Damgalama (Stigma) ve Ruh Sağlığı
Synopsis
Damgalanma, olumsuz algılanan durumlardan kaynaklanan bireyin adını kötüye çıkaran ve sosyal reddedilme olarak tanımlanmaktadır. Toplumları etkileyen geniş çaplı salgınlarda, hastalıklarda, fiziksel, düşünsel, ırk, inanç, toplumsal cinsiyet ve cinsel yönelim vb. gibi alanlarla ilgili farklılıklar nedeniyle bireyler damgalanma yaşamaktadır. Ruh sağlığı alanında görülen en önemli sorunlardan biri olarak bireylere, ailelerine ve toplumlara zarar veren bir deneyimdir. Önyargılar sonucu gelişen ayrımcılığa maruz kalmak, bireylerin hayatında acı yaşamalarına neden olmaktadır. Aile ilişkilerinin ve sosyalleşmenin bozulmasına yol açarak, iş bulma ve işi sürdürme konularında sorunlar yaşamasına neden olur. Damgalama içselleştirildiğinde bireyin iyilik halini olumsuz etkileyerek bakış açılarının bir parçası haline gelmektedir. Utanç, suçluluk, umutsuzluk, karamsarlık, yalnızlık hissi, kaygı, endişe, düşük benlik saygısı, sosyal olarak geri çekilme, korku, reddedilme ve sosyal izolasyon yaşanmasına neden olmaktadır. Bölümde damgalanmaya maruz kalmış bireylerin, ailelerin görüşlerinden alıntılara yer verilerek yaşanan olumsuzluklar vurgulanmıştır. Damgalanmanın engellenmesi ve azaltılmasına yönelik önlemlerin alınması, müdahalelerin planlanması bu sorunların önlenmesi için büyük önem taşımaktadır.
References
Haugen, PT., MCCrillis, AM., Smid, GE, Nijdam MJ. Mental health stigma and barriers to mental health care for first responders: a systematic review and meta-analysis. Journal of Psychiatric Research. 2017;94(11):218-229.
Arboleda, FJ. Stigmatization and human rights violations. World Health Organization mental health: A call for action by world health ministers Geneva: WHO.2002; p. 57-70.
Goffman, E. (Ed.) Stigma: Notes on the management of spoiled identity. 2009; New York: Simon and Schuster Inc.
Bekiroğlu, S. Ruhsal hastalığa sahip bireylere yönelik damgalama: etkileyen faktörlere ve bireyler üzerindeki etkilerine dair kavramsal bir çalışma. OPUS- Uluslararası Toplum Araştırmaları Dergisi. 2021;17(33):595-618.
Thornicroft, G, Rose, D, & Kassam, A. Discrimination in health care against people with mental illness. International Review of Psychiatry. 2007;19:113–122.
Özmen, S., Erdem, R. Damgalamanın kavramsal çerçevesi. Suleyman Demirel University Journal of Faculty of Economics & Administrative Sciences. 2018;23(1):185-208.
Avcil, C, Bulut, H, Hızlı Sayar, G. Psikiyatrik hastalıklar ve damgalama. Üsküdar Üniversitesi Sosyal Bilimler Dergisi; 2016;2(2):175-202
Ye J, Chen TF, Paul D, McCahon R, Shankar S, Rosen A, O'Reilly CL. Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings. Int J Soc Psychiatry. 2016;62(6):532-41.
Thornicroft, C, Wyllie, A, Thornicroft, G, & Mehta, N. Impact of the “Like Minds, Like Mine” anti-stigma and discrimination campaign in New Zealand on anticipated and experienced discrimination. Australian and New Zealand Journal of Psychiatry. 2014;48(4):360–370.
Brian K. Ahmedani, 2011,Mental Health Stigma: Society. Individuals, and the Profession, J Soc Work Values Ethics. 2011;8(2):4-16.
Sickel AE, Seacat JD, Nabors NA, Mental health stigma: Impact on mental health treatment attitudes and physical health. Journal of Health Psychology 2019;24(5):586–599.
Küçük L. Stigma ve Toplum. Ünsal Barlas G, editör. Toplum Ruh Sağlığı Hemşireliği. 1. Baskı. Ankara: Türkiye Klinikleri. 2018. p.29-33.
Corrigan PW. How stigma interferes with mental health care. American Psychologist. 2004;50(7):614–625.
