Stigma toward the mentally ill in the general hospital: a qualitative study

Background: Stigma associated with mental illness is frequently reported in the community but there is little published information about stigma within general hospitals. Objectives: The objective of this study was to describe the experience of stigma in patients and health professionals using a Liaison Psychiatry service in a general hospital. Design: We used a grounded theory qualitative method to analyze audiotaped interviews of participants. Setting: A general hospital in Auckland, New Zealand. Subjects: Ten participants, five patients and five referrers. Measurements: The qualitative method generated various categories that made up the construct of "stigma" in the general hospital. Results: A central category of "Relating Mind to Matter" was developed and linked to the major categories of "It's a Scary Business," "It's All Hopeless," "She's One of Them," "Expressions of Relatedness," "You are Not Genuinely III" and "Playing by the Roles." Conclusion: The presence, or suspicion, of a mental illness in a patient has a negative impact in the general hospital setting. The key experiences are silence, disbelief and invalidation. The category title "Relating Mind to Matter" refers to the tensions in the patient health professional relationship and to the uncomfortable relationship between the mind and the body. (c) 2005 Elsevier Inc. All rights reserved.