title: Stigma and discrimination against people with schizophrenia related to medical services.
abstract: OBJECTIVE
  To investigate whether people with schizophrenia experience discrimination when using health care services.
  
  
  METHODS
  A cross-sectional survey in 27 countries in centres affiliated to the INDIGO Research Network, using face-to-face interviews with 777 participants with schizophrenia (62% male and 38% female). We analysed the data related to health issues, including health care, disrespect of mental health staff, and also personal privacy, safety and security, starting a family, pregnancy and childbirth. Discrimination was measured by the Discrimination and Stigma Scale (DISC), which consists of 36 items comprising three sub-scales: positive experienced discrimination; negative experienced discrimination; and anticipated discrimination.
  
  
  RESULTS
  More than 17% of patients experienced discrimination when treated for physical health care problems. More than 38% of participants felt disrespected by mental health staff, with higher ratings in the post-communist countries.
  
  
  CONCLUSIONS
  Mental health service providers have a key role in decreasing stigma in their provision of health care, and by doing more against stigmatizing and discriminating practices on the therapeutic and organizational level. This will require a change of attitudes and practices among mental and physical health care staff.
authors.affiliation: Centre for Community Psychiatry, Semmelweis Medical University, Budapest, Hungary.
authors.forename: J
authors.initials: J
authors.lastname: Harangozo
authors.affiliation: Instituto de Psiquiatría, Instituto de Investigación biomédica del Hospital Clínico San Carlos, Departamento de Psiquiatría, Universidad Complutense, Madrid, Spain blanca@reneses.es.
authors.forename: B
authors.initials: B
authors.lastname: Reneses
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Brohan
authors.affiliation: Department of Psychiatry, Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
authors.forename: J
authors.initials: J
authors.lastname: Sebes
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis Medical University, Budapest, Hungary.
authors.forename: G
authors.initials: G
authors.lastname: Csukly
authors.affiliation: Instituto de Psiquiatría, Instituto de Investigación biomédica del Hospital Clínico San Carlos, Departamento de Psiquiatría, Universidad Complutense, Madrid, Spain.
authors.forename: J J
authors.initials: JJ
authors.lastname: López-Ibor
authors.affiliation: Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Sartorius
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Rose
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Thornicroft
mesh_terms: D000850:Anomie; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services; D011247:Pregnancy; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012559:Schizophrenia; D013240:Stereotyping
keywords: Stigma; discrimination; health services; integrated care; mental health services; schizophrenia