Gaiha et al. Effectiveness of arts interventions to reduce mental-health-related stigma among youth: a systematic review and meta-analysis, BMC Psychiatry. 2021;21:364
Corrigan, PW, Shapiro, JR. Measuring the impact of programs that challenge the public stigma of mental illness. Clin Psychol Rev. 2010;30(8):907–922.
Evans-Lacko S, Brohan E, Mojtabai R, Thornicroft G. Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med. 2012;42(8):1741-52.
Corrigan PW, Larson JE, Rüsch N. Self-stigma and the why try effect: impact on life goals and evidence-based practices. World Psychiatr. 2009;8:75-81.
Corrigan, PW, Rao, D. On the self-stigma of mental illness: stages, disclosure, and strategies for change. Can J Psychiatry. 2012;57(8):464–469.
Stull, LG, Mcgrew, JH, Salyers, MP. Implicit and explicit stigma of mental illness: attitudes in an evidence-based practice. J Nerv Ment Dis. 2013;201(12):1072–1079.
Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med. 2010;71(12):2150-61.
Brohan, E., Slade, M., Clement, S. et al. Experiences of mental illness stigma, prejudice and discrimination: a review of measures. BMC Health Serv Res; 2010; 10:80.
Świtaj P, Chrostek A, Grygiel P, Wciórka J, Anczewska M. Exploring factors associated with the psychosocial impact of stigma among people with schizophrenia or affective disorders. Community Ment Health J. 2016;52(3):370-8.
Lysaker PH, Davis LW, Warman DM, Strasburger A, Beattie N. Stigma, social function and symptoms in schizophrenia and schizoaffective disorder: associations across 6 months. Psychiatry Res. 2007; 15:149(1-3):89-95.
Zhang TM, Wong IY, Yu YH, Ni SG, He XS, Bacon-Shone J, et al. An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China. Soc Psychiatry Psychiatr Epidemiol. 2019;54(8):911-8.
Koçak Z, Taylan HH. Şizofreni hastalarında içselleştirilmiş damgalanmanın yaşam kalitesi üzerindeki etkisi.Akademik Sosyal Araştırmalar Dergisi. 2018;6(78):621-640.
Schmitt MT, Branscombe NR, Postmes T, Garcia A. The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychol Bull. 2014;140(4):921-48.
Ertugrul, A., Uluğ, B. Perception of stigma among patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2004; 39:73–77.
Hatzenbuehler, M. L., & Link, B. G. Introduction to the special issue on structural stigma and health. Social Science & Medicine. 2014; 103:1–6.
Corrigan, P.W., Druss, B.G. and Perlick, D.A. The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest. 2014;15(2):37-70.
Corrigan, PW, Watson, AC, Gracia, G, Slopen, N, Rasinski, K., Hall, LL., Newspaper stories as measures of structural stigma, Psychiatric Services. 2005;56(5):551-556.
Torrey, E. F., ve Yolken, R. Psychiatric genocide: Nazi attempts to eradicate schizophrenia. Schizophrenia Bulletin. 2010;36(1):26-32.
Link, B. G., Phelan, J. C. Conceptualizing stigma. Annual Review of Sociology. 2001; 27:363–385.
Goffman, E, Damga: Örselenmiş Kimliğin İdare Edilişi Üzerine Notlar, Çeviri, Ş. Geniş- L. Unsaldı-SN. Ağırnaslı; 2014; Ankara, Heretik Yayıncılık.
Sickel AM, Seacat JD, Nabors NA. Mental health stigma update: A review of consequences, Advances in Mental Health. 2014;12(3):202-215,
Kao YC, Lien YJ, Chang HA, Wang SC, Tzeng NS, Loh CH. Evidence for the indirect effects of perceived public stigma on psychosocial outcomes: The mediating role of self-stigma. Psychiatry Res. 2016;30(240):187-195.
Watson AC, Corrigan P, Larson JE, Sells M. Self-stigma in people with mental illness.
Schizophrenia Bulletin. 2007;33(6):1312-8.
Krüger C, Schallreuter KU. Stigmatisation, Avoidance Behaviour and Difficulties in Coping are Common Among Adult Patients with Vitiligo. Acta Derm Venereol. 2015; 95(5):553-8.
Can Öz Y, Ünsal Barlas G. Şizofreni hastalığı olan bireylerin işe yerleştirme ile ilgili görüşleri ve beklentileri: niteliksel bir çalışma. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2017;3(3):28-32.
