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A qualitative study on the stigma experienced by people with mental health problems and epilepsy in the Philippines

机译：对菲律宾精神健康问题和癫痫患者遭受的耻辱的定性研究

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Stigma towards people with mental health problems (PMHP) is known to have substantial negative impacts on their lives. More in-depth exploration of the stigma and discrimination experienced by PMHP in low- and middle-income countries is needed. Previous research suggests that negative attitudes towards PMHP are widespread among the Filipino general public. However, no study has investigated PMHP’s own experiences of being stigmatised in the Philippines. A qualitative study was conducted on the stigma experienced by PMHP (including people with epilepsy) and its related factors in the Philippines, employing the constructivist grounded theory approach. We analysed data on 39 PMHP collected through interviews with PMHP, their carers, and community health volunteers who know them well. The findings highlight the culturally and socio-economically specific contexts, consequences, and impact modifiers of experiences of stigma. Participants emphasised that PMHP face stigma because of the cultural traits such as the perception of mental health problem as a disease of the family and the tendency to be overly optimistic about the severity of the mental health problem and its impact on their life. Further, stigma was experienced under conditions where mental health care was not readily available and people in the local community could not resolve the PMHP’s mental health crisis. Stigma experiences reduced social networks and opportunities for PMHP, threatened the economic survival of their entire family, and exacerbated their mental health problems. An individual’s reaction to negative experiences can be fatalistic in nature (e.g. believing in it is God’s will). This fatalism can help PMHP to remain hopeful. In addition, traditional communal unity alleviated some of the social exclusion associated with stigma. The study indicates that existing stigma-reduction strategies might have limitations in their effectiveness across cultural settings. Therefore, we propose context-specific practical implications (e.g. emphasis on environmental factors as a cause of mental health problems, messages to increase understanding not only of the possibility of recovery but also of challenges PMHP face) for the Philippines.
机译：众所周知，对患有精神健康问题的人的耻辱会对他们的生活产生重大的负面影响。需要对中低收入国家PMHP遭受的污名和歧视进行更深入的探索。先前的研究表明，菲律宾人对PMHP持消极态度。但是，尚无研究调查PMHP自己在菲律宾受到侮辱的经历。利用建构主义扎根的理论方法对菲律宾的PMHP（包括癫痫患者）遭受的耻辱及其相关因素进行了定性研究。我们分析了39名PMHP的数据，这些数据是通过与PMHP，其护理人员和熟识社区卫生志愿者的访谈收集的。研究结果突出了文化和社会经济方面的特定背景，后果和耻辱经历的影响修正因素。与会人员强调，由于文化特征，例如将心理健康问题视为家庭疾病，以及对心理健康问题的严重性及其对生活的影响过于乐观的趋势，PMHP面临耻辱。此外，在无法获得精神卫生保健且当地社区的人们无法解决PMHP的精神卫生危机的情况下，遭受了耻辱。耻辱感减少了社交网络和PMHP的机会，威胁了他们整个家庭的经济生存，并加剧了他们的心理健康问题。个人对消极经历的反应本质上可能是宿命论（例如，相信这是上帝的旨意）。这种宿命论可以帮助PMHP保持希望。此外，传统的社区团结减轻了一些与耻辱有关的社会排斥。该研究表明，现有的减少耻辱感的策略在跨文化环境中的有效性可能受到限制。因此，我们提出了针对菲律宾的具体情况的实际含义（例如，强调作为精神健康问题根源的环境因素，传达信息，不仅使人们了解恢复的可能性，而且对PMHP面临的挑战有更多的了解）。

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