Experiences of stigma and discrimination endured by people suffering from schizophrenia

OBJECTIVE: It is important to understand stigma in India, given its varied culture and mixture of rural and urban populations. Information from western literature cannot be applied without considering the sociocultural differences. AIMS: The research aimed to study the subjective experiences of stigma and discrimination undergone by people suffering from schizophrenia in rural and urban environments in India. SETTINGS AND DESIGN: Patients were selected from the outpatient services of six adult psychiatric units of the National Institute of Mental Health and Neurosciences (NIMHANS), India, and from the six outreach centers located in rural areas. MATERIALS AND METHOD: Two hundred patients diagnosed with schizophrenia were selected from rural and urban areas. The experiences of stigma and discrimination were assessed using a semi-structured instrument. STATISTICAL TECHNIQUES: Both quantitative and qualitative analyses were done. RESULTS: Significant differences were seen between rural and urban respondents. Urban respondents felt the need to hide their illness and avoided illness histories in job applications, whereas rural respondents experienced more ridicule, shame, and discrimination. The narratives provide direct views of patients, supporting the key findings. CONCLUSION: Mental health programs and policies need to be sensitive to the consumers’ needs and to organize services and to effectively decrease stigma and discrimination.