An international team of researchers, led by Professor Graham Thornicroft at King's College London's Institute of Psychiatry, used detailed questionnaires to ask 1082 people being treated for depression in 35 different countries about their experiences of discrimination.
Over a third (34%) of participants reported that they had been avoided or shunned by other people because of their mental health problems. Anticipated discrimination had prevented over a third (37%) of participants from initiating a close personal relationship, and a quarter (25%) had not applied for work at some point because they expected that they would be discriminated against.
However, the researchers also found that people who anticipated discrimination did not necessarily find that their experiences confirmed this, with nearly half (47%) of participants who reported having anticipated discrimination in finding or keeping a job, and 45% who anticipated discrimination in their personal relationships, finding that they did not actually experience discrimination in these situations.
Almost three quarters (71%) of participants said that they actively wished to conceal their depression from other people, leading to concerns that people with depression may be put off from seeking treatment due to fears of discrimination if they disclose their condition – so that they would not benefit from treatment, as a result of which the condition would be more likely to become chronic.
According to Professor Thornicroft, "Previous work in this area has tended to focus on public attitudes towards stigma based on questions about hypothetical situations, but ours is the first study to investigate the actual experiences of discrimination in a large, global sample of people with depression. Our findings show that discrimination related to depression is widespread, and almost certainly acts as a barrier to an active social life and having a fair chance to get and keep a job for people with depression."
In a linked Comment, Dr Anthony Jorm at the University of Melbourne in Australia, highlights the importance of the new study, but adds that, "Further research could provide much needed input into the design of anti-discrimination interventions—such as public education about human rights and the effect of discrimination on the person with depression; action from health services to help overcome anticipated discrimination as a barrier to help seeking; and the incorporation into treatments such as cognitive behavioural therapy of techniques to address anticipated discrimination and symptoms."
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Paper online: www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61379-8/abstract