Stigmatisation of those with mental health conditions in the acute general hospital setting. A qualitative framework synthesis
Open accessAbstract
Rationale Patients with long-term mental health conditions often have complex physical, mental, and social needs. They are frequent users of the acute general healthcare system, but can experience stigmatising attitudes and behaviours, and structural discrimination. We wished to improve understanding of stigmatisation in the acute healthcare setting, to target areas for future intervention.Objective A synthesis of qualitative literature was undertaken in order to understand how patients with long-term mental health conditions are stigmatised, or otherwise treated, within the acute healthcare system.Method A theory-driven framework approach was implemented. Existing stigma theory was used to outline a framework for categorizing stigmatising and non-stigmatising phenomena within the acute healthcare system.Results A systematic literature search of qualitative studies identified a sample of 51 studies that would inform the framework. Using data in these studies, a final theoretical 'best fit' framework was developed. In this framework there is an overarching pattern of labelling and stereotyping, plus five ways in which patients with mental health conditions are stigmatised in the acute healthcare system: devaluation, social control, avoidance, rejection, and failure to act. In addition, the framework outlines positive attitudes and behaviours - valuing, adjustment, responding, legitimising, and positive action - which contrast with the stigmatisation patterns.Conclusions The study offers a framework for identifying stigmatisation and positive treatment of those with mental health conditions in an acute health setting. This framework is of potential value in targeting areas for improved quality of care and may have utility beyond this setting and stigmatised group.
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“…experiences are intertwined with systemic issues that contribute to health disparities, such as implicit bias in care delivery, cultural barriers to accessing services, and other factors that influence how different individuals and population groups interact with the healthcare system [29–32].”
- Authors
- Perry, A., Lawrence, V., & Henderson, C.
- Affiliations
- King's College London (GB)
- Corresponding author
- Henderson, Claire
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 255
- Pages
- 112974
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W3021258398
- Cited by
- 51
- References
- 102
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 5 · 2023: 6 · 2022: 8 · 2021: 9 · 2020: 2
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Funders
- Economic and Social Research Council
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- mental health stigma, stigma theory, currency devaluation, social control, rejection, avoidance, failure to act, structural discrimination, quality of care
- MeSH terms
- Mental Disorders, Hospitals, General, Humans, Mental Health, Stereotyping, Qualitative Research, Social Stigma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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