RESUMEN

Mental health, historically framed as the mere absence of mental health disorders, has led to unequal treatment, resulting in more persons living with mental health challenges. This limited framing of mental health, often woven into policy and practices across a broad range of governance structures, programs, and services, has led to individual and collective discrimination and structural and systemic inequities, culminating in the infringement of fundamental human rights. Using a broader framework for viewing mental health (e.g., mental health as a continuum), the authors of this article propose that a right to mental health should form the basis of mental health policy. The article also considers the impact of stigma and discrimination and the implications of social determinants of health in forwarding a rights-based approach to mental health policy. The authors conduct a trends analysis of 80 years of United States' mental health policy and reflect on how social determinants and efforts to reduce stigma and discrimination have led to measurable progress toward achieving mental health equity. The Call-to-Action highlights opportunities to further support mental health and wellness through the use of interdisciplinary policy and practice recommendations that include the framing of mental health as a human right. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Asunto(s)

Política de Salud , Derechos Humanos , Salud Mental , Estigma Social , Humanos , Estados Unidos , Determinantes Sociales de la Salud , Historia del Siglo XX , Trastornos Mentales/terapia , Historia del Siglo XXI , Servicios de Salud Mental/organización & administración , Servicios de Salud Mental/legislación & jurisprudencia

RESUMEN

Background: Efforts to understand the mechanisms and consequences of mental health-related stigma and discrimination need to center the perspectives of people affected by these negative impacts, through research efforts that are led or co-led by people with lived experience (PWLE) of mental health conditions. Methods: This study used co-production principles to explore global perspectives of stigma and discrimination among people meeting the inclusion criteria of identifying as PWLEs and being willing to share their experiences of stigma and discrimination resulting from a diagnosis of a mental health condition, and who had also participated in anti-stigma activities. Participants were recruited online via a self-selecting snowball sampling method. Qualitative data were collected from respondents via an anonymous global online survey conducted between 12/01/2021 and 02/28/2022. The main outcomes assessed were open-ended, qualitative responses to questions exploring experiences of stigma and discrimination, experiences regarding diagnoses, language/terminology related to mental health, impact of stigma and discrimination, and involvement with anti-stigma interventions. Data were synthesised through digital text network analysis and thematic content analysis. Findings: A total of 198 respondents from over 30 countries across Europe, the Americas, Africa, Asia, and Australia/Oceania were included in the study. The results reflected five themes: 1) the role of language and words; 2) the role of media in perpetuating and reducing stigma; 3) societal reactions to mental health conditions and strategies to cope with these; 4) knowledge about activities to reduce stigma and discrimination and their impact; and 5) personal involvement in activities to reduce stigma and discrimination. Interpretation: The findings highlight that people with mental health conditions are aware of and experience stigma and discrimination across core domains of daily life. The importance of recognising the key role PWLEs can play in efforts to reduce stigma and discrimination was highlighted, and how they can be appropriately supported to contribute and have their experiential expertise recognised. Meaningful and authentic collaborations between PWLEs and other stakeholders can enhance the quality and relevance of strategies to reduce stigma and discrimination. This is, to our knowledge, the first study of its kind to use a co-production approach to explore experiences and reflections of stigma and discrimination related to mental health from a global perspective. However, the results are not broadly representative of the general PWLE population or suggestive of globally uniform experiences of stigma and discrimination. Funding: None.