The Relationship Between Stigmatization and Psychological Wellbeing of Relative of Mentally Ill Person

The Relationship Between Stigmatization and Psychological Wellbeing of Relative of Mentally Ill Person

Chapter One

  Objectives of the Study

In specific terms, the objectives of the study are to:

1. Investigate the relationship between stigmatization and social adjustments of mentally ill people in Kaduna State, Nigeria.
2. Find out the relationship between stigmatization and psychological wellbeing of mentally ill people in Kaduna State, Nigeria.
3. Investigate the impact of stigmatization on social adjustments of mentally ill people in Kaduna State, Nigeria.

CHAPTER TWO

REVIEW OF RELATED LITERATURE

Roots of concept

Stigma

The term stigma is derived from the Greek word ‘sigma’ referring ‘to bodily signs designed to expose something unusual and bad about the moral status of the signifier’ (Goffman 1963, p. 1). In the early Christian era, stigma referred to an ‘eruptive blossom on the skin’ and ‘… bodily signs of social disorder’ (Goffman 1963, p. 1). This description of stigma indicates that it is something that marks a person as different. According to Stuart (2008), in the late 16th and early 17th centuries, the phrase stigma was used to express ‘a mark of shame or degradation’ (p. 185). The term stigma has been used as branding on criminals, traitors and slaves for identification (Goffman 1963). As a result, the term stigma has a very negative connotation. The term stigma or stigmata also refers to the five wounds Christ experienced during crucifixion that are visible on a person’s body. Interestingly, a person with stigmata in the Christian faith is viewed as being spiritually blessed and an example of holiness for others or set apart. In more recent times, a person with stigmata may be viewed as mentally ill. Goffman (1963) defined the concept of stigma as ‘an attribute that is deeply discrediting, but should be seen that a language of relationships, not attributes, is really needed’ (p. 3). Goffman (1963) in his work described the severe consequences of being stigmatized and emphasized that human relationships play an important role in developing and allowing stigma to occur. According to Pinto-Foltz & Logsdon (2008), the term stigma re-emerged in the 1990s in psychology, especially related to mental illness (p. 23). Garry (2005) defined stigma as ‘referring to a collection of negative attitudes, beliefs, thoughts and behaviours that influences the individual, or the general public, to fear, reject, avoid, be prejudiced and discriminate against people with mental disorders’ (p. 980). Fearing that they may be labelled as having a mental illness, many people will accept those negative stigmatizing attributes as truth and are afraid of seeking help. According to Corrigan (2004), the concept of stigma is twofold. Stigma is manifested in the social world of the individual, which devalues and ridicules persons with mental illness and in the private world of the person where negative public beliefs become internalized. Public stigma portrays stigmatized groups as incompetent and attributes to these groups a range of negative stereotypes, such as that they may be violent or behave inappropriately (Corrigan 2004; Knifton 2012). According to Pinto-Foltz & Logsdon (2008), people are afraid of being diagnosed with mental illness and of being stigmatized, and may not want to seek treatment due to concerns of being labelled. Self-stigma can hinder the way individuals see themselves, their quality of life and often decreases their self-esteem (Corrigan 2004). Link & Phelan (2001) proposed that stigma includes four interrelated components. The first component is the labelling of differences; highlighting people’s differences can be socially relevant. The second component is stereotyping the person with negative characteristics. The third component is separating ‘us’ from ‘them’. And the fourth component is that people experience status loss and discrimination, leading to a decrease in self-esteem (Link & Phelan 2001).

 Stigma of mental illness

‘A mental illness is a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others… and daily functioning’ (National Alliance on Mental Illness 2014). The concept of stigma must be addressed if we want to improve mental health care. People with mental illnesses are stigmatized by the public, socially deprived of employment and have less access to support (Knifton 2012). PintoFoltz & Logsdon (2008) defined stigma as ‘when an individual accepts and consequently embodies the negative attributes based on societal norms and the perceived evaluation of others. As a result of this self-identification, individuals are subject to prejudice, discrimination, and discredit from others’ (p. 24). By internalizing these negative attributes, persons with mental illnesses may develop low self-esteem. They may also develop secretive behaviours towards their illness, preferring to hide symptoms and their need for assistance out of fear of scorn and rejection. Stigma of mental illness can cause people who are sick to deny symptoms, delay treatment, have difficulty developing relationships, and experience difficulties getting employment and housing (Weiss et al. 2006). Stigma towards mental illness has many health consequences and creates undue suffering. ‘Stigma of mental illness may also impair achievement of personal aspiration; therefore, evidence-based practices need to be examined in terms of their effect on stigma’ (Corrigan & Wassel 2008, p. 48). Nursing interventions to decrease the stigma towards mental illness will help to build a more sympathetic community.

