Schulze Beate
Department of General and Social Psychiatry, University of Zurich, Zurich, Switzerland.
Int Rev Psychiatry. 2007 Apr;19(2):137-55. doi: 10.1080/09540260701278929.
In the past decade, mental health professionals have initiated a number of national and international efforts against the stigma of mental illness. While largely successful in beating stigma and discrimination, these programmes have, in part, been criticized to be largely uninformed by the lived realities of people with mental illness and their families. Some critics claimed that anti-stigma efforts led by mental health professionals were in fact a concealed attempt at de-stigmatizing psychiatry itself as a profession. This paper will attempt to throw light on the various ways in which mental health professionals are 'entangled' in anti-stigma activities. It will outline the complex relationships between stigma and the psychiatric profession, presenting evidence on how its members can simultaneously be stigmatizers, stigma recipients and powerful agents of de-stigmatization. In exploring the role of mental health professionals as targets of stigma, new findings will be presented on the role of stigma as a professional stressor in psychiatry. Conclusions will be drawn on how the pursuit of professional self-interest can be a legitimate goal of anti-stigma programmes. Further, ways in which acknowledging psychiatry's own agenda can contribute to both credibility and success of fighting stigma from within psychiatry will be discussed.
在过去十年里,心理健康专业人员发起了多项国内和国际行动,以消除对精神疾病的污名化。尽管这些项目在很大程度上成功地战胜了污名和歧视,但部分项目受到批评,认为它们很大程度上未基于精神疾病患者及其家人的实际生活情况。一些批评者声称,由心理健康专业人员主导的反污名化努力实际上是将精神病学本身作为一个职业去污名化的隐蔽尝试。本文将试图阐明心理健康专业人员在反污名化活动中“卷入”的各种方式。它将概述污名与精神病学专业之间的复杂关系,展示其成员如何同时成为污名施加者、污名承受者和有力的去污名化推动者的证据。在探讨心理健康专业人员作为污名目标的角色时,将呈现关于污名作为精神病学专业压力源的作用的新发现。将得出关于追求专业自身利益如何能够成为反污名化项目合理目标的结论。此外,还将讨论承认精神病学自身议程如何能够促进精神病学内部反污名化斗争的可信度和成功。