Experience of courtesy stigma among relatives of individuals with schizophrenia - a qualitative study

The aim of the study was to describe the experience of stigma as experienced by individuals accompanying their relatives with schizophrenia in Poland.

Four qualitative techniques were triangulated in the study: participant observation, content analysis, expert-interviews, and in-depth interviews. Collected data were analyzed in accordance with M.B. Miles and A.M. Huberman's model.

Development of schizophrenia in a family member poses a risk for his/hers family caregivers to enter ‛the zone of stigma'. They encounter a discursive invisibility of the mental health problems as well as missing comprehension and empathy. The stereotype-based social grid of convictions about schizophrenia, psychiatry and the lack of social clues of how to proceed, lead to the development of caregivers' sense of constant uncertainty and feeling lost. The common misconceptions about mental disorders create a greater distance and reluctance between caregivers and their distant relatives, neighbours and friends.The prevalence of the disadvantageous discourse on mental illness stimulates the relatives' anticipation of exclusion, evokes shame. Relatives often experience reluctance in their contact with psychiatric staff, ignorance of their needs and as well as professionals' therapeutic pessimism. Such components of ‛the zone of stigma' pose a threat to the realization of what is at stake for family caregivers, and give way to their powerlessness.

This article presents the results of the first qualitative study on the phenomenon conducted in Poland and characterizes the impact of stigmatizing character of schizophrenia on lives of afflicted individual's family caregivers. In-depth comprehension of the social context of accompanying a relative is crucial for addressing family caregivers' needs in a better way and developing models of cooperation between psychiatric staff and patient's family.