Nigerians and mental illness

According to Desrosiers & St. Fleurose (2002), mental health in the Nigerian population is seen in two different facets. The first is as a supernatural occurrence or a natural problem. What a person does to get help will depend on how he or she interprets the illness. Persons who believe it is a supernatural force will try to get help through the Voodoo gods. If they are Christian, they will seek help from God by praying. Secondly, people are considered victims of powerful forces with shame attached to the disease. ‘The shame is not attached to the illness per se but to the decline in the level of functioning that comes with it’ (Desrosiers & St. Fleurose 2002; p. 514). Families are ashamed and do not want people to know that a member of the family is mentally ill. When a Haitian person cannot function normally, has suffered many psychotic episodes, cannot work or reach education or career goals, he or she may be labelled ‘fou’ (crazy) (Desrosiers & St. Fleurose 2002).

Defining attributes

Defining attributes are characteristics that help explain a concept. According to Avant and Walker & Avant (2011), defining attributes are viewed as the ‘heart of the concept analysis’ (p. 162). The attributes of the stigma of mental illness are labelling, stereotypes, negative attitudes, emotional responses and discrimination.

 Labelling

Labelling can be either positive or negative. A person may have a positive label such as being intelligent, humorous, compassionate and so on. Conversely, when thinking of mental illness, persons may have negative labels attached to them, such as being ‘crazy’, ‘wacko’, ‘a few cents short of a dollar’ etc. (Link & Phelan 2001). Therefore, when we label people as having a mental illness, that label is the process through which they are stigmatized (McLoughlin 2013). These negative labels act to dehumanize the person.

Stereotype

A stereotype is ‘a fixed, over generalized belief about a particular group or class of people’ (Cardwell 1996, p. 234). There are many stereotypes about mental illness. Persons with mental illness are stereotyped as ‘raving lunatics’, incapable of being able to function in society, and as dangerous. As Zartaloudi & Madianos (2010) have stated, ‘all people with a diagnosed mental illness can be considered a stereotype’ (p. 78). A person with mental illness is bombarded with these stereotypes; they are heard in conversation, and depicted on the television screen and in literature. Persons with mental illnesses may fear being stereotyped and will therefore avoid revealing their condition and seeking much needed help (Link et al. 2004). Corrigan & Wassel (2008) addressed the cultural aspects of stereotyping. Stereotypes are often learned in the family and cultural group to which one belongs. Therefore, teaching people how not to stereotype is an important aspect of our nursing responsibility.

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CHAPTER THREE

METHODOLOGY

Research Design

This research adopted correlation design. It is a non- experimental design used to describe relationship between or among variables. A correlation research study is an opportunity to foretell results and explain the relationship among variables (Waters, 2011). In a correlation research, no attempt is made to control or manipulate the variables as in experimental design; however, the correlation statistic is used to describe and measure the degree of relationship between two or more variables or sets of scores (Davis, Gamble, Humphries, Mitchell, and Pendergrass,2011). Quantitative correlation study was appropriate because it involved the collection of data to determine whether, and to what degree, a relationship existed between two or more quantifiable variables (Gay, 1992).

Population of the Study   

The population for this research is made up of all SS3 students in the six selected secondary schools in Kaduna State. The population was 8002 as obtained from Kaduna State Ministry of Education (School Census Report 2012/2013). Below is the population distribution of the six schools selected for this study:

Table 3.1 Distribution of Population of Students in six selected Public Schools in

CHAPTER FOUR

RESULTS AND DISCUSSIONS

Results

 Bio Data of Respondents (Subjects)

The bio-data of subjects by location and the nature of stigmatize are presented in

Tables 4.1 and 4.2 respectively. 

