Intimate partner violence survivors' reported experiences of discrimination in mental health treatment settings.

Research indicates that survivors of intimate partner violence (IPV) face substantial stigma and discrimination, with varying impacts based on demographic factors such as race and income. This study explored perceived discrimination among 88 IPV survivors across different racial backgrounds and income levels in mental health settings. Participants completed a mixed-method electronic survey assessing discrimination experiences related to survivor status, income, and race within mental health treatment. Results revealed high levels of perceived discrimination based on survivor status among both racially minoritized and majoritized survivors. However, racially minoritized survivors reported greater racial discrimination and associated stress within mental healthcare settings. Regardless of income level, all survivors reported significant discrimination experiences. Qualitative analysis highlighted factors perceived as helpful or unhelpful within mental health settings. This study underscores the need for further research on socioeconomic influences on stigma experiences among IPV survivors and suggests implications for provider training to better support survivors, especially those from diverse racial backgrounds.

Prosumers' experiences of witnessed discrimination and internalized stigma: A moderated mediation.

Discrimination toward individuals with lived experiences of mental illness is widespread within the field of clinical psychology. Further, there is some presence of clinical psychologists who are both consumers and providers of mental health services, termed prosumers. However, no research has evaluated how witnessing discrimination as part of professional activities may influence prosumers' experiences with internalized stigma, anticipated stigma, and stigma resistance. This exploratory study aimed to establish associations and interactions between having witnessed discrimination toward others with lived experiences of mental illness and internalized stigma, anticipated stigma, and stigma resistance from the perspective of prosumers within the clinical psychology field. A cross-sectional quantitative approach was employed to understand these dynamics by utilizing descriptive, correlational, and multivariate regressions analysis. A total 175 prosumers (39 graduated doctoral-level clinical psychologists and 136 in training) completed survey measures pertaining to witnessed discrimination, internalized and anticipated stigma, and stigma resistance. Prosumers reported witnessing frequent subtle and overt discrimination by their colleagues, supervisors, and faculty members. Overt discrimination was reported as witnessed more frequently compared with subtle discrimination experiences or microaggressions. Our findings have implications for the prevalence of witnessed discrimination and how these may create cumulative experiences of stigma and stigma resistance among prosumers in clinical psychology. Further research should explore additional understanding of how clinical psychologists, including prosumers, may hold stigmatizing attitudes and perpetuate discrimination toward individuals with lived experiences of mental illness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prosumers' experiences of stigma dimensions within the clinical psychology field.

Lived experiences of mental illness and stigmatizing attitudes toward psychiatric diagnoses are common throughout the world. Research demonstrates that clinical psychologists are not exempt from having lived experiences of mental illness, nor experiencing, witnessing and perpetuating stigma. However, no research has examined prosumers' (providers and consumers of mental health services) experiences of witnessing discrimination within the field of clinical psychology. The purpose of this study was to explore prosumer's experiences of stigma within clinical psychology. A total of 175 doctoral level prosumers (graduated N = 39 and N = 136 in-training) completed a mixed-method online survey regarding their stigma experiences within the field. Emergent qualitative themes from grounded theory analyses included: witnessed discrimination (invalidation, over pathologizing, clinical psychologists as experts and training as a breeding ground for stigma, psychological distress, negative feelings related to field), anticipated stigma (agency and identity rejected, degree of acceptance), internalized stigma (perceived competence and social desirability), and stigma resistance (academia in action, engaging communities, comes with a risk, worthwhile). Our findings have implications for the role of clinical psychology in perpetuating stigmatizing views and attitudes toward individuals with lived experiences of mental illness, specifically in-training and academic settings. Further research should strive to evaluate how clinical psychologists, including prosumers, engage in stigma, and the associations between discrimination and other stigma dimensions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reliability of the Term "Serious Mental Illness": A Systematic Review.

OBJECTIVE: The term "serious mental illness" (SMI) is widely used across research, practice, and policy settings. However, there is no consistent operational definition, and its reliability has not been systematically evaluated. The purpose of this review was to provide a comprehensive qualitative content analysis of "SMI" empirical research, including study and sample characteristics and SMI operational definitions. These data can provide important considerations for how stakeholders conceptualize SMI. METHODS: Systematic review of PsycInfo, PsycArticles, and PubMed databases from January 1, 2015, to December 31, 2019, identified 788 original empirical studies that characterized the sample as having "SMI." RESULTS: Descriptive content analysis indicated that most studies (85%) provided no operational definition for SMI. Only 15% defined the term, and an additional 26% provided examples of SMI that included only psychiatric diagnostic categories (e.g., SMI, such as schizophrenia). Of the 327 studies that provided any description of SMI, variability was noted regarding whether criteria included any mental health diagnosis (N=31) or only specified diagnoses (N=289), functional impairment (N=73), or any specified duration of symptoms (N=39). Across all studies that characterized samples as having SMI, substantial variability was noted regarding included diagnostic classifications. CONCLUSIONS: Referencing "SMI" is second nature for many stakeholders. Findings suggest that evidence-based practice and policy efforts should weigh the level of research support indicating that the construct and the term "SMI" lacks generalizability. Researchers and stakeholders are encouraged to develop precise and agreed-upon diagnostic language in their efforts to support and advocate for people with mental illnesses.

Variation in provider attitudes and treatment recommendations for individuals with schizophrenia and additional marginalized identities: A mixed-method study.

Objective: This study evaluated correlates of mental health stigma among treatment providers, including whether provider attitudes, conceptualizations, and treatment recommendations regarding serious mental illness (SMI) may differ depending on client demographic characteristics. Methods: A total of 246 providers (medical students, psychology trainees, and licensed clinical psychologists) and 98 community members completed an online survey including measures of mental illness stigma and questions regarding a vignette of a person presenting to an emergency department (ER) with primary complaints of pain and a historical schizophrenia diagnosis. The vignette demographics were randomly varied using 2 × 2 × 2 factorial design including race (Black/White), housing status (housed/homeless), and criminal justice history (arrest/no arrest). Results: Providers endorsed mental health stigma at varying levels compared with the community sample, with medical students demonstrating the highest stigma. Prior experience working with psychiatric populations was associated with lower stigma. Providers were more likely to conceptualize homeless ER presentations as potentially due to a lack of resources or substance dependence and were less likely to conceptualize ER presentations with arrest histories as pain related. Homeless vignettes were more likely to be referred for social services and vignettes with arrest histories were less likely to be referred for follow-up pain services. Conclusions and Implications for Practice: Findings suggest that individuals with SMI and additional marginalized identities likely experience exacerbated stigma within treatment settings, and this may also influence treatment decision-making. There is a need to consider intersectionality in future research and interventions for decreasing mental health stigma in healthcare settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).