Subtle ways of stigmatization among professionals: the subjective experience of consumers and their family members.
Abstract
OBJECTIVE: Subtle expressions of stigmata or microaggressions consist of insensitive and demeaning remarks or statements which negate an individual's perception of their reality. They are differentiated from more traditional and overt forms of discrimination in that they are often voiced by well-intentioned individuals who are unaware of the negative underpinnings and potentially harmful effects of their comments. This study aimed to explore the subjective experience of stigma and macroaggression among consumers and their family members during their encounters with mental health care providers. METHOD: Sixteen individuals who were recently diagnosed with schizophrenia spectrum disorders and 15 of their family members were interviewed. The interviews were recorded, transcribed verbatim, and analyzed using grounded theory. RESULTS: Three major forms of subtle stigma expressions or microaggressions were identified: that lived experience is not relevant, people diagnosed with a psychosis have no hope for recovery, and sharing and discussing professional knowledge is not necessary. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Encounters with mental health care providers include subtle conveyance of stigmatizing messages that are well recognized as a barrier to recovery. Psychoeducational interventions for staff that emphasize the importance of lived experience and sharing professional knowledge are recommended, as well as further studying the subtle ways of stigmatization among staff. (PsycINFO Database Record
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Clinicians can express stigma subtly and unintendedly to people with psychosis.
“Clinicians can express stigma subtly and unintendedly to people with psychosis (76).”
From Making meaning of trauma in psychosis (2023) · cites this paper as [76]
Cites
Basics of Qualitative Research: Grounded Theory Procedures and Techniques.
Ellis, C., Strauss, A., & Corbin, J. M. (1992) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2074814 · Cited by 29,279 · see citing works
Racial microaggressions in everyday life: Implications for clinical practice.
Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M. B., Nadal, K. L., & Esquilin, M. (2007) · American Psychologist · doi:10.1037/0003-066x.62.4.271 · Cited by 5,569 · see citing works
Content Analysis in Mass Communication: Assessment and Reporting of Intercoder Reliability
Lombard, M., Snyder-Duch, J., & Bracken, C. C. (2002) · Human Communication Research · doi:10.1111/j.1468-2958.2002.tb00826.x · Cited by 3,068 · see citing works
Evidence for effective interventions to reduce mental-health-related stigma and discrimination
Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., Koschorke, M., Shidhaye, R., O'Reilly, C., & Henderson, C. (2016) · The Lancet · doi:10.1016/s0140-6736(15)00298-6 · Cited by 1,338 · see citing works
Comprehensive mental health action plan 2013–2020
Saxena, S., Funk, M. K., & Chisholm, D. (2015) · Eastern Mediterranean Health Journal · doi:10.26719/2015.21.7.461 · Cited by 831 · see citing works
Racial microaggressions in the life experience of Black Americans.
Sue, D. W., Capodilupo, C. M., & Holder, A. M. B. (2008) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.39.3.329 · Cited by 682 · see citing works
Attitudes of Mental Health Professionals Toward People With Schizophrenia and Major Depression
Nordt, C., Wulf Rössler, A., & Lauber, C. (2005) · Schizophrenia Bulletin · doi:10.1093/schbul/sbj065 · Cited by 539 · see citing works
Griffiths, K. M., Carron-Arthur, B., Parsons, A., & Reid, R. (2014) · World Psychiatry · doi:10.1002/wps.20129 · Cited by 466 · see citing works
Discrimination in health care against people with mental illness
Thornicroft, G., Rose, D. S., & Kassam, A. (2007) · International Review of Psychiatry · doi:10.1080/09540260701278937 · Cited by 448 · see citing works
Newspaper Stories as Measures of Structural Stigma
Corrigan, P. W., Watson, A. C., Gracia, G., Slopen, N. B., Rasinski, K. A., & Hall, L. L. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.5.551 · Cited by 359 · see citing works
Torres, L., Driscoll, M. W., & Burrow, A. L. (2010) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2010.29.10.1074 · Cited by 351 · see citing works
Shared decision making for in‐patients with schizophrenia
Hamann, J., Langer, B., Winkler, V., Busch, R., Cohen, R., Leucht, S., & Kissling, W. (2006) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2006.00798.x · Cited by 296 · see citing works
Questioning an Axiom: Better Prognosis for Schizophrenia in the Developing World?
Cohen, A., Patel, V., THARA, R., & Gureje, O. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm105 · Cited by 274 · see citing works
Recovering Our Sense of Value After Being Labeled: Mentally Ill
Deegan, P. E. (1993) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/0279-3695-19930401-06 · Cited by 236 · see citing works
Shared Decision Making and Long-Term Outcome in Schizophrenia Treatment
Hamann, J., Cohen, R., Leucht, S., Busch, R. M., & Kissling, W. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0703 · Cited by 184 · see citing works
Hamann, J., Mendel, R., Cohen, R., Heres, S., Ziegler, M. D., Bühner, M., & Kissling, W. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.8.1107 · Cited by 155 · see citing works
Microaggressions experienced by persons with mental illnesses: An exploratory study.