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATIONS

  Summary

This study was structured into five chapters in order to effectively carry out this research work. Chapter one presented the background and purpose and objectives of the study, the statement of the problem, six research questions, six hypotheses, basic assumptionsas well as the scope and limitations of the study. The study is significant as it will provide Kaduna state government and NGOs with adequate information on experts‟ views on how to curb the menace of social and psychological forms of stigmatize among mentally ill people and provide quality service delivery to the socially and psychologically stigmatized students for better wellbeing and social adjustment. Chapter Two presented literatures related to this study under the conceptual framework, theories of stigmatization, stigmatizations as they affect wellbeing and social adjustment of students.

In Chapter Three, the research methodology adopted was discussed. The target population for this research consisted of 21,469 Primary Five students of public schools in Kaduna State. Six schools were selected and 377 stigmatized respondents were used. Three (3) instruments, namely stigmatized questionnaire, stigmatization questionnaire and social adjustment questionnaire were used for the study. Students‟ examination results in English, Mathematics, Social Studies and Computer Science were derived from their third term examination results. Content and face validity of the instruments were assessed by lecturers in the Department of Educational Psychology and Counselling in Ahmadu Bello University Zaria and corrections were made. The researcher proceeded to conduct a pilot study to test the reliability of the instrument using Cronbach alpha coefficient statistical technique. Procedures for data collection were administered and the data collected were analyzed using Statistical

Packages for Social Sciences (SPSS version19) in which Pearson Moment Correlation (PPMR) was used to analyse hypotheses One(1) to Four (4) and T- test was used to analyse hypotheses Five (5) and six (6). The number of students who had experienced different types of stigmatize was expressed in percentages andthe P value enabled the researcher to reject or retain the formulated hypotheses. The interpretation of the significant value calculated by SPSS was done by comparing the value with alpha level (0.05) at which each of the hypothesis was tested.

The analysis, presentation and discussion of the result were carried out in chapter four. The SPSS version 20 statistical package was used to carry out the entire data analysis. It was discovered that stigmatized had significant negative association with social adjustments and wellbeing of mentally ill people in Kaduna State.It was revealed that stigmatization had significant negative relationship with social adjustment and wellbeing of mentally ill people in Kaduna State. The result also showed that psychologically stigmatized students had lower social adjustment and poor wellbeing than their stigmatized counterparts. Finally, Chapter five presented the summary, conclusion and recommendations of the entire study.

Contributions to Knowledge

The study established that:

1. Significant relationship existed between social and social adjustment of stigmatized students ( P = 0.001),
2. Significant relationship existed between stigmatization and wellbeing of stigmatized students ( P = 0.001),
3. Significant relationship existed between stigmatization and social adjustment of stigmatized students ( P = 0.001),
4. Significant relationship existed between stigmatization and wellbeing of stigmatized students ( P = 0.028).
5. Significant difference existed between socially and psychologically stigmatized students on the social adjustment ( P = 0.004) and also
6. Significant differences existed between socially and psychologically stigmatized students in the wellbeing ( P = 0027)

 Conclusions  

Based on the above findings, the researcher concluded that social and psychological forms of stigmatize have negative association with low social adjustment and poor wellbeing among students,especially those attending public primary schools. In addition, the psychologically stigmatized students are discovered to have lower social adjustment Recommendations

Based on the outcome of the study, the researcher recommended that:

1. Psychologists, counselors, teachers and parents should be sensitized through workshops on how to prevent low social adjustment among stigmatized students and to develop maladaptive coping strategies and techniques to remedy the menace that showed as stigmatization increases, the social adjustment of students decreases.
2. Psychologists, counselors, teachers and parents should give proper educational support and counselling supervision to stigmatized students. They should be made to understand that as stigmatized increases students wellbeing decreases and vice versa. This can be achieved by increase in funding of educational inspectorate departments.
3. Psychologists, counselors and teachers should be given special allowance to provide psychological support services and conducive learning environment to psychologically stigmatized students. They should be made to understand that increase in stigmatization leads to decrease in the social adjustment of students.
4. Psychologists, counselors, teachers and parents should provide academic and social skills enhancement training in schools for psychologically stigmatized students. They should understand that when stigmatization increases, the wellbeing of students decreases.
5. Significant difference existed between social adjustment of stigmatized students with mean difference of 1.98. The stigmatized have better social adjustment.
6. Significant difference existed between wellbeing of stigmatized students with mean difference of 0.60. The stigmatized performed better.

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