Covarrubias I, Han M. Mental health stigma about serious mental illness among MSW students: social contact and attitude. Soc Work. 2011;56(4):317-25.
Sandhu, HS, Arora, A, Brasch, J, & Streiner, DL. Mental health stigma: explicit and implicit attitudes of Canadian undergraduate students, medical school students, and psychiatrists. The Canadian Journal of Psychiatry. 2019;64(3):209–217.
Knaak, S, Mantler, E, & Szeto, A. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum. 2017;30(2):111–116.
Weiss M, Ramakrishna J. Health-related stigma: rethinking concepts and interventions. Psychol Health Med. 2006;11(3):277-287.
Çam O, Çuhadar D. Ruhsal hastalığa sahip bireylerde damgalama süreci ve içselleştirilmiş damgalama. Journal of Psychiatric Nursing. 2011;2(3):136-140.
Rao, D, Elshafei, A, Nguyen, M. et al. A systematic review of multi-level stigma interventions: state of the science and future directions. BMC Med, 2019;17:41.
Heijnders M, Van Der Meij S. The fight against stigma: an overview of stigma-reduction strategies and interventions. Psychol Health Med. 2006; 11:353–63.
Thorncroft, G. Toplumun Reddettiği: Ruhsal Hastalığı Olan İnsanlara Karşı Ayrımcılık, Çeviri Editörü: Haldun Soygür, Çvrn: Uluhan, N, Doğan T., Soygür, H., 2014; Şizofreni Dernekleri Fedarasyonu- Mavi At Kafe. Ankara.
Hall PL, Tarrier N. The cognitive-behavioural treatment of low self-esteem in psychotic patients: a pilot study. Behav Res Ther. 2003;41(3):317–32.
Van der Stouwe, ECD, Geraets, CNW, Rutgers, M. et al. Cognitive behavioral group treatment for low self-esteem in psychosis: a proof of concept study. BMC Psychiatry. 2021; 21:567.
Hartog K, Hubbard CD, Krouwer AF, Thornicroft G, Kohrt BA, Jordans MJD. Stigma reduction interventions for children and adolescents in low- and middle-income countries: Systematic review of intervention strategies. Soc Sci Med. 2020; 246:112749.
Kocabaşoğlu N. ve Aliustaoğlu S. Bir kavram olarak stigmatizasyon. Yeni Symposium. 2003;41(4):190-192.
Can Öz, Y. Şizofreni hastalığı olan bireyleri işe yerleştirme ile ilgili görüşler ve beklentiler: Hasta, Ailesi ve İşverenler (Doktora Tezi), Marmara Üniversitesi, Sağlık Bilimleri Enstitüsü ,2016, İstanbul, Türkiye.
Xu X, Li XM, Zhang J, Wang W. Mental health-related stigma in China. Issues in Mental Health Nursing. 2018;39(2):126-134.
Arboleda, FJ. Stigmatization and human rights violations. World Health Organization mental health: A call for action by world health ministers Geneva: WHO.2002; p. 57-70.
Goffman, E. (Ed.) Stigma: Notes on the management of spoiled identity. 2009; New York: Simon and Schuster Inc.
Bekiroğlu, S. Ruhsal hastalığa sahip bireylere yönelik damgalama: etkileyen faktörlere ve bireyler üzerindeki etkilerine dair kavramsal bir çalışma. OPUS- Uluslararası Toplum Araştırmaları Dergisi. 2021;17(33):595-618.
Thornicroft, G, Rose, D, & Kassam, A. Discrimination in health care against people with mental illness. International Review of Psychiatry. 2007;19:113–122.
Özmen, S., Erdem, R. Damgalamanın kavramsal çerçevesi. Suleyman Demirel University Journal of Faculty of Economics & Administrative Sciences. 2018;23(1):185-208.
Avcil, C, Bulut, H, Hızlı Sayar, G. Psikiyatrik hastalıklar ve damgalama. Üsküdar Üniversitesi Sosyal Bilimler Dergisi; 2016;2(2):175-202
Ye J, Chen TF, Paul D, McCahon R, Shankar S, Rosen A, O'Reilly CL. Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings. Int J Soc Psychiatry. 2016;62(6):532-41.
