Department of Sociology, The University of Manchester, Manchester, UK.
Sociol Health Illn. 2023 May;45(4):855-871. doi: 10.1111/1467-9566.13615. Epub 2023 Feb 3.
This article critically reviews previous research in the field of stigma, mental illness and 'race' and ethnicity, and argues for a shift of focus from individual and community blame, as inferred by mental illness stigma, to a more comprehensive view of how stigma operates against a backdrop of structural and institutional racism. Ethnic minority people have poorer mental health outcomes compared with White majority populations. Dominant narratives of greater mental illness stigma in ethnic minority populations, due to religious, spiritual or traditional beliefs and leading to a lower use of services, have taken centre stage in the explanations for these consequent poorer outcomes. This article argues that this 'fact' has become taken for granted as knowledge without corresponding comparative research evidence. Research in the field has also failed to robustly consider how racism might operate in conjunction with different forms of mental illness stigma (particularly structural stigma) to exacerbate mental illness and influence pathways to mental health treatment. Future research should centre the role of racism and structural stigma in explaining the poorer mental health outcomes for ethnic minority people.
本文批判性地回顾了以往在污名、精神疾病和“种族”领域的研究,并主张将重点从精神疾病污名所暗示的个人和社区责任转移到更全面的观点,即污名是如何在结构性和制度性种族主义背景下运作的。与白人多数群体相比,少数族裔人群的心理健康结果更差。由于宗教、精神或传统信仰而导致更多精神疾病污名的主导性说法,以及由此导致服务利用率降低,已成为解释这些较差结果的核心。本文认为,这一“事实”已被视为理所当然的知识,而没有相应的比较研究证据。该领域的研究也未能充分考虑种族主义可能如何与不同形式的精神疾病污名(特别是结构性污名)相互作用,从而加剧精神疾病并影响心理健康治疗途径。未来的研究应该将种族主义和结构性污名在解释少数族裔人群心理健康结果较差方面的作用作为研究中心。