Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 10/2018

01-10-2018 | Original Paper

Intersections of discrimination due to unemployment and mental health problems: the role of double stigma for job- and help-seeking behaviors

Authors: Tobias Staiger, Tamara Waldmann, Nathalie Oexle, Moritz Wigand, Nicolas Rüsch

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 10/2018

Login to get access

Abstract

Purpose

The everyday lives of unemployed people with mental health problems can be affected by multiple discrimination, but studies about double stigma—an overlap of identities and experiences of discrimination—in this group are lacking. We therefore studied multiple discrimination among unemployed people with mental health problems and its consequences for job- and help-seeking behaviors.

Methods

Everyday discrimination and attributions of discrimination to unemployment and/or to mental health problems were examined among 301 unemployed individuals with mental health problems. Job search self-efficacy, barriers to care, and perceived need for treatment were compared among four subgroups, depending on attributions of experienced discrimination to unemployment and to mental health problems (group i); neither to unemployment nor to mental health problems (group ii); mainly to unemployment (group iii); or mainly to mental health problems (group iv).

Results

In multiple regressions among all participants, higher levels of discrimination predicted reduced job search self-efficacy and higher barriers to care; and attributions of discrimination to unemployment were associated with increased barriers to care. In ANOVAs for subgroup comparisons, group i participants, who attributed discrimination to both unemployment and mental health problems, reported lower job search self-efficacy, more perceived stigma-related barriers to care and more need for treatment than group iii participants, as well as more stigma-related barriers to care than group iv.

