Background: Stigma towards people diagnosed with a severe mental disorder (SMD) is one of the main obstacles for these service users to receive timely and relevant healthcare. This study was undertaken to understand how stigmatizing attitudes are demonstrated towards people with SMD in primary healthcare centers (PHC) from the perspective of those affected and primary healthcare professionals. Methods: We used a qualitative exploratory research design to contrast the differences and similarities regarding stigmatizing attitudes towards people with SMD in primary healthcare centers (PHC) from the perspective of two groups: (i) people diagnosed with a severe mental disorder, and (ii) healthcare professionals. Data was collected through semi-structured interviews and discussion groups and subsequently analyzed using Atlas.ti software. Results: Our results indicate that both service users and healthcare professionals manifest stereotypes, prejudices, and discriminatory behavior in health care. In addition, structural aspects of the health system and organizational culture appear to contribute to stigmatization. Both groups agreed that there is a need for healthcare professionals to have more education, specialization, and skill development related to mental health issues. Conclusions: Interventions to reduce the stigma towards people with SMD in PHC must consider delivery of information about mental disorders, development of skills in the healthcare professionals, and modifications in the culture of the health centers.

Resumen Antecedentes. El estigma es uno de los obstáculos principales para la integración social de las personas con trastornos mentales. Objetivo. Estudiar las propiedades psicométricas y adaptar la Escala de Distancia Social de Link (DS) en una muestra chilena. Ésta evalúa las actitudes públicas hacia personas con trastornos mentales mediante una viñeta seguida de un grupo de preguntas. Método. Se tomaron dos muestras por conveniencia: la primera estuvo compuesta por 399 personas y la segunda por 350. La confiabilidad se evaluó por medio del coeficiente alfa de Cronbach. Para valorar su estructura factorial, se realizó un análisis factorial exploratorio con la primera muestra y uno confirmatorio con la segunda. Finalmente, se utilizó el coeficiente de correlación de Pearson para estudiar la validez concurrente con la Escala de Orientación a la Dominancia Social. Resultados. Los resultados indican que el instrumento final posee dos factores “cercanía e interacción social”, compuesto por tres reactivos, e “intimidad y confianza”, compuesto por dos. A pesar de que las muestras tenían distinto nivel educativo, los índices de ajuste del modelo obtenido en el análisis factorial confirmatorio, así como la consistencia interna del instrumento, fueron adecuados. Discusión y conclusión. La existencia de dos factores puede estar relacionada con el crecimiento del modelo de salud mental comunitaria en Chile, lo que ha impactado en la cantidad de dispositivos sanitarios y por tanto en la cercanía que se tiene sobre el tema. Los resultados obtenidos avalan la posibilidad de usar este instrumento en distintos grupos sociales.

Background: In the literature on stigma, authors often use self-stigma or internalized stigma interchangeably to refer to this type of stigma. This results in a lack of conceptual clarity with negative repercussions for measurement and intervention. Aims: To identify how internalized stigma and self-stigma are conceptualized in people diagnosed with a mental disorder and establish similarities and differences between both concepts. Method: A scoping review was conducted. Thirty-five studies that conceptualized internalized stigma or self-stigma were selected. Results: It was identified that the concepts are defined from nine components, and there are more conceptualizations that have points in common than those that consider some component of their own. To gain conceptual clarity, the use of the term internalized stigma is recommended, being a process made up of stages: acceptance of stereotypes and prejudices by people with mental disorders and their subsequent internalization. The latter leads to negative consequences for those affected, which can be understood as the personal impact of this process, which has a crucial socio-cultural component. Lines of research are proposed to provide solidity to studies on this type of stigma. Conclusions: The term internalized stigma should be used when referring to the type of stigma that includes acceptance, internalization and personal impact for the subjects of the stigma. In contrast, self-stigma should be reserved to refer to stigma that is directed toward the ‘self’ and includes subtypes of stigma.

Background: While there are reviews of the literature on mental health stigma reduction programs, very few have focused on the workplace. Objective: We sought to identify, describe and compare the main characteristics of the interventions to reduce the stigma towards mental health at work. Method: The search of original articles (2007 to 2022) was carried out in the Web of Science Core Collection and Scopus databases, selecting 25 articles from the key terms: 1. Stigma, 2. Workplace, 3. Anti-stigma intervention/program, 4. Mental health. Results: These interventions can be effective in changing the knowledge, attitudes, and behaviors of workers towards people with mental health problems, although further verification of these results is needed as they are limited to date. Discussion and conclusion: Interventions to reduce stigma in the workplace could create more supportive work environments by reducing negative attitudes and discrimination and improving awareness of mental disorders.

Background: The mass media are relevant in shaping the population’s attitudes towards mental disorders. In low- and middle-income countries there is little information about the portrayal of people with mental disorders in the mass media. Aim: The general objective of the study was to assess the tone and content of Chilean newspaper articles about mental disorder from 2000 to 2019. Method: The digital editions of four national circulation Chilean newspapers were intentionally selected. The search engine Google News was used to identify and retrieve the news. To evaluate the news, a standardised codebook was administered. A total of 385 news were evaluated. Results: The results show that a large proportion of the news items has an overall positive/optimistic tone 43.5% and 57.5% does not stigmatise; however, only 18.4% emphasises recovery as part of the content. The highest percentages of news stigmatising in tone and content are observed for bipolar disorder and schizophrenia. Furthermore, the experts are quoted much more frequently than people diagnosed with mental disorders or their families and/or friends. When comparing by years there is a trend towards general decrease in stigmatisation, moving towards a more positive or optimistic view of mental health, Conclusions: In general, low stigmatisation towards mental disorders was found in the news and this was reduced steadily over time. Although there are aspects to improve in some particular areas, suggesting that manifest stigma has diminished, but more subtle forms still remain.