Social inclusion, stigma and discrimination relating to employment and physical health: the experiences of people with a bipolar disorder diagnosis

Background/Objectives: To date, schizophrenia and depression have been the main focus of mental illness stigma research. Such research has typically taken a quantitative approach and surveyed public opinion rather the subjective experiences of people with psychiatric diagnoses. The experiences of stigma and discrimination amongst people who have been given a diagnosis of bipolar disorder have been under-researched. With regard to this diagnostic group, some attention has been afforded to experiences of stigma and discrimination relating to employment in the U.S., but very little is known about the European context. Experiences of stigma and discrimination relating to the physical health needs of people with a bipolar disorder diagnosis have largely gone unexplored too. Also, little is known about the ways gender, age and ethnicity affect stigma experience. In order to redress this imbalance, this wholly qualitative study investigated the experiences of stigma and discrimination amongst people with a diagnosis of bipolar disorder, particularly in relation to employment and physical health.Methods: In-depth interviews and mixed gendered friendship mini-focus groups were conducted with individuals who self-reported a diagnosis of bipolar disorder. All participants self-defined their ethnicity as White, Black African or Black Caribbean. Participants were recruited via mental health charities and participant networking. Issues explored included anticipated and experienced stigma and discrimination, the impact of discrimination on different areas of everyday life, and ideas about how stigma and discrimination could be reduced. Fieldwork was audio recorded, transcribed and subjected to Thematic Analysis with the aid of NVivo 8 software.Results: Three friendship mini-focus groups, involving 3–4 participants, and 15 individual in-depth interviews were conducted. Full results will be presented. Preliminary results indicate that many people with a bipolar disorder diagnosis experience or anticipate stigma and discrimination in the context of employment and their physical health needs. Experiences of stigma and discrimination were recorded when applying for jobs and within workplace relationships. Furthermore, there are indications that ‘diagnostic overshadowing’ and the dismissal of patients’ physical health complaints by healthcare professionals are issues within clinical settings. Such experiences exacerbated social exclusion.Discussion/Conclusions: The means of reducing stigma and discrimination, as well as some of the potential difficulties inherent in this, will be discussed with the view to fostering greater social inclusion. In particular, the focus for strategies will centre on health professionals and employment related initiatives as these were viewed as key sources of stigma and discrimination by people in this diagnostic group. Issues relating to gender, age and ethnicity will be highlighted as will recommendations for future research.Funding: This presentation presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0606–1053). DR and FC are supported by the specialist BRC in mental health at the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health