Stigma of mental illnesses: from vector to pathogenicity

Abstract

Dear editors and readers of the journal Debates em Psiquiatria

The growing movement to raise awareness of the stigma of mental illnesses in recent years is notable. In particular, the campaign by the Brazilian Psychiatric Association (ABP) stands out, orchestrated and coordinated by psychiatrist Antônio Geraldo da Silva, since 2014, entitled Psychophobia, a neologism created by the coordinator to represent the stigma of mental illnesses. Fortunately, the action has been gaining attention and space on social networks, the media, in meetings between health professionals and, mainly, among people who are directly affected by prejudice. In etymology, stigma derives from the Greek "stigma" and the Latin "stigma", both representing mark or sign. While the word “prejudice” derives from the union of the prefix “pre”, meaning anteriority, and “concept”; therefore, it refers to a value judgment or opinion constructed without adequate evaluation and understanding of information and definitions. In this way, by recognizing psychophobia as a problem, there is a healthy opening to talk and hear about the challenges experienced in the course of mental illness. However, information, guidance and discussions regarding psychiatry are growing, from psychopathology to treatments. From these movements, in a similar way, it is possible to reach the vectors that carry prejudice against mental illnesses through awareness and, therefore, slow down the pathogenicity of psychophobia. Mental illnesses are commonly perceived through preconceived cultural distortions and stereotypes, arising in most people from a lack of understanding of the process of mental illness. However, we were surprised when we consulted the scientific literature, and came across studies that highlight these stigmas, also in health professionals themselves, including mental health professionals. The literature review by Henderson et al. describes this situation by pointing out the difference found in health professionals' care for mental illnesses compared to physical illnesses, highlighting discriminatory, avoidant attitudes and devaluation of physical complaints in patients with a diagnosis of mental disorder. According to the review presented in the article Corrigan and collaborators, there is an association between the stigma of mental illnesses and a worse prognosis in their evolution. The impact of stigma results in less search for professional help, delay in diagnosis, impaired adherence or abandonment of treatment, decreased opportunities throughout life and self-esteem, and increased social isolation. The literature also points to a deficiency in the training of future health professionals with regard to awareness and the consequences of prejudices regarding mental illnesses. Reinforcing the importance of expanding discussions on this topic in academic circles. During medical graduation, a qualitative study observed reports of the impact of psychophobia on the inter and intrapersonal relationships of students with mental disorders, such as exclusion from academia, efforts to hide the illness, the weight of self-stigmatization and the losses caused by the lack of support. and resources for the adequate inclusion of this topic, whether in family, colleagues and even at the university. Given this context and movements to raise awareness of the negative repercussions of psychophobia, we would like to contribute to the expansion of this topic of such relevance in society in environments observed in the literature survey carried out and mentioned throughout the text, especially health services and academic environments, as well as stimulating new scientific research, projects and resources seeking to understand and promote advances so that stigmas are just memories of a past that will never return.