The burden of disease
The stigma of mental disease is an experience, which the affected person shares with his/her environment, especially with the family.
This experience is associated not only with the loss of social status, exclusion from many areas in life, higher dependence on other people and institutions but also with a crisis of ties and trust, which also is present in the family.
Based on the information, collected from patients, members of their families and professionals, employed in psychiatric care institutions, and concerning the subjective feeling of discrimination, the following four areas of stigmatisation have been identified:
- interpersonal relations,
- structural discrimination,
- the picture of mental disease in society,
- the access to social roles.
Each of the above-mentioned areas finds new clarification in the context of the problem with occupational activity and employment, being one of the key aspects in the issue of inclusion of the persons after mental crisis. The stigma of mental disease may also be very sharply felt by the patient's family. It should be emphasised that, in many cases, the burden of care over a chronically ill, adult son or daughter falls on the parents, especially on the mother. It is the mother who bears the burden of her child's disease and suffers of the "transferred stigma".
The higher is the sense of the burden, associated with the disease, the more negative is the attitude towards therapy and bigger problems in therapeutic contacts, less frequent use of medical services and a higher risk of disease relapse.