6
- Making efforts to explain the situation or psychiatric condition of their family member 6
Factors Contributing to Associative Stigma
Factors that contribute to higher associative stigma include:
- Worsened relationship between the patient and the family member 6
- Conduct problems to family members 6
- The patient's residence in a residential care setting 6
- Hereditary attributional factors like genetic hereditability and character 6
- Disruptive behavior by the patient towards in-housing family members 6
- Knowing more people with mental illness 5
- Having more core (friends and family members) versus peripheral ties 5
- Having ties who are most at risk of facing public stigma themselves 5
Prevalence of Associative Stigma
The prevalence of associative stigma in family members of psychotic patients is high, with one study finding a prevalence of 86% 6.