Queen's University, Kingston, Ontario.
Can J Psychiatry. 2012 Aug;57(8):457-63. doi: 10.1177/070674371205700803.
Our paper provides an overview of current stigma discourse, the origins and nature of the stigma associated with mental illnesses, stigmatization by health providers, and approaches to stigma reduction. This is a narrative review focusing on seminal works from the social and psychological literature, with selected qualitative and quantitative studies and international policy documents to highlight key points. Stigma discourse has increasingly moved toward a human rights model that views stigma as a form of social oppression resulting from a complex sociopolitical process that exploits and entrenches the power imbalance between people who stigmatize and those who are stigmatized. People who have a mental illness have identified mental health and health providers as key contributors to the stigmatization process and worthy targets of antistigma interventions. Six approaches to stigma reduction are described: education, protest, contact-based education, legislative reform, advocacy, and stigma self-management. Stigma denigrates the value of people who have a mental illness and the social and professional support systems designed to support them. It creates inequities in funding and service delivery that undermine recovery and full social participation. Mental health professionals have often been identified as part of the problem, but they can redress this situation by becoming important partners in antistigma work.
我们的论文概述了当前的污名化论述、与精神疾病相关的污名的起源和本质、卫生保健提供者的污名化以及减少污名的方法。这是一篇叙事性综述，重点关注社会和心理学文献中的开创性作品，并选择了一些定性和定量研究以及国际政策文件来突出要点。污名化论述越来越倾向于一种人权模式，将污名视为一种社会压迫形式，源于一种复杂的社会政治过程，该过程利用和加深了污名者和被污名者之间的权力不平衡。精神疾病患者将心理健康和卫生保健提供者视为污名化过程的主要促成因素，并认为他们是反污名干预的合适目标。描述了六种减少污名的方法：教育、抗议、基于接触的教育、立法改革、宣传和污名自我管理。污名贬低了患有精神疾病的人的价值以及旨在支持他们的社会和专业支持系统。这造成了资金和服务提供方面的不平等，破坏了康复和充分的社会参与。精神卫生专业人员经常被认为是问题的一部分，但他们可以通过成为反污名工作的重要合作伙伴来改变这种情况。