Conclusions

Multiple discrimination may affect job search and help-seeking among unemployed individuals with mental health problems. Interventions to reduce public stigma and to improve coping with multiple discrimination for this group should be developed.
Literature
1.
Jahoda M, Lazarsfeld PF, Zeisel H (1971) The sociography of an unemployed community, Marienthal. Aldine, Chicago (published in German in 1933)
2.
Frasquilho D, Matos MG, Salonna F, Guerreiro D, Storti CC, Gaspar T, Caldas-de-Almeida JM (2016) Mental health outcomes in times of economic recession. A systematic literature review. BMC Public Health 16:115CrossRef
3.
Olesen SC, Butterworth P, Leach LS, Kelaher M, Pirkis J (2013) Mental health affects future employment as job loss affects mental health. Findings from a longitudinal population study. BMC Psychiatry 13:144CrossRef
4.
Olesen SC, Butterworth P, Rodgers B (2012) Is poor mental health a risk factor for retirement? Findings from a longitudinal population survey. Soc Psychiatry Psychiatr Epidemiol 47(5):735–744CrossRef
5.
Honkonen T, Virtanen M, Ahola K, Kivimäki M, Pirkola S, Isometsä E, Aromaa A, Lönnqvist J (2007) Employment status, mental disorders and service use in the working age population. Scand J Work Environ Health 33(1):29–36CrossRef
6.
Brand JE (2015) The far-reaching impact of job loss and unemployment. Annu Rev Sociol 41(1):359–375CrossRef
7.
Wanberg CR (2012) The individual experience of unemployment. Annu Rev Psychol 63:369–396CrossRef
8.
Butterworth P, Leach LS, Pirkis J, Kelaher M (2012) Poor mental health influences risk and duration of unemployment. A prospective study. Soc Psychiatry Psychiatr Epidemiol 47(6):1013–1021CrossRef
9.
Lamberg T, Virtanen P, Vahtera J, Luukkaala T, Koskenvuo M (2010) Unemployment, depressiveness and disability retirement. A follow-up study of the Finnish HeSSup population sample. Soc Psychiatry Psychiatr Epidemiol 45(2):259–264CrossRef
10.
Staiger T, Waldmann T, Rüsch N, Krumm S (2017) Barriers and facilitators of help-seeking among unemployed persons with mental health problems: a qualitative study. BMC Health Serv Res 17(1):39CrossRef
11.
Åhs A, Burell G, Westerling R (2012) Care or not care—that is the question. Predictors of healthcare utilisation in relation to employment status. Int J Behav Med 19(1):29–38CrossRef
12.
Becker DR, Drake RE (2003) A working life for people with severe mental illness. Oxford Press, New YorkCrossRef
13.
Link BG, Phelan JC (2001) Conceptualizing stigma. Annu Rev Sociol 27(1):363–385CrossRef
14.
Rüsch N, Angermeyer MC, Corrigan PW (2005) Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 20(8):529–539CrossRef
15.
Corrigan PW (2004) How stigma interferes with mental health care. Am Psychol 59(7):614–625CrossRef
16.
Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rüsch N, Brown JSL, Thornicroft G (2015) What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med 45(1):11–27CrossRef
17.
Corrigan PW, Larson JE, Rüsch N (2009) Self-stigma and the “why try” effect: impact on life goals and evidence-based practices. World Psychiatry 8(2):75–81CrossRef
18.
19.
Furåker B, Blomsterberg M (2003) Attitudes towards the unemployed. An analysis of Swedish survey data. Int J Soc Welf 12(3):193–203CrossRef
20.
Maddy LM, Cannon JG, Lichtenberger EJ (2015) The effects of social support on self-esteem, self-efficacy, and job search efficacy in the unemployed. J Employ Couns 52(2):87–95CrossRef
21.
Albion MJ, Fernie KM, Burton LJ (2005) Individual differences in age and self-efficacy in the unemployed. Austral J Psychol 57(1):11–19CrossRef
22.
Saks AM, Zikic J, Koen J (2015) Job search self-efficacy. Reconceptualizing the construct and its measurement. J Vocat Behav 86:104–114CrossRef
23.
Hatzenbuehler ML, Phelan JC, Link BG (2013) Stigma as a fundamental cause of population health inequalities. Am J Public Health 103(5):813–821CrossRef
24.
Cole ER (2009) Intersectionality and research in psychology. Am Psychol 64(3):170–180CrossRef
25.
Rosenthal L (2016) Incorporating intersectionality into psychology: an opportunity to promote social justice and equity. Am Psychol 71(6):474–485CrossRef
26.
27.
Grollman EA (2014) Multiple disadvantaged statuses and health: the role of multiple forms of discrimination. J Health Soc Behav 55(1):3–19CrossRef
28.
von dem Knesebeck O, Kofahl C, Makowski AC (2017) Differences in depression stigma towards ethnic and socio-economic groups in Germany—exploring the hypothesis of double stigma. J Affect Disord 208:82–86CrossRef
29.
Hamilton S, Corker E, Weeks C, Williams P, Henderson C, Pinfold V, Rose D, Thornicroft G (2016) Factors associated with experienced discrimination among people using mental health services in England. J Ment Health 25(4):350–358CrossRef
30.
O’Donnell AT, Corrigan F, Gallagher S (2015) The impact of anticipated stigma on psychological and physical health problems in the unemployed group. Front Psychol 6:1263CrossRef
31.