Gonzales, L., Davidoff, K. C., Nadal, K. L. Y., & Yanos, P. T. (2014) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000096 · Cited by 118 · see citing works
Trends and perspectives of shared decision-making in schizophrenia and related disorders
Beitinger, R., Kissling, W., & Hamann, J. (2014) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000057 · Cited by 108 · see citing works
Do the Effects of Antistigma Programs Persist Over Time? Findings From a Meta-Analysis
Corrigan, P. W., Michaels, P. J., & Morris, S. B. (2015) · Psychiatric Services · doi:10.1176/appi.ps.201400291 · Cited by 95 · see citing works
Mental Health Reform at a Systems Level: Widening the Lens on Recovery-Oriented Care
Kidd, S. A., McKenzie, K. J., & Virdee, G. (2014) · The Canadian Journal of Psychiatry · doi:10.1177/070674371405900503 · Cited by 88 · see citing works
Hasson‐Ohayon, I., Levy, I., Kravetz, S., Vollanski-Narkis, A., & Roe, D. (2010) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2010.04.008 · Cited by 82 · see citing works
Self-citationvan der Sanden, R. L. M., Stutterheim, S. E., Pryor, J. B., Kok, G., & Bos, A. E. R. (2014) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000189 · Cited by 65 · see citing works
Piat, M., & Sabetti, J. (2009) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2009-0020 · Cited by 45 · see citing works
Microaggressions: The experience of individuals with mental illness
Peters, H. J., Schwenk, H. N., Ahlstrom, Z. R., & McIalwain, L. N. (2016) · Counselling Psychology Quarterly · doi:10.1080/09515070.2016.1164666 · Cited by 43 · see citing works
Dissecting the Heterogeneity of Schizophrenia Outcomes
McGrath, J. J. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm133 · Cited by 34 · see citing works
Prejudice and discrimination from mental health service providers.
Nemec, P. B., Swarbrick, M. A., & Legere, L. (2015) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000148 · Cited by 26 · see citing works
Hope, Faith, Love, and Treating Serious Mental Health Conditions
Bauer, M. S. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.15121604 · Cited by 5 · see citing works
Flagged first, then by citations
1 of the 28 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Yin, M., Li, Z., & Zhou, C. (2019) · International Journal of Mental Health Nursing · doi:10.1111/inm.12668 · Cited by 85 · see citing works
Alyafei, A., Alqunaibet, T., Mansour, H., Ali, A., & Billings, J. (2021) · PLoS ONE · doi:10.1371/journal.pone.0254351 · Cited by 73 · see citing works
Zhou, Z., Wang, Y., Feng, P., Li, T., Tebes, J. K., Luan, R., & Yu, Y. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.631420 · Cited by 62 · see citing works
Time to Support Extensive Implementation of Shared Decision Making in Psychiatry
Zisman‐Ilani, Y., Roth, R. M., & Mistler, L. A. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.2247 · Cited by 62 · see citing works
Kaku, S. M., Sibéoni, J., Basheer, S., Chang, J. P., Dahanayake, D. M. A., Irarrázaval, M., Lachman, J. M., Mapayi, B. M., Mejía, A., Orri, M., et al. (2022) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-022-00512-8 · Cited by 42 · see citing works
Guan, Z., Huang, C., Wiley, J. A., Sun, M., Bai, X., & Tang, S. (2019) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12571 · Cited by 41 · see citing works
EghbalManesh, A., Dalvandi, A., & Zoladl, M. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e14333 · Cited by 29 · see citing works
Igra, L., Michal Lavidor, B., Atzil–Slonim, D., Arnon-Ribenfeld, N., de Jong, S., & Hasson‐Ohayon, I. (2020) · European Psychiatry · doi:10.1192/j.eurpsy.2020.67 · Cited by 22 · see citing works
Self-citationBittner, R. A., Reif, A., & Qubad, M. (2023) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000871 · Cited by 20 · see citing works
Mlunde, L. B., Saalim, K., Mbwambo, J. K. K., Kiwia, P., Fitch, E. R., Manyama, W., Rugemalila, I., Clay, S., Lambdin, B. H., Stelmach, R. D., et al. (2024) · Harm Reduction Journal · doi:10.1186/s12954-024-00965-4 · Cited by 14 · see citing works
Making meaning of trauma in psychosis
van Sambeek, N., Franssen, G., van Geelen, S., & Scheepers, F. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1272683 · Cited by 10 · see citing works
Growing up with a sibling with depression: A qualitative study in Israel
