The Herald (Zimbabwe)

Stigma in mental health must STOP!

- Dr Sacrifice Chirisa Mental Health Matters Dr Sacrifice Chirisa is a passionate mental health specialist at Parirenyat­wa Hospital, one of the country’s major referral centresren­t. He can be reached at drsmchiris­a@yahoo.com

THE word stigma referred originally to a mark or brand on Greek slaves, clearly separating them from free men. In common usage the word signifies a disgrace or defect placed on another human. There are two ways stigma is expressed: 1. Felt stigma: Also known as internal stigma or self-stigmatisa­tion. This refers to the shame and expectatio­n of discrimina­tion that prevents people from talking about their psychiatri­c or psychologi­cal issue and stops them seeking help.

2. Enacted stigma: Also known as external stigma or discrimina­tion. This refers to the experience of unfair treatment by others.

Both types of stigma can be as damaging since it leads to withdrawal and restrictio­n of social support. Many psychiatri­c disorders can be hidden once the person has recovered. Goffman in his book written in the 1960s describes two states of Stigma as a whole, these are:

◆ Discredita­ble -This allows people to pass as normal so long as no one finds out their conditions or have condition that are not obvious to the naked eye or not expressed to the public.

◆ Discredite­d -This where people with psychiatri­c conditions that cannot be hidden from the public and are obvious to the naked eye and to the general public. People with a discredita­ble condition like bipolar disorder in remission, anxiety disorders, sleep disorders, and sexual dysfunctio­ns as examples must decide how much to tell and to whom. By careful informatio­n management they can minimise social rejection and enacted stigma.

Those who live with a discrediti­ng condition such as schizophre­nia with tardive dyskinesia, intellectu­al disability, and movement disorders will have serious difficulti­es with informatio­n management and are at highest risk of experienci­ng enacted stigma.

At its worst stigma leads to discrimina­tion, isolation, labeling worsening of simple conditions, unorthodox management of psychiatri­c patients, hiding of patients by relatives, physical abuse and denial and defaulting of treatment.

Mental health discrimina­tion stems from structures in society and from individual­s’ attitudes and behaviors; both individual­s and structures need to be changed by legal reform, public education , protests and grassroots activities to increase activities of Mental Health Days.

This is best done by both the public and private sector. Mental health must be given the attention it deserves. We must channel more funding to awareness activities in schools, colleges and work places. The time to stop STIGMA IS NOW!!!!!!

 ??  ?? People with a discredita­ble condition like bipolar disorder, for example, must decide how much to tell and to whom
People with a discredita­ble condition like bipolar disorder, for example, must decide how much to tell and to whom
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