“It’s just a very taboo and secretive kind of thing”: making sense of living with stigma and discrimination from accounts of people with psychosis

Abstract

Stigma is a common and pervasive problem for many people with psychosis. Much of the research examining internalised stigma has utilised quantitative methodology; however, it has been argued that to conceptualise experiences of psychosis, research should also attend to subjective experience. This study explores accounts of stigma from nine people with psychosis through semi-structured interviews that were analysed using Interpretative Phenomenological Analysis. Three super-ordinate themes of judgement, disclosure and psychological distress were identified. Analysis of the data found that stigma was experienced directly and indirectly through social judgements. In particular, it was considered that negative messages and the absence of positive images of psychosis in the media perpetuated social judgements. Difficulties were reported in relation to disclosure, including avoidance from others following disclosure and coping strategies to conceal experiences of psychosis. Ultimately, judgement and issues of disclosure had a negative impact on psychological well-being, either contributing to, or resulting in, psychological distress, including increased paranoia, anxiety and lowered self-esteem. Potential exits from the negative effects of stigma, including peer support, were identified in the data. Implications for future research and clinical practice, including interventions to reduce internalised stigma, are suggested.

Keywords:

• stigma
• schizophrenia
• prejudice

Acknowledgements

The authors thank the people who participated in this study and the Psychosis Research Unit Service User Reference Group (PRU-SURG) for their consultation regarding this study.