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Articles   |    
Discrimination Attributed to Mental Illness or Race-Ethnicity by Users of Community Psychiatric Services
Jheanell Gabbidon, M.Sc.; Simone Farrelly, Ph.D.; Stephani L. Hatch, Ph.D.; Claire Henderson, M.D., Ph.D.; Paul Williams, M.P.H.; Dinesh Bhugra, Ph.D., F.R.C.Psych.; Lisa Dockery, M.Sc.; Francesca Lassman, M.Sc.; Graham Thornicroft, M.D., Ph.D.; Sarah Clement, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300302
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Except for Dr. Hatch, the authors are with the Department of Health Services and Population Research, Institute of Psychiatry, King's College London, London, United Kingdom (e-mail: jheanell.gabbidon@kcl.ac.uk). Dr. Hatch is with the Department of Psychological Medicine, King’s College London.

Copyright © 2014 by the American Psychiatric Association

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Objective  This study assessed participants’ experienced discrimination and their causal attributions, particularly to mental illness or race-ethnicity.

Methods  In a cross-sectional study, 202 service users with severe mental illnesses were interviewed to assess their reported experiences of discrimination. The Major Experiences of Discrimination Scale assessed major experiences of discrimination and their recency and frequency across 12 life domains and perceived reasons (attributions). The Everyday Experiences of Discrimination Scale assessed ten types of everyday discrimination and attributions for these experiences.

Results  Most participants (88%) reported discrimination in at least one life domain, and 94% reported ever experiencing everyday discrimination. The most common areas of major discrimination were mental health care (44%), neighbors (42%), police (33%), employment (31%), and general medical care (31%). The most common attributions for major discrimination were mental illness (57%), race-ethnicity (24%), education or income (20%), or appearance (19%). Almost half (47%) attributed experiences of major discrimination to two or more causes. No differences were found between racial-ethnic groups in overall experienced discrimination or in main attributions to mental illness. However, compared with the mixed and white groups, participants in the black group were most likely to endorse race-ethnicity as a main attribution (p<.001).

Conclusions  Mental illness–related discrimination was found to be a common issue across racial-ethnic groups, and discrimination based on race-ethnicity was prevalent for the mixed and black groups. There is a need for antidiscrimination strategies that combine efforts to reduce the experience of discrimination attributed to mental illness and to race-ethnicity for racial-ethnic minority groups.

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