Thornicroft, C, Wyllie, A, Thornicroft, G, & Mehta, N. Impact of the “Like Minds, Like Mine” anti-stigma and discrimination campaign in New Zealand on anticipated and experienced discrimination. Australian and New Zealand Journal of Psychiatry. 2014;48(4):360–370.
Brian K. Ahmedani, 2011,Mental Health Stigma: Society. Individuals, and the Profession, J Soc Work Values Ethics. 2011;8(2):4-16.
Sickel AE, Seacat JD, Nabors NA, Mental health stigma: Impact on mental health treatment attitudes and physical health. Journal of Health Psychology 2019;24(5):586–599.
Küçük L. Stigma ve Toplum. Ünsal Barlas G, editör. Toplum Ruh Sağlığı Hemşireliği. 1. Baskı. Ankara: Türkiye Klinikleri. 2018. p.29-33.
Corrigan PW. How stigma interferes with mental health care. American Psychologist. 2004;50(7):614–625.
Gaiha et al. Effectiveness of arts interventions to reduce mental-health-related stigma among youth: a systematic review and meta-analysis, BMC Psychiatry. 2021;21:364
Corrigan, PW, Shapiro, JR. Measuring the impact of programs that challenge the public stigma of mental illness. Clin Psychol Rev. 2010;30(8):907–922.
Evans-Lacko S, Brohan E, Mojtabai R, Thornicroft G. Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med. 2012;42(8):1741-52.
Corrigan PW, Larson JE, Rüsch N. Self-stigma and the why try effect: impact on life goals and evidence-based practices. World Psychiatr. 2009;8:75-81.
Corrigan, PW, Rao, D. On the self-stigma of mental illness: stages, disclosure, and strategies for change. Can J Psychiatry. 2012;57(8):464–469.
Stull, LG, Mcgrew, JH, Salyers, MP. Implicit and explicit stigma of mental illness: attitudes in an evidence-based practice. J Nerv Ment Dis. 2013;201(12):1072–1079.
Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med. 2010;71(12):2150-61.
Brohan, E., Slade, M., Clement, S. et al. Experiences of mental illness stigma, prejudice and discrimination: a review of measures. BMC Health Serv Res; 2010; 10:80.
Świtaj P, Chrostek A, Grygiel P, Wciórka J, Anczewska M. Exploring factors associated with the psychosocial impact of stigma among people with schizophrenia or affective disorders. Community Ment Health J. 2016;52(3):370-8.
Lysaker PH, Davis LW, Warman DM, Strasburger A, Beattie N. Stigma, social function and symptoms in schizophrenia and schizoaffective disorder: associations across 6 months. Psychiatry Res. 2007; 15:149(1-3):89-95.
Zhang TM, Wong IY, Yu YH, Ni SG, He XS, Bacon-Shone J, et al. An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China. Soc Psychiatry Psychiatr Epidemiol. 2019;54(8):911-8.
Koçak Z, Taylan HH. Şizofreni hastalarında içselleştirilmiş damgalanmanın yaşam kalitesi üzerindeki etkisi.Akademik Sosyal Araştırmalar Dergisi. 2018;6(78):621-640.
Schmitt MT, Branscombe NR, Postmes T, Garcia A. The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychol Bull. 2014;140(4):921-48.
Ertugrul, A., Uluğ, B. Perception of stigma among patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2004; 39:73–77.
Hatzenbuehler, M. L., & Link, B. G. Introduction to the special issue on structural stigma and health. Social Science & Medicine. 2014; 103:1–6.
Corrigan, P.W., Druss, B.G. and Perlick, D.A. The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest. 2014;15(2):37-70.
Corrigan, PW, Watson, AC, Gracia, G, Slopen, N, Rasinski, K., Hall, LL., Newspaper stories as measures of structural stigma, Psychiatric Services. 2005;56(5):551-556.
Torrey, E. F., ve Yolken, R. Psychiatric genocide: Nazi attempts to eradicate schizophrenia. Schizophrenia Bulletin. 2010;36(1):26-32.
Link, B. G., Phelan, J. C. Conceptualizing stigma. Annual Review of Sociology. 2001; 27:363–385.
Goffman, E, Damga: Örselenmiş Kimliğin İdare Edilişi Üzerine Notlar, Çeviri, Ş. Geniş- L. Unsaldı-SN. Ağırnaslı; 2014; Ankara, Heretik Yayıncılık.
