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Lecture - The meaning of mental health and illness - Stigma and Marginalisation

This is an hour long vodcast of a lecture relating to the meaning of mental health. It considers how we have come to view mental health problems as discrete from other problems, how mental disorder is categorised and what the implications of our changing conceptions of health and illness are in relation to stigma and discrimination. The PDF link is to associated readings and references.

Mac Gabhann, L., Lakeman, R., McGowan, P., Parkinson, M., Redmond, M., Sibitz, I., et al. (2010). Hear my voice: The experience of discrimination of people with mental health problems in Ireland. Dublin: Dublin City University / Amnesty International.

The PDF links to the final report published at DCU.

Lakeman, R., McGowan, P., MacGabhann, L., Parkinson, M., Redmond, M., Sibitz, I., Stevenson, C., & Walsh, J. (2012). A qualitative study exploring experiences of discrimination associated with mental-health problems in Ireland. Epidemiology and Psychiatric Sciences, 21(3), 271-279. https://doi.org/10.1017/S2045796012000017

Aims - Stigma and discrimination related to mental health problems impacts negatively on people's quality of life, help seeking behaviour and recovery trajectories. To date, the experience of discrimination by people with mental health problems has not been systematically explored in the republic of Ireland. This study aimed to explore the experience impact of discrimination as a consequence of being identified with a mental health problem.
Methods - Transcripts of semi-structured interviews with 30 people about their experience of discrimination were subject to thematic analysis and presented in summary form.
Results - People volunteered accounts of discrimination which clustered around employment, personal relationships, business and finance, and health care. Common experiences included being discounted or discredited, being mocked or shunned, and being inhibited or constrained by oneself and others.
Conclusions - Qualitative research of this type may serve to illustrate the complexity of discrimination and the processes whereby stigma is internalised and may shape behaviour. Such an understanding may assist health practitioners reduce stigma, and identify and remediate the impact of discrimination.

Lakeman, R., & Matthews, A. (2010). The views and experiences of members of new communities in Ireland: perspectives on mental health and well-being. Translocations: Migration and Social Change, 6(1), http://www.translocations.ie/volume_6_issue_1/index.shtml.

Ireland has a long history of outward migration but in recent years Ireland has become a destination of choice for migrants from the rest of the world. This has posed a challenge to Irish institutions and Irish society. This paper reports on the findings from a community development project undertaken in partnership between Cairde (a non government resource and advocacy organisation for ethnic minority groups) and Dublin City University. Members of new community groups in Dublin who were affiliated with Cairde took part in focus groups exploring their perceptions regarding mental health, mental ill-health and their experiences of mental health care provision. Participants focused more on their everyday experiences affecting their health and well-being rather than presenting their difficulties from within an illness paradigm. Whilst most participants had experience of accessing health services they had little contact with specialist mental health services. So while the study was designed to focus on conceptions of mental health/ill-health and services, the findings highlight structural inequalities that some migrants face in relation to legal status, accessing educational, occupational opportunities, and social service eligibility; all aspects of their everyday lives that cause them distress and fear.

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