Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings

Int J Soc Psychiatry. 2016 Sep;62(6):532-41. doi: 10.1177/0020764016651459. Epub 2016 Jun 21.


Aims: To describe the perceived experiences of stigma and discrimination among people living with severe and persistent mental illness in assertive community treatment (ACT teams) settings in New South Wales (NSW), Australia.

Methods: The Discrimination and Stigma Scale (DISC) was used in this cross-sectional study with people living with severe and persistent mental illness. The DISC is a reliable and valid, quantitative and qualitative instrument used to explore and measure levels of negative, anticipated and positive discrimination. Relevant clinical history and socio-demographic information were also collected.

Results: A total of 50 clients participated, with 40 (80%) reporting experienced negative discrimination in at least one life area. Negative discrimination was most commonly experienced in being avoided or shunned (n=25, 50%), by neighbours (n=24, 48%) and family (n=23, 46%). Anticipated discrimination was common, with half of participants (n=25, 50%) feeling the need to conceal their mental health diagnosis.

Conclusion: Discrimination was highly prevalent in everyday aspects of life. While healthcare professionals often tend to increase perceived stigma and discrimination, this was only experienced in interactions with general health professionals, while interactions with ACT team members decreased perceived stigma and increased positive discrimination. This indicates that healthcare professionals potentially have a significant role in reducing stigma and discrimination in mental health and that such an effect may be optimised in an ACT team setting.

Keywords: Schizophrenia; discrimination; healthcare professionals; mental disorders; mental health services; social stigma.

MeSH terms

  • Adult
  • Community Mental Health Services*
  • Cross-Sectional Studies
  • Female
  • Health Personnel
  • Humans
  • Interviews as Topic
  • Male
  • Mental Disorders / psychology*
  • Mental Disorders / therapy
  • Mental Health*
  • Middle Aged
  • New South Wales
  • Social Discrimination / statistics & numerical data*
  • Social Stigma*