Stimulus piece

Schizophrenia has been found to be one of the most stigmatizing conditions. Most research on stigma has looked more at public opinions about the disorder, rather than at the views of those living with schizophrenia. Aiming to explore stigma from the perspective of people with schizophrenia, a focus group study was carried out at the four centers in Germany. For each of the centers, three separate focus groups were established. One with people suffering from schizophrenia, one with their relatives, and one with mental health professionals. 83 individuals participated in the study. Participants were recruited through letters of invitation that were distributed through the centers’ out-patient department.

Focus groups consisted of 8 – 12 participants. The moderator asked the group the following opening question: What has changed for you after you first developed schizophrenia? Tell me concrete incidences and stories that you have experienced. The focus of the discussion was concrete stigmatization experiences, ideas about the causes of stigmatization, and suggestions for anti-stigma interventions.

The focus group sessions were audio and video recorded and transcripts were coded using an inductive method. Once the focus groups of those living with schizophrenia had been analyzed, a content analysis was carried out on the transcripts of relatives and mental health professionals.

Results revealed several dimensions of stigma, including changes in interpersonal interaction, discrimination in the workplace, and inequity in access to health care. For most of the patients, the diagnosis of schizophrenia had resulted in a reduction of social contact. Relatives, too, observed how friends of the patient usually stayed away, did not come to see them at hospital, or often avoided speaking with them. While the patients’ experience of stigma is dominated by the hurt they experience through the loss of social contacts and the fact that the illness shapes people’s perception of them, relatives feel that patients are particularly discriminated against through deficits in the quality of the treatment they receive, especially compared with health services available for patients with physical illness.

Source: Schulze, B, M. Angermeyer. Subjective experiences of stigma: A focus group study of schizophrenic patients, their relatives and mental health professionals. Social Science & Medicine 56 (2003) 299 - 312.