Levkovich, I., & Labes, M. (2023) · PLoS ONE · doi:10.1371/journal.pone.0290999 · Cited by 10 · see citing works
Omundo, J., Stiehl, S. A., Schulz, M., & Zingsheim, A. (2025) · The Journal of Mental Health Training Education and Practice · doi:10.1108/jmhtep-05-2024-0052 · Cited by 10 · see citing works
May, C. R., Gravenhorst, K. C., Hillis, A., Arber, M. R., Chew-Graham, C. A., Gallacher, K., Mair, F. S., Nolte, E., & Richardson, A. M. (2024) · Health and Social Care Delivery Research · doi:10.3310/hgtq8159 · Cited by 8 · see citing works
Defourny, P., van Sambeek, N., van de Bovenkamp, H., Scheepers, F. E., & Heerings, M. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06262-5 · Cited by 8 · see citing works
Family perspectives of healthcare for relatives living with a mental illness
Schaffer, M. A. (2020) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12718 · Cited by 7 · see citing works
Kappel, V. B., Goulart, B. F., Pereira, A. R., Chaves, L. D. P., Iwamoto, H. H., & Barbosa, M. H. (2019) · Texto & Contexto - Enfermagem · doi:10.1590/1980-265x-tce-2019-0025 · Cited by 7 · see citing works
Tay, J. Y., Li, Z., & Goh, Y. S. (2024) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.13126 · Cited by 6 · see citing works
Grandón, P., Gutiérrez, D. A. V., Vielma-Aguilera, A., Bustos, C., Contreras, Y., Castillo, G., Cid, P., Araya, C., & Flores, R. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115428 · Cited by 6 · see citing works
Jara‐Ogeda, R., Legües, D. L., & Grandón, P. (2022) · Journal of Community Psychology · doi:10.1002/jcop.22838 · Cited by 5 · see citing works
Peer Work in Rural and Remote Communities and Mental Health Services
Jackson, F., Heffernan, T., Orr, M., Young, R. B., Puckett, C., & Daly, S. M. (2020) · Springer eBooks · doi:10.1007/978-981-10-5012-1_21-1 · Cited by 5 · see citing works
Peer Work in Rural and Remote Communities and Mental Health Services
Jackson, F., Heffernan, T., Orr, M., Young, R. B., Puckett, C., & Daly, S. M. (2021) · Springer eBooks · doi:10.1007/978-981-15-6631-8_21 · Cited by 2 · see citing works
Duque, H., Díaz-Granados, E. T. A., & Suárez-Colorado, Y. (2021) · Duazary · doi:10.21676/2389783x.4383 · Cited by 2 · see citing works
Facilitating a Warm Handoff in State Vocational Rehabilitation Service Delivery
Peterson, S. (2022) · Journal of Applied Rehabilitation Counseling · doi:10.1891/jarc-2021-0019 · Cited by 2 · see citing works
Alam, F. H., Fiky, E. R. E., & El-Amrosy, S. H. (2022) · Tanta Scientific Nursing Journal · doi:10.21608/tsnj.2022.274248 · Cited by 1 · see citing works
Du stigmate à l’évitement des personnes avec un trouble mental
Laberon, S., Desmette, D., & Corbière, M. (2025) · Santé mentale au Québec · doi:10.7202/1121400ar · Cited by 1 · see citing works
Counseling Strategies for Clients in Recovery From Substance Use Disorders and Mental Illness
Peterson, S. (2023) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-6684-6155-6.ch008 · Cited by 1 · see citing works
Lin, C.-W., Chang, Y., & Yen, C. (2023) · Vaccines · doi:10.3390/vaccines11121781 · Cited by 1 · see citing works
Zirnsak, T., Spencer, T., Niclola, J. D., Dasvarma, A., Rayner, A. D. M., Heffernan, T., English, L., Bentley, J., Lawn, S., Brophy, L. M., et al. (2026) · Community Mental Health Journal · doi:10.1007/s10597-026-01714-6
- Authors
- Amsalem, D., Hasson-Ohayon, I., Gothelf, D., & Roe, D.
- Venue
- Psychiatric Rehabilitation Journal
- Published
- 2018-09
- Volume
- 41
- Issue
- 3
- Pages
- 163-168
- ISSN
- 1095-158X (ISSN-L)
- 1559-3126
- OpenAlex
- W2872265199
- Cited by
- 30
- References
- 28
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 3
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Rehabilitation Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- microaggressions, macroaggressions, mental health care providers, schizophrenia spectrum disorders, psychosis, family members, lived experience, professional knowledge sharing, barriers to recovery, psychoeducational intervention
- MeSH terms
- Adolescent, Adult, Aggression, Attitude of Health Personnel, Female, Humans, Male, Mental Health Services, Professional-Patient Relations, Psychotic Disorders, Schizophrenia, Qualitative Research, Young Adult, 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 ›
Are you an author, or do you see a problem with this page? Request a review
