Self-stigma in young people at high risk of psychosis and

 
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Presentation First Author: 
Xu Ziyan
Abstract: 

Early detection and intervention programs for young people at high risk for psychosis aim to increase help-seeking rates to improve clinical outcome. While it is likely that young people at risk of psychosis would encounter self-stigma about 'mental illness label (Wright et al, 2011). The first onset of illness is often a catastrophic event for individuals and their family carers. Self-stigma may be particularly relevant for individuals who are experiencing their first diagnosis of a mental illness. Under the collectivistic nature of Chinese culture, people are more likely to internalize negative stereotypes of mental illness and suffer self-stigma. Fear of stigma has been identified as a significant barrier to help-seeking for health services. Self-stigma has been also associated with reduced hope, poorer well-being and reduced quality of life (Corrigan et al, 2013). Engulfment of self-stigma has been found to be particularly pertinent in individuals experiencing first episode of psychosis. (McCay et al, 2007). The risk of stigma may be particularly problematic because labeling or diagnosis typically be made with young adults who are in the early stage of development of their identify, formation of self-concept and entering into striving towards educational or vocational attainment (Yang et al, 2010). However, potential harmful effects of self-labeling and stigma are easy to be neglected in early intervention programs. Interventions are needed to facilitate a non-stigmatizing use of labeling in mental health services and society. Furthermore, effective strategies to address the self-stigma and its impact on young people at high risk of psychosis and in first-episode psychosis are also needed. The major elements of intervention are outlined as follows: 1. Psychoeducation with realistic and empirical information about mental illness. In our experience, patients and carers prefer pyschosocial to biogentic explanations. 2. Motivational interviewing to change problematic behaviors, e.g reluctant to seek help. 3. Reconstruction and normalization of self-stigmatized beliefs. (Needs to attention do not suggest stigma is flaw which need to be corrected.) Focusing more on strengthening the art of acceptance to improve psycholoogical flexibility. 4. Social skills training enhance specific skills: selective disclosure, openness and contact with others, and dealing with stigmatizing social situation, etc. 5. Personal empowerment and goal attainment to instill hope and develop realistic life goals. 6. Peer support to provide a range of services. In the Chinese community, caring for a person with a mental health problem is seen as a family responsibility. Therefore, family members are encouraged to participate in the sessions to provide emotional, instrumental and practical support, increase understanding and acceptance of the patients situation, refrain from treating them differently, and actively engage the young person at different levels to go back to normal life. Offering an early intervention in a positive frame and anti-stigma intervention program may represent a cost-effective way to reduce poor outcome for young people at high risk of psychosis and in first-episode psychosis.

Conference Name: 
Presentation Date: 
January, 2015
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