RESEARCH WEEKLY: Experiences of Stigma Among Latinx Individuals at High-Risk for Psychosis
By Morré Taylor
(June 8, 2022) Clinical high-risk for psychosis (CHR) is a highly stigmatized label in part because of the negative cultural stereotypes about severe mental illness. Stigma and negative stereotypes about this particular diagnostic label tend to be highly anticipated and internalized by CHR patients, which can make them reluctant to seek help and increase their engagement in negative coping strategies that worsen illness outcomes. For example, in an effort to avoid anticipated negative stigma, CHR patients may engage in maladaptive coping strategies, such as social isolation, which can be detrimental to one’s overall well-being. However, adopting positive coping strategies can improve illness course and encourage treatment engagement.
A 2022 study from Early Interventions in Psychiatry suggests that experiences with stigma and subsequent coping strategies are influenced by cultural factors and contribute to the development of psychosis in racial minorities. To explore this hypothesis, the authors of this study examined psychosis stigma among Latinx CHR patients. The authors cite several previous studies that found that Latinx adults are three times more likely to be diagnosed with a psychiatric disorder compared to their white counterparts, yet Latinx individuals report having lower mental health literacy and lower use of behavioral health services. Latinx individuals also face higher rates of discrimination compared to their white counterparts, which may reduce treatment engagement among this population and can increase the risk of transitioning to syndromal psychosis.
Study details
The authors of this study investigated the stigma experiences and related coping strategies of Latinx individuals who are at clinical high-risk for psychosis. Twenty-six participants (15 who self-identified as Latinx and 11 who self-identified as non-Latinx whites) between the ages of 18 and 27 were recruited from the Center of Prevention and Evaluation at New York State Psychiatric Institute at the Columbia University Irving Medical Center. To be considered eligible for the study, participants had to possess at least one of three psychosis risk syndromes. Semi-structured interviews were conducted with eligible participants between January and October of 2014. These interviews were coded for stigma, discrimination and coping responses.
Results
Consistent with pre-existing literature, this study found that both Latinx and non-Latinx whites frequently reported internalizing negative stereotypes about mental illness, however, this internalization appeared to be more prevalent among non-Latinx white participants. The authors of this study suggest that this could be a result of this demographic’s greater exposure to mental illness compared to Latinx families who tend to avoid discussing mental illness altogether. Anticipated rejection due to mental health status and experiences of discrimination, however, were more common among Latinx participants than non-Latinx white participants.
With respect to coping responses, there was greater variation in coping responses among Latinx participants. Non-Latinx white participants most often engaged in covering— a type of coping response that involves disguising one’s treatment as something unrelated to mental health. Meanwhile, Latinx participants engaged in higher rates of both empowerment and secrecy, referring to the concealment of symptoms and treatment history from family and friends. The high prevalence of secrecy among Latinx individuals at clinical high-risk for psychosis could be the result of internalized and anticipated negative stereotypes about psychosis, according to the authors. However, once one’s mental health status was disclosed to friends and family, participants were more likely to employ strategies of empowerment, such as educating loved ones about mental illness in the hopes of reducing negative stigma.
Implications
These findings prompted the authors of this study to recommend that minority CHR patients who struggle with stigma, discrimination and secrecy surrounding their mental health status should participate in interventions that target disclosure. Such interventions have the potential to reduce self-stigma, foster social support, empower CHR patients, and facilitate access to care. As demonstrated by this study’s findings, the capacity to utilize empowering coping strategies following the disclosure of one’s mental health status can promote community solidarity and self-advocacy.
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