Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Oudshoorn, Abram

Abstract

Familial mental illness stigma is stigma held by family members towards a loved one living with mental illnesses. There are few empirical studies on familial mental illness stigma, especially compared to studies on other, more public forms of stigma. This dissertation follows an interpretive phenomenological methodology with thematic analysis to understand familial mental illness stigma from the perspectives of both family members and persons with mental illnesses, including ways to reduce this stigma. Thirty interviews were conducted, including 15 persons diagnosed with mental illnesses and 15 family members, all within a mid-sized city in Ontario, Canada. From the perspective of those living with a mental illness, the following themes were developed: (1) diagnosis as a ‘double-edged sword; (2) potential familial isolation; (3) familial stigma as societal stigma localized; (4) stories of acceptance; and (5) confronting potential familial mental illness stigma. From the perspective of family members, the following themes were developed: (1) layered perspectives of social and familial stigma; (2) family-related stigma; (3) complex interplay of family relationships and mental illness; (4) confronting stigma personally; and (5) envisioning a better future. The analysis of empirical literature on familial mental illness stigma in high-income countries produced additional six interconnected themes: (1) enactment of familial stigma; (2) familial struggles; (3) coping with familial stigma; (4) negative social consequences; (5) psychosocial impacts; and (6) meta-theme: unspoken stigma. Participants noted that familial mental illness stigma is embedded within the broader social stigma towards mental illness, which then is lived out in family relations. Stigma can be enacted in discriminatory ways such as exclusion, relationship breakdown, and alienation from family decision-making. Where familial mental illness stigma exists, it can impede mental health recovery, while supportive environments that actively confront or prevent stigma were of benefit to participants. That is, participants looked beyond the individual level and because familial mental illness stigma is often just a form of broader mental illness stigma, suggested efforts to confront mental illness stigma broadly. Finally, participants observed that insufficient services for those living with mental illnesses exacerbate the problem by impeding adequate treatment of their conditions. Future research should continue to build the evidence-base to prevent stigma at both the individual and societal levels.

Summary for Lay Audience

Stigma involves unfair negative beliefs about a person or group of people. Mental illness stigma is a known challenge, and this includes stigma within families. Familial mental illness stigma is rarely discussed compared to other more public forms of stigma. Unfortunately, when people with mental illnesses experience stigma from their family members, this can get in the way of their mental health and prolong their recovery. This study explored the experiences of familial mental illness stigma from both the perspective of family members and people living with mental illnesses. We interviewed 15 people from each group to understand their experiences of stigma and what we can do about it. Participants’ stories indicate that familial mental illness stigma does occur in some families. This can have negative impacts in terms of how individuals might be excluded from the family or lose relationships. On the other hand, many participants also shared positive experiences with their families who helped with their care and helped them feel respected. Overall, all participants felt we need to be doing a better job to reduce mental illness stigma that still exists.

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