The other side of the fence: Iatrogenic stigma.

“A professional colleague of mine recently wrote to me following a difficult experience: “I guess if we are to tackle stigma in mental health, we need to start closer to home in our colleagues”.  It is now a decade since the debate above took place and one is left wondering where we are now given campaigns to tackle stigma such as ‘Changing Minds,’ ‘See Me’ and ‘Time to Change’. Is the story of the last ten years a tale of ‘benign professional progress?’ Has our profession led us out into the light and free of the dark stain of stigma? Has the biological and genetic paradigm as the prevailing explanation of mental illness helped in this? Do we really have meaningful engagement with users, sufferers, patients, and carers? And if we start closer to home as my colleague suggested, are we more like Sartorius thought, guilty of iatrogenic stigma or more like Dr Smith suggested, unlikely to misuse diagnosis and stigmatise others?” Peter J Gordon

Hole Ousia

This is an Editorial that I submitted to the British Journal of Psychiatry. It was rejected for the following reasons:

MS ID#: BJP/2012/115832

The strengths of this paper are:

  • It discusses an important set of issues ie how far psychiatric staff themselves contribute towards stigma

The limitations of the paper are:

  • It takes a rather anecdotal approach eg a colleague of mine recently wrote etc
  • The paper does not seek to examine the evidence that stigma more generally, or more specifically within the psychiatric profession, are getting better or worse
  • The paper tends to go over old ground somewhat eg in rehearsing definitions of stigma
  • The literature review is rather patchy ie citing the Angermeyer review on biological causal explanations of mental illness but not the recent Schomerus paper
  • The discussion is rather wide ranging eg referring to ‘herd instinct’ and Kierkergaard etc
  • There is a fairly substantial literature on mental…

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