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2014, Number 4

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Salud Mental 2014; 37 (4)

Estigma estructural, género e interseccionalidad. Implicaciones en la atención a la salud mental

Mora-Ríos J, Bautista N

Language: Spanish
References: 27
Page: 303-312
PDF size: 326.08 Kb.


ABSTRACT

The purpose of this paper is to describe the most common forms and expressions of structural stigma from the perspective of a group of people who attended four treatment centers as a result of having received a psychiatric or neuropsychiatric diagnosis (n=68) and a group of health service providers engaged in these services in Mexico City (n=95). We adopted an approach, based on the intersectionality approach, which involves the interplay between social determinants, including gender, in the processes of social exclusion in mental health. In this qualitative study, the in-depth interview technique was used, for which specific guidelines were designed for providers and users of psychiatric services. The interviews were audio recorded, transcribed and subsequently encoded through a specialized program (Atlas ti, version 7.0). This paper examines the perceptions and experiences of stigma and discrimination related to psychiatric disorders, and other specific aspects related to the care process. Among the findings are the structural nature of discrimination not only directed at people affected by severe mental illness, but also at health personnel. Moreover, the respondents’ accounts reveal certain structural barriers that impact the quality of care, particularly for users who have multiple conditions of social vulnerability that go beyond the scope of these service providers, constituting dilemmas for the provider. Lastly, on the basis of the analysis of the various difficulties expressed by the study population in relation to the care services, the main challenges to improving the quality of services in the field of mental health are described.


REFERENCES

  1. Stuart H, Arboleda-Florez J, Sartorius N. Paradigms lost. Fighting stigma and the lessons learned. Oxford: Oxford University Press; 2012.

  2. Bos A, Pryor J, Reeder G, Stutterheim S. Stigma: advances in theory and research. Basic Applied Social Psychology 2013;35(1):1-9.

  3. Goffman E. Stigma: Notes on the management of spoiled identity. Englewood Cliffs: Prentice Hall; 1963.

  4. Corrigan P. Illness self-management strategies. A guideline developed for the behavioural health recovery management project. Illinois: University of Chicago Center for Psychiatric Rehabilitation; 2008.

  5. Link B, Phelan P. Conceptualizing Stigma. Annual Review Sociology 2001;27:363-385.

  6. Corrigan P, Markowitz F, Watson A. Structural Levels of Mental Illness. Stigma and Discrimination. Schizophrenia Bulletin 2004;30:481-491.

  7. Herek G. Sexual stigma and sexual prejudice in the United States: A conceptual framework. En: Hope D (ed.). Contemporary perspectives on lesbian, gay and bisexual identities: The 54th Nebraska Symposium on Motivation. Nueva York: Springer; 2009.

  8. Flores F, Mora-Rios J. Pobres, enfermas y locas, una historia de vulnerabilidades acumuladas. En: Montero E (ed.). Ecología social de la pobreza: Impactos psicosociales, desafíos multidisciplinarios. México: UNAM; 2010.

  9. Romero M, Saldívar G, Loyola L, Rodríguez E et al. Inequidades de género, abuso de sustancias y barreras al tratamiento en mujeres en prisión. Salud Mental 2010;33(6):499-506.

  10. Miller K, Rasmussen A. War exposure, daily stressors, and mental health in conflict and post-conflict settings: Brindging the divide between trauma-focused and psychosocial frameworks. Social Science Medicine 2010;70:7-16.

  11. Espinosa LM, Mora-Rios J, Valenzuela M. Saberes y trayectorias de atención a la salud de poblaciones vulneradas en México: abordaje interdisciplinario. Revista Saúde Sociedade 2013;22(25):590-602.

  12. Crenshaw K: Mapping the Margins: Intersectionality, identity politics and violence against women of colour. Critical Race Theory: The Key Writings that Informed the Movement. Nueva York: New York Press; 1995.

  13. Hankivsky O, Reid C, Cornier R, Varcoe C et al. Exploring the promises of intersectionality for advancing women’s health research. International J Equity Health 2010;9(5):1-15.

  14. Hankivsky O. Women’s health, men’s health, and gender and health: Implications of intersectionality. Social Science Medicine 2012;74:1712-1720.

  15. Pedersen D. Estigma y exclusión social en la enfermedad mental: Apuntes para el análisis y diseños de intervenciones. Acta Psiquiátrica Psicológica América Latina 2009;55(1):39-50.

  16. Mora-Ríos J, Natera G, Bautista-Aguilar N, Ortega-Ortega M. Estigma público y enfermedad mental. Una aproximación desde la teoría de las representaciones sociales. En: Flores F (Coord.). Representaciones sociales y contextos de investigación con perspectiva de género. México: CRIM-UNAM; 2013.

  17. Mora-Ríos J, Ortega-Ortega M, Natera G. Autoestigma en usuarios de servicios psiquiátricos y su relación con variables sociodemográficas, clínicas y psicosociales. Acta Psiquiátrica Psicológica América Latina 2013;59(3):147-158.

  18. Atlas-ti 7.0 for Windows [computer software]. (2012). Berlin: Cincom Systems, Inc. (5 de febrero de 2014).

  19. Lauber C, Nordt C, Braunschweig C, Rossler W. Do mental health professionals stigmatize their patients? Acta Psychiatr Scand 2006;(Suppl): 429:51-59.

  20. Schulze B. Stigma and mental health professionals: A review of the evidence on an intricate relationship. International Review Psychiatry 2007;19:137-155.

  21. Wahl O, Aroesty-Cohen E. Attitudes of mental health professionals about mental illness a review of the recent literature. J Community Psychology 2009;38:49-62.

  22. Szasz, Ivonne. “Género y salud. Propuesta para el análisis de una relación compleja”. En: Bronfman M, Castro R (cords.). Salud, cambio social y política. Perspectivas desde América Latina. México: Instituto Nacional de Salud Pública y Foro Internacional de Ciencias Sociales y Salud; 1999; pp.109-121.

  23. Martínez-Hernáez A. Más allá de la rehabilitación psicosocial. Metáforas de exclusión y tareas de inclusión. Cad Bras Saúde Mental 2009;1:1-12.

  24. Kleinman A. Anthropology and psychiatry. The role of culture in a cross-cultural research on illness. British J Psychiatry 1987;151:447-454.

  25. Wang J, Fick G, Adair C, Lai D. Gender specific correlates of stigma toward depression in a Canadian general population simple. J Affective Disorders 2007;103:91-97.

  26. Carpenter-Song E, Chu E, Drake R, Ritsema M et al. Ethno-cultural variations in the experience and meaning of mental illness and treatment: implications for access and utilization. Transcultural Psychiatry 2010;47(2):224-251.

  27. Coll-Vinent B, Echeverría T, Farras U, Rodríguez D et al. El personal sanitario no percibe la violencia doméstica como un problema de salud. GacSanit 2008;22(1):7-10.




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