Stigma,Discrimination,Empowerment and Social Networks: a Preliminary Investigation of Their Influence On Subjective Quality of Life in a Swedish Sample
Available accessResearch articleFirst published online January, 2008
Stigma,Discrimination,Empowerment and Social Networks: a Preliminary Investigation of Their Influence On Subjective Quality of Life in a Swedish Sample
Background: Studies investigating the importance of social network, empowerment and experiences of stigma on subjective quality of life among persons with mental illness are rare.
Aim: This study aimed to investigate beliefs of devaluation/discrimination, actual rejection experiences, empowerment, social network and the relationship of these factors to subjective quality of life among subjects with mental illness.
Methods: A cross-sectional study assessing beliefs of devaluation/discrimination, actual rejection experiences, empowerment, social network and subjective quality of life was performed on 150 subjects with mental illness.
Results: The factors most prominently related to subjective quality of life were overall empowerment and overall social network. For a subgroup of subjects suffering from psychotic disorders there was a significant negative relationship between subjective quality of life and rejection experiences. This group also reported more frequent rejection experiences.
Conclusion: The findings indicate that persons with mental illness are a heterogeneous group with regard to the influence of social network, stigma and empowerment on subjective quality of life. The negative impact of actual rejection experiences might express that, in order to increase subjective quality of life, stigma must be addressed as a separate and important factor in its own right.
Angermeyer, M.C. & Matschinger, H. (1997) Social distance towards the mentally ill: results of representative surveys in the Federal Republic of Germany. Psychological Medicine, 27, 131—41.
2.
Bengtsson-Tops, A. & Hansson, L. (2001) Quantitative and qualitative aspects of the social network in schizophrenic patients living in the community. Relationship to sociodemographic and clinical factors and subjective quality of life. International Journal of Social Psychiatry, 47, 67—77.
3.
Björkman, T. & Svensson, B. (2005) Quality of life in people with severe mental illness. Reliability and validity of the Manchester Short Assessment of Quality of life (MANSA). NordicJournal of Psychiatry, 59, 302—6.
4.
Björkman, T., Svensson, B. & Lundberg, B. (in press) Experiences of stigma among people with severe mental illness. Reliability, acceptability and construct validity of the Swedish versions of two stigma scales measuring devaluation/discrimination and rejection experiences . Nordic Journal of Psychiatry.
5.
Brunt, D. & Hansson, L. (2002) The social networks of persons with severe mental illness in in-patient settings and supported community settings. Journal of Mental Health, 11(6), 611—21.
6.
Byrne, P. (1997) Psychiatric stigma: past, passing and to come. Journal of the Royal Society of Medicine, 90, 618—21.
7.
Corrigan, P.W. (2002) Empowerment and serious mental illness: Treatment partnerships and community opportunities. Psychiatric Quarterly,73, 217—28.
8.
Corrigan, P.W., Faber, D., Rashid, F. & Leary, M. (1999) The construct validity of empowerment among users of mental health services. Schizophrenia Research,38, 77—84.
9.
Corrigan, P.W., River, L.P., Lundin, R.K., Penn, D.L., Uphoff-Wasowski, K., Campion, J., Mathisen, J., Gagnon, C., Bergman, M., Goldstein, H. & Kubiak, M.A. (2001) Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin, 27(2), 187—95.
10.
Crisp, A.H., Gelder, M.G., Rix, S., Meltzer, H.I. & Rowlands, O.J. (2000) Stigmatisation of people with mental illnesses. British Journal of Psychiatry, 177, 4—7.
11.
Goffman, E. (1963) Stigma: Notes on the Management of Spoiled Identity . Englewood Cliffs, NJ: Prentice-Hall .
12.
Hansson, L. & Björkman, T. (2005) Empowerment in people with a mental illness: reliability and validity of the Swedish version of an empowerment scale. Scandinavian Journal of Caring Sciences, 19, 32—8.
13.
Hansson, L., Middelsboe, T., Merinder, L., Bjarnason, O., Bengtsson-Tops, A., Nilsson, K., Sandlund, M., Sourander, A., Sourander, A., Sørgaard, K.W. & Vinding, H. (1999) Predictors of subjective quality of life in schizophrenic patients living in the community. A Nordic multicenter study. International Journal of Social Psychiatry, 45, 247—58.
14.
Henderson, S., Duncan-Jones, P., Byrne, D.G. & Scott, R. (1980) Measuring social relationships: The Interview Schedule for Social Interaction. Psychological Medicine, 10, 723—34.
15.
Lauber, C., Nordt, C., Falcato, L. & Rössler, W. (2004) Factors influencing social distance toward people with mental illness. Community Mental Health Journal, 40, 265—74.
16.
Lehman, A. (1988) A Quality of Life Interview for the chronically mentally ill (QOLI). Evaluation and Program Planning, II, 51—62.
17.
Link, B.G., Cullen, F.T., Struening, E., Shrout, P. & Dohrenwend, B.P. (1989) A modified labelling theory approach in the area of mental disorders: an empirical assessment. American Sociological Review, 54, 400—23.
18.
Link, B.G., Struening, E.L., Rahav, M., Phelan, J.C. & Nuttbrock, L. (1997) On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnosis of mental illness and substance abuse. Journal of Health and Social Behavior, 38, 177—90.
19.
Link, A.G., Phelan, J.C., Bresnahan, M., Stueve, A. & Pescosolido, B. (1999) Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health, 89, 1328—33.
Oliver, J., Huxley, P., Priebe, S. & Kaiser, W. (1997) Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile. Social Psychiatry and Psychiatric Epidemiology, 32, 76—83.
22.
Pescosolido, B.A., Monahan, J., Link, B.G., Stueve, A. & Kikuzawa, S. (1999) The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems. American Journal of Public Health, 89, 1339—45.
23.
Priebe, S., Huxley, P., Knight, S. & Evans, S. (1999) Application and results of the Manchester Short Assessment of Quality of Life (MANSA). International Journal of Social Psychiatry, 45, 7—12.
24.
Rappaport, J. (1981) In praise of a paradox: a social policy of empowerment over prevention. American Journal of Community Psychology , 9, 1—25.
25.
Rogers, E.S., Chamberlin, J., Ellison, M.L. & Crean, T. (1997) A consumer constructed scale to measure empowerment among users of mental health services. Psychiatric Services,48, 1042—7.
26.
Rosenfield, S. (1992) Factors contributing to the subjective quality of life of the chronic mentally ill. Journal of Health and Social Behavior, 33, 299—315.
27.
Rosenfield, S. (1997) `Labeling Mental Illness': The effects of received services and perceived stigma on life satisfaction. American Sociological Review, 62, 660—72.
28.
Undén, A-L. & Orth-Gomér, K. (1989) Development of a social support instrument for use in population surveys. Social Science & Medicine, 29, 1387—92.
29.
Wahl, O.F. (1999) Mental health consumers' experience of stigma. Schizophrenia Bulletin, 25(3), 467—78.
30.
World Health Organization (1993) The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO.
31.
Yanos, P.T., Rosenfield, S. & Horwitz, A.V. ( 2001) Negative and supportive social interactions and quality of life among persons diagnosed with severe mental illness. Community Mental Health Journal, 37, 405—19.
