Dissertation committee:
Ευμορφία Κούκια, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Μαρίνα Οικονόμου, Καθηγήτρια, Τμήμα Ιατρικής, ΕΚΠΑ
Χρυσούλα Νταφογιάννη, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Μιχαήλ Χατζούλης, Αναπληρωτής καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Κωνσταντίνος Κοντοάγγελος, Επίκουρος καθηγητής, Τμήμα Ιατρικής, ΕΚΠΑ
Βενετία Βελονάκη, Αναπληρώτρια καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Πολυξένη Μαγγούλια, Επίκουρη καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Introduction: The definition of stigma highlights how stereotypes, prejudices and labeling, due to a specific characteristic, lead certain categories of people to the margins. Despite the progress of science and the evolution of society, stigma, marginalization and social exclusion still exist as phenomena to this day. Mental illness is intertwined with concepts such as
disability, aggression and dangerousness. In this way,arbitrary assessments are created which
cultivate prejudices and stereotypes and ultimately stigmatize individuals.The stigma of
mental illness falls into two categories. The first refers to the public and social stigma, from
society s point of view towards people with mental illness. The second concerns self-stigma
the stereotypes, prejudices and discrimination experienced and internalized by people with a
mental illness. High levels of self-stigma are associated with low levels of self-esteem,
functioning, and overall quality of life. They also make adherence to treatment, rehabilitation,
independent living and socialization difficult. Lack of knowledge and inability to understand
mental illness are some of the characteristics that contribute to the perpetuation of stigma and
its consequences.
Objectives: The main purpose of the present study was to investigate the association of self-
stigma levels of functioning and self-care with attitudes, perceptions and the desire or not for
social distance towards other people with mental illness. The individual objectives were: 1.
Exploring the views and attitudes of mentally ill patients in relation to other patients with the
same or similar mental health problem through social distance. 2. Correlation of participants'
demographic characteristics, level of functioning with internalized stigma, stigmatization
toward other mentally ill patients, and social distance. 3. The investigation of self-stigma,
functionality and psychiatric diagnosis with the self-care actions of the mentally ill.
Methods: The target population of the study was people with mental illness, absence of
active psychopathology and an average age of 48.2 years, in three Psychiatric public hospitals
of Attica and their psychosocial rehabilitation units. In Aeginetio N= 66, Dafni N=49 and
Dromokaitio N=49. For data collection, the demographic information questionnaire, the Self-
Care Assessment Scale-Revised (ASAS-R), the self-stigma assessment scale (ISMI), the social distance scale (SDS), the questionnaire of attitudes towards severe mental illness were
used (ASMI) and the WHODAS 2.0 disability rating scale.
Results: A higher score on the Total Disability Scale found to be associated with lack of self-
care ability. Fewer stereotypes, greater optimism, and better coping with mental illness were associated with greater self-care power. Greater desire for social distance, fewer temporary and permanent relationships or trusting relationships with other people with mental illness,was associated with less self-care power and effort. Work profile, self-stigma has a significant effect on motor ability. Also, those who lived alone had worse coping with mental
illness, compared to those who lived with family, friends or in institutions. Greater
discrimination was associated with understanding more negative perceptions about mental
illness. Increased stereotyping is associated with a greater desire for distance from trusting
relationships with people with mental illness.
Conclusions: Stigma and self-stigma are indisputable factors of reduced functioning and self-care for people who experience mental difficulties. However, as shown by the present
study, the impact of the disease and stigma leads individuals to reproduce negative attitudes and perceptions of other individuals with the same or different psychiatric diagnostic category, perpetuating the vicious cycle of reproduction of social exclusion. Negative
attitudes and perceptions towards mental illness, as well as the desire for social distance, from people with a psychiatric diagnosis themselves were observed in cases where there was low functioning and increased internalized stigma. Even for the people whose diagnosis wasschizophrenia, seem to reproduce the image of an incompetent, unworthy and untrustworthy
person, who has no possibility of recovery or person particularly dangerous to others. These
deficits come because of not being involved by the social context and the insufficient psychoeducation of these individuals regarding the disease and its treatment.
Keywords:
Stifma, Self stigma, Mental illness, Self care, Functionality, Social distance
