Associative stigma among mental health professionals. Consequences for professionals’ and clients’ quality of life

Objectives: Numerous studies have already revealed that clients of mental health services are often stigmatized and that these experiences can affect their quality of life. In the literature on stigma, less attention has been paid to mental health professionals. However, there is some evidence that mental health professionals are also stigmatized: so-called associative stigma or courtesy stigma. This empirical study focuses on experiences of associative stigma among mental health professionals and its link with specific indicators of both professionals’ and their clients’ quality of life. In a first step the relationship between associative stigma and the job-related quality of life of professionals (burnout and job satisfaction) is explored. In a second step, the link with clients’ self-stigma and service satisfaction is investigated. It was hypothesized that burnout – especially depersonalized treatment – could function as a link between associative stigma among mental health professionals and their clients’ experiences. Methods: This research problem is studied using survey data about professionals (N=543) and clients (N=713) from a diversity of mental health settings (N=70) in Belgium. Multilevel analyses techniques are used to account for the clustered dataset, as first mental health organizations, and then clients and professionals were selected. Results and conclusion: The results reveal that associative stigma among mental health professionals is associated with their job-related quality of life, as it is negatively related with two dimensions of burnout and with general job satisfaction. These relationships are independent of job autonomy and relationships with colleagues, which are generally known as important determinants of burnout and job satisfaction. Furthermore, associative stigma among mental health professionals is related with their clients’ self-stigma experiences and, through these experiences, with their satisfaction with services. However, this relationship between associative stigma among professionals and self-stigma among clients can not be explained by professionals’ reports of burnout in general, or depersonalized treatment in particular. Nevertheless, it can be concluded that associative stigma is negatively related with both provider and client satisfaction in mental health services.

Publication year:2008