The stigma of eating disorders: which interventions might help?

Eating disorders are serious psychiatric conditions affecting up to 5% of the population over the life-course and bearing some of the highest mortality rates of all psychiatric disorders | By Francesca Solmi for The Mental Elf

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It is not uncommon that in public discourse they are trivialised as disorders of volition; the result of media and peer pressures on young girls to achieve unattainable beauty standards. A case in point is last year’s comment by Baroness Joan Bakewell (who afterwards apologised for her remark) suggesting that to suffer from anorexia nervosa is a “sign of the overindulgence of our society, over-introspection, narcissism”.

In this context, a new systematic review on the effectiveness of different types of interventions to reduce stigma towards eating disorders by Doley and colleagues is a much-needed piece of research in an area lacking evidence.

Stigma-reduction strategies

A combination of educational and contact approaches was the most effective approach at reducing attitudinal, affective, and behavioural measures of stigma. No studies directly compared educational and contact approaches, but, overall, studies evaluating the impact of these two approaches individually did not observe improvements in attitudinal stigma after the intervention or found small improvement in behavioural stigma that, however, did not persist at follow-up.

Read the full blog post here

The original research abstract is available here

 

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Trait Mindfulness Attenuates the Adverse Psychological Impact of Stigma on Parents of Children with Autism Spectrum Disorder

Chan, K.K.S. & Lam, C.B. Mindfulness (2017). doi:10.1007/s12671-016-0675-9

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Stigma attached to autism spectrum disorder (ASD) is prevalent, but few studies have examined its psychological impact on parents of children with ASD and the potential protective factors in this family context. The present study aimed to test the associations of public stigma and courtesy stigma with depression, anxiety, and caregiving burden among parents of children with ASD and to explore whether trait mindfulness would moderate these associations.

Cross-sectional questionnaire data were collected from 424 parents of children with ASD residing in Hong Kong, China. Hierarchical regressions revealed significant interactions between public stigma and trait mindfulness and between courtesy stigma and trait mindfulness in predicting depression, anxiety, and caregiving burden.

Our findings contributed to the theoretical literature by highlighting the adverse impact of both public stigma and courtesy stigma on the mental health and caregiving experience of parents of children with ASD, as well as the potential protective effects of trait mindfulness in such processes. Our findings also had important practical implications for the design of effective interventions for this stigmatized group of families.

Read the abstract here

Nursing attitudes to deliberate self-harm

Carswell, C. & Noble, H. BMJ Evidence-Based Nursing blog. Published online: 6 February 2017

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Attitudes can have a significant effect on behaviour meaning that the attitudes nurses hold can have an impact on their nursing practice. Patients who self-harm report high levels of stigma and negative attitudes, stating that they have been called ‘attention seeking’ or ‘manipulative’ as a result of the self-injurious behaviour. The text Blades, Blood and Bandages tells the stories of 25 people’s experiences of self-injury and investigates how those who self-injure are ‘affected by suffering, ritual and stigma’ http://www.palgrave.com/br/book/9780230252813

These negative attitudes and beliefs have originated from not only their friends and family, but also from medical professionals and emergency department personnel following presentation for their injuries. These attitudes can be interpreted through the professional’s behaviour and can have a profound effect on the patient. They can determine whether the patient decides to stay in the hospital for assessment, treatment or referral and whether they are instilled with a sense of hope and validation which in turn can help reduce the risk of further incidents of self-harm and even suicide. Attitudes can also have a more direct impact on nursing practice, for example nurses may feel unequipped or unprepared to perform a comprehensive assessment or to refer on to specialist mental health services.

Read the full blog post here

Does more mental health treatment and less stigma produce better mental health?

Two articles published this week shine a revealing light on how the general public views mental health care and its practitioners | The Conversation

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Mental health problems continue to carry a heavy stigma. People who experience them are often feared, excluded, shamed and discriminated against. Overcoming that stigma is a high priority, not least because it’s a barrier to engaging people in treatments that might help them.

People suffering from mental health problems are not the only ones to experience the stigma of mental illness, however. Those who treat them sometimes share the burden. Just as the shadow of death falls on workers in the funeral industry, psychiatric stigma casts a shadow on the public image of mental health professionals.

Psychiatrists in particular have been concerned they are held in low esteem by the public and within the medical profession. This negative view of the field has significant consequences, such as making it difficult to recruit students into psychiatric training. The chronic under-funding of mental health research and treatment arguably reflects the same devaluation.

Read the full blog post here

I am Whole: A report investigating the stigma faced by young people experiencing mental health difficulties

YMCA | Published online: October 2016

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Image source: YMCA

The purpose of this research was to examine the stigma faced by young people experiencing mental health difficulties.

Growing up can be a positive time for many. However, there are hundreds of thousands of young people across England and Wales for whom the experience is very different. Mental health difficulties among children and young people are common and can be both persistent and damaging.

However, the challenges that young people face are not limited to the symptoms mental health difficulties; many must also take on the day-to-day stigma that too often goes with this.

By giving young people the platform to share their views and stories, I AM WHOLE seeks to go beyond the headline statistic ‘one in 10 young people experience mental health difficulties’ that so often dominates the discourse.

Instead, this research seeks to get under the surface and understand the real experiences of those with mental health difficulties. This is done by examining the prevalence of this stigma, who is experiencing it and how they are doing so, the impact of this stigma, and the potential solutions that the young people themselves have identified.

Read the summary here

Read the full report here

Mental health – our attitudes and awareness

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Image source: Hey Paul Studios – Flickr // CC BY 2.0

Understanding what works to keep us mentally healthy and support those experiencing mental health problems is fundamental to reducing health inequalities.

PHE have been working with the National Centre for Social Research (NatCen) to understand more about public attitudes to mental wellbeing and mental illness and commissioned a series of questions on attitudes to mental health as part of the latest British Social Attitudes survey. This blog goes through some of the findings.

Two distinct pictures of public attitude emerged from the findings. On one hand people are being positive and aware about mental wellbeing, but on the other, we are still seeing negative attitudes towards mental health problems, despite widespread prevalence.

Topics covered include:

  • Mental wellbeing
  • Stigma

Read the full blog post here

Children and young people’s mental health – policy, CAMHS services, funding and education

House of Commons Library. Published online: 22 June 2016

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Image source: HoC Library

House of Commons Library briefing on children and young people’s mental health policy and services.

One in four people on average experience a mental health problem, with the majority of these beginning in childhood. A report by the Chief Medical Officer in 2014 found that 50 per cent of adult mental health problems start before the age of 15 and 75 per cent before the age of 18.

The Coalition Government committed to improving mental health for children and young people, as part of their commitment to achieving “parity of esteem” between physical and mental health, and to improving the lives of children and young people. The Government’s 2011 mental health strategy, No Health without Mental Health, pledged to provide early support for mental health problems, and the Deputy Prime Minister’s 2014 strategy, Closing the Gap: priorities for essential change in mental health, included actions such as improving access to psychological therapies for children and young people. The Department of Health and NHS England established a Children and Young People’s Mental Health and Wellbeing Taskforcewhich reported in March 2015 and set out ambitions for improving care over the next five years. The Coalition Government also pledged funding for children and adolescent mental health, detailed in the briefing.

Read the full introduction here

Read the full report here