Sickel AM, Seacat JD, Nabors NA. Mental health stigma update: A review of consequences, Advances in Mental Health. 2014;12(3):202-215,
Kao YC, Lien YJ, Chang HA, Wang SC, Tzeng NS, Loh CH. Evidence for the indirect effects of perceived public stigma on psychosocial outcomes: The mediating role of self-stigma. Psychiatry Res. 2016;30(240):187-195.
Watson AC, Corrigan P, Larson JE, Sells M. Self-stigma in people with mental illness.
Schizophrenia Bulletin. 2007;33(6):1312-8.
Krüger C, Schallreuter KU. Stigmatisation, Avoidance Behaviour and Difficulties in Coping are Common Among Adult Patients with Vitiligo. Acta Derm Venereol. 2015; 95(5):553-8.
Can Öz Y, Ünsal Barlas G. Şizofreni hastalığı olan bireylerin işe yerleştirme ile ilgili görüşleri ve beklentileri: niteliksel bir çalışma. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2017;3(3):28-32.
Covarrubias I, Han M. Mental health stigma about serious mental illness among MSW students: social contact and attitude. Soc Work. 2011;56(4):317-25.
Sandhu, HS, Arora, A, Brasch, J, & Streiner, DL. Mental health stigma: explicit and implicit attitudes of Canadian undergraduate students, medical school students, and psychiatrists. The Canadian Journal of Psychiatry. 2019;64(3):209–217.
Knaak, S, Mantler, E, & Szeto, A. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum. 2017;30(2):111–116.
Weiss M, Ramakrishna J. Health-related stigma: rethinking concepts and interventions. Psychol Health Med. 2006;11(3):277-287.
Çam O, Çuhadar D. Ruhsal hastalığa sahip bireylerde damgalama süreci ve içselleştirilmiş damgalama. Journal of Psychiatric Nursing. 2011;2(3):136-140.
Rao, D, Elshafei, A, Nguyen, M. et al. A systematic review of multi-level stigma interventions: state of the science and future directions. BMC Med, 2019;17:41.
Heijnders M, Van Der Meij S. The fight against stigma: an overview of stigma-reduction strategies and interventions. Psychol Health Med. 2006; 11:353–63.
Thorncroft, G. Toplumun Reddettiği: Ruhsal Hastalığı Olan İnsanlara Karşı Ayrımcılık, Çeviri Editörü: Haldun Soygür, Çvrn: Uluhan, N, Doğan T., Soygür, H., 2014; Şizofreni Dernekleri Fedarasyonu- Mavi At Kafe. Ankara.
Hall PL, Tarrier N. The cognitive-behavioural treatment of low self-esteem in psychotic patients: a pilot study. Behav Res Ther. 2003;41(3):317–32.
Van der Stouwe, ECD, Geraets, CNW, Rutgers, M. et al. Cognitive behavioral group treatment for low self-esteem in psychosis: a proof of concept study. BMC Psychiatry. 2021; 21:567.
Hartog K, Hubbard CD, Krouwer AF, Thornicroft G, Kohrt BA, Jordans MJD. Stigma reduction interventions for children and adolescents in low- and middle-income countries: Systematic review of intervention strategies. Soc Sci Med. 2020; 246:112749.
Kocabaşoğlu N. ve Aliustaoğlu S. Bir kavram olarak stigmatizasyon. Yeni Symposium. 2003;41(4):190-192.
Can Öz, Y. Şizofreni hastalığı olan bireyleri işe yerleştirme ile ilgili görüşler ve beklentiler: Hasta, Ailesi ve İşverenler (Doktora Tezi), Marmara Üniversitesi, Sağlık Bilimleri Enstitüsü ,2016, İstanbul, Türkiye.
Xu X, Li XM, Zhang J, Wang W. Mental health-related stigma in China. Issues in Mental Health Nursing. 2018;39(2):126-134.
Pages
161-188
Published
April 3, 2023
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1.
Can Öz Y. Damgalama (Stigma) ve Ruh Sağlığı. In: Ünsal G, Avcı D, Duran S, editors. Toplum Ruh Sağlığı Hemşireliği [Internet]. Türkiye: Academician Publishing Book DOI Portal; 2023 [cited 2026 Jul. 16]. pp. 161-88. Available from: https://omp35.books.akademisyen.net/index.php/akya/catalog/book/2510/chapter/12838