Khan M, Ilcisin M, Saxton K (2017) Multifactorial discrimination as a fundamental cause of mental health inequities. Int J Equity Health 16(1):43CrossRef
32.
Luck-Sikorski C, Schomerus G, Jochum T, Riedel-Heller SG (2018) Layered stigma? Co-occurring depression and obesity in the public eye. J Psychosom Res 106:29–33CrossRef
33.
Oexle N, Waldmann T, Staiger T, Xu Z, Rüsch N (2018) Mental illness stigma and suicidality. The role of public and individual stigma. Epidemiol Psychiatr Sci 27(2):169–175CrossRef
34.
Rüsch N, Corrigan PW, Waldmann T, Staiger T, Bahemann A, Oexle N, Wigand M, Becker T (2018) Attitudes toward disclosing a mental health problem and reemployment. A Longitudinal Study. J Nerv Ment Dis 206(5):383–385CrossRef
35.
Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand S-LT, Manderscheid RW, Walters EE, Zaslavsky AM (2003) Screening for serious mental illness in the general population. Arch Gen Psychiatry 60(2):184–189CrossRef
36.
Brown RL, Rounds LA (1995) Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Wis Med J 94(3):135–140PubMed
37.
Hinkin CH, Castellon SA, Dickson-Fuhrman E, Daum G, Jaffe J, Jarvik L (2001) Screening for drug and alcohol abuse among older adults using a modified version of the CAGE. Am J Addict 10(4):319–326CrossRef
38.
Üstün TB, Chatterji S, Kostanjsek N, Rehm J, Kennedy C, Epping-Jordan J, Saxena S, von Korff M, Pull C (2010) Developing the World Health Organization Disability Assessment Schedule 2.0. Bull World Health Organ 88(11):815–823CrossRef
39.
Andrews G, Kemp A, Sunderland M, von Korff M, Üstün TB (2009) Normative data for the 12 item WHO Disability Assessment Schedule 2.0. PLoS One 4(12):e8343CrossRef
40.
Williams DR, Yan Y, Jackson JS, Anderson NB (1997) Racial differences in physical and mental health: socio-economic status, stress and discrimination. J Health Psychol 2(3):335–351CrossRef
41.
van Ryn M, Vinokur AD (1992) How did it work? An examination of the mechanisms through which an intervention for the unemployed promoted job-search behavior. Am J Commun Psychol 20(5):577–597CrossRef
42.
Choi JN, Price RH, Vinokur AD (2003) Self-efficacy changes in groups. Effects of diversity, leadership, and group climate. J Organ Behav 24(4):357–372CrossRef
43.
Clement S, Brohan E, Jeffery D, Henderson C, Hatch SL, Thornicroft G (2012) Development and psychometric properties the Barriers to Access to Care Evaluation scale (BACE) related to people with mental ill health. BMC Psychiatry 12:36CrossRef
44.
Marks KA, Fastenau PS, Lysaker PH, Bond GR (2000) Self-Appraisal of Illness Questionnaire (SAIQ): relationship to researcher-rated insight and neuropsychological function in schizophrenia. Schizophr Res 45(3):203–211CrossRef
45.
Lantz B (2013) The impact of sample non-normality on ANOVA and alternative methods. Br J Math Stat Psychol 66(2):224–244CrossRef
46.
Kang SK, Bodenhausen GV (2015) Multiple identities in social perception and interaction: challenges and opportunities. Annu Rev Psychol 66:547–574CrossRef
47.
Rusu A, Chiriac DC, Sălăgean N, Hojbotă AM (2013) Job search self-efficacy as mediator between employment status and symptoms of anxiety. Rom J Appl Psychol 15(2):69–75
48.
49.
Rüsch N, Heekeren K, Theodoridou A, Müller M, Corrigan PW, Mayer B, Metzler S, Dvorsky D, Walitza S, Rössler W (2015) Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis. Schizophr Res 166(1–3):43–48CrossRef
50.
Moore THM, Kapur N, Hawton K, Richards A, Metcalfe C, Gunnell D (2017) Interventions to reduce the impact of unemployment and economic hardship on mental health in the general population: a systematic review. Psychol Med 47(6):1062–1084CrossRef
51.
Thornicroft G, Mehta N, Clement S, Evans-Lacko S, Doherty M, Rose D, Koschorke M, Shidhaye R, O’Reilly C, Henderson C (2016) Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 387(10023):1123–1132CrossRef
Metadata
Title
Intersections of discrimination due to unemployment and mental health problems: the role of double stigma for job- and help-seeking behaviors
Authors
Tobias Staiger
Tamara Waldmann
Nathalie Oexle
Moritz Wigand
Nicolas Rüsch
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 10/2018
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-018-1535-9

Other articles of this Issue 10/2018

Social Psychiatry and Psychiatric Epidemiology 10/2018 Go to the issue

Original Paper

Inpatient use and area-level socio-environmental factors in people with psychosis

Original Paper

Perceived neighbourhood social cohesion and depressive symptom trajectories in older adults: a 12-year prospective cohort study

Original Paper

‘Between a rock and a hard place’: family members’ experiences of supporting a relative with bipolar disorder

Original Paper

Interpersonal and institutional ethnic discrimination, and mental health in a random sample of Palestinian minority men smokers in Israel

Original Paper

Depression literacy and health-seeking attitudes in the Western Pacific region: a mixed-methods study

Invited Review

Pathways to mental health services for young people: a systematic review