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Psychiatr Q. 2009 Mar;80(1):55-64. doi: 10.1007/s11126-009-9093-7. Epub 2009 Feb 4.

"Unfortunately, we treat the chart:" sources of stigma in mental health settings.

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  • 1Department of Psychiatry, Yale School of Medicine, 319 Peck Street, Building 1, New Haven, CT 06513, USA.



Stigma within mental health settings may be equally detrimental to people with mental illnesses as societal stigma.


This study investigated stigma in mental health settings through a mixed qualitative-quantitative design.


Practitioners at a community mental health center indicated (1) their subjective experience of treating people with mental illness, and (2) descriptive features of people with mental illness.


Interpretive phenomenological analysis found that a primary theme across practitioners was the causes and effects of labeling patients, a process practitioners attributed to other practitioners and/or to systemic pressures to "treat the chart" instead of the patient. Beyond symptoms and deficits, practitioners rated people with mental illnesses as "insightful" and "able to recover."


These data suggest that stigma in mental health settings may be due to structural, systemic pressures on practitioners, with practitioners' emphasis on symptoms and deficits as a secondary factor.

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