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- Anticipated and experienced stigma and discrimination in the workplace among individuals with major depressive disorder in 35 countries: qualitative framework analysis of a mixed-method cross-sectional studyPublication . Van Bortel, Tine; Wickramasinghe, Nuwan Darshana; Treacy, Samantha; Khan, Nashi; Ouali, Uta; SUMATHIPALA, ATHULA; Svab, Vesna; Nader, Doaa; Kadri, Nadia; Monteiro, Maria Fátima Jorge; Knifton, Lee; Quinn, Neil; Van Audenhove, Chantal; Lasalvia, Antonio; Bonetto, Chiara; Thornicroft, Graham; Van Dissel, Jaap; Brouwers, EvelienABSTRACT: Objectives: Workplace stigmatisation and discrimination are significant barriers to accessing employment opportunities, reintegration and promotion in the workforce for people with mental illnesses in comparison to other disabilities. This paper presents qualitative evidence of anticipated and experienced workplace stigma and discrimination among individuals with major depressive disorder (MDD) in 35 countries, and how these experiences differ across countries based on their Human Development Index (HDI) level. Design: Mixed-method cross-sectional survey. Participants, setting and measures: The qualitative data were gathered as part of the combined European Union Anti-Stigma Programme European Network and global International Study of Discrimination and Stigma Outcomes for Depression studies examining stigma and discrimination among individuals with MDD across 35 countries. Anticipated and experienced stigma and discrimination were assessed using the Discrimination and Stigma Scale version 12 (DISC-12). This study used responses to the open-ended DISC-12 questions related to employment. Data were analysed using the framework analysis method. Results: The framework analysis of qualitative data of 141 participants identified 6 key 'frames' exploring (1) participants reported experiences of workplace stigma and discrimination; (2) impact of experienced workplace stigma and discrimination; (3) anticipated workplace stigma and discrimination; (4) ways of coping; (5) positive work experiences and (6) contextualisation of workplace stigma and discrimination. In general, participants from very high HDI countries reported higher levels of anticipated and experienced discrimination than other HDI groups (eg, less understanding and support, being more avoided/shunned, stopping themselves from looking for work because of expectation and fear of discrimination). Furthermore, participants from medium/low HDI countries were more likely to report positive workplace experiences. Conclusions: This study makes a significant contribution towards workplace stigma and discrimination among individuals with MDD, still an under-researched mental health diagnosis. These findings illuminate important relationships that may exist between countries/contexts and stigma and discrimination, identifying that individuals from very high HDI countries were more likely to report anticipated and experienced workplace discrimination.
- Psychometric properties of the measure of achieved capabilities in homeless servicesPublication . Greenwood, Ronni Michelle; O'Shaughnessy, Branagh R.; Manning, Rachel M.; Vargas-Moniz, Maria; Sacchetto, Beatrice; Ornelas, José; Jorge-Monteiro, Maria Fátima; Almas, Inês; Duarte, Teresa; Disperati, Francesca; Gaboardi, Marta; Lenzi, Michela; Santinello, Massimo; Vieno, Alessio; Marques, Rita P.; Carmona, Maria; Nave, Américo; Bernad, Roberto; Rivero Jiménez, Borja; Julien, Martin; Bokszczanin, Anna; Zmaczynska-Witek, Barbara; Katarzyna, Skałacka; Rogowska, Aleksandra; Schel, Sandra; Peters, Yvonne; vanLoenen, Tessa; Raben, Liselotte; Wolf, Judith; Beijer, Ulla; Blid, Mats; Källmen, Håkan; Bispo, Maria Teresa; Cruz, Tiago; Pereira, Carla; Auquier, Pascal; Petit, Junie M.; Loubière, Sandrine; Tinland, AurélieBackground Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.