A life without stigma : A SANE Report

download A life without stigma : A SANE Report

of 36

Transcript of A life without stigma : A SANE Report

  • 7/28/2019 A life without stigma : A SANE Report

    1/36

    2

    B [BM@ X`part

  • 7/28/2019 A life without stigma : A SANE Report

    2/36

  • 7/28/2019 A life without stigma : A SANE Report

    3/36

    2Wobt da w` l`bm hy stjglb1

    ;[tjglb bmd paijky

    8Wobt js stjglbs jlpbkt1

    4Wobt js h`jmg dam`1

    0Wobt wares1

    3[ullbry + X`kall`mdbtjams

    7X`c`r`mk`s

  • 7/28/2019 A life without stigma : A SANE Report

    4/36

    Wobt js

    stjglb1

  • 7/28/2019 A life without stigma : A SANE Report

    5/36

    2

    B ijc` wjtoaut stjglb 2

    Wobt js stjglb1

    [tjglb wbs car l` to` last bgamjsjmg pbrt ac ly djsard`r. Jt kast crj`mdsojps,

    kbr``r appartumjtj`s, bmd last jlpartbmtiy ly s`ic-`st``l.

    Wo`m to` ward stjglb js us`d, jt g`m`rbiiy cakus`s am

    to` umjmcarl`d bmd m`gbtjv` bttjtud`s o`id hy lbmy jm to`

    g`m`rbi kallumjty tawbrds p`api` wjto l`mtbi jiim`ss.Woji` krjtjkbiiy jlpartbmt, tojs t`iis amiy pbrt ac to` stary.

    [tjglb kal`s jm lbmy sobp`s bmd carls.

    [tjglb obs h``m d`skrjh`d bs bm av`rbrkojmg kamk`pt tobt

    kamtbjms tor`` `i`l`mts6 prahi`ls ac emawi`dg` (jgmarbmk`),

    prahi`ls ac bttjtud`s (pr`fudjk`), bmd prahi`ls ac h`obvjaur

    (djskrjljmbtjam) (Toarmjkract `t bi 8>>7).

    B ijc` wjtoaut stjglbtbe`s b hrabd bpprabko, g`ttjmg ta to` o`brt

    ac to` d`vbstbtjmg jlpbkt stjglb kbm obv` am to` ijv`s ac p`api`

    wjto l`mtbi jiim`ss bmd to`jr cbljij`s, crj`mds bmd ato`r kbr`rs.

    Jt kobii`mg`s to` ourtcui bmd jmbkkurbt` vj`ws tobt p`api` wjto

    l`mtbi jiim`ss br` ac i`ss vbiu` ta sakj`ty ar ta to`ls`iv`s.

    Drbwjmg cral sakjbi to`ary bmd puhijk o`bito, tojs d`flmjtjam

    ac stjglb jmkarparbt`s to` jlpartbmk` ac to` `mvjraml mt jm

    wojko p`api` ijv`, bs w`ii bs to` strukturbi, paijtjkbi bmd paw`r

    jlhbibmk`s tobt br` sa jmt`grbi ta to` prak`ss ac stjglbtjsjmg.

    [tjglb js to`r`car` b kalpi`x sakjbi prak`ss tobt obs b mulh`r

    ac jmt`rkamm`kt`d bmd lutubiiy r`jmcarkjmg pbrts wojko ware

    tag`to`r ta `xkiud` bmd tbe` bwby to` rjgots ac p`api` wjto b

    l`mtbi jiim`ss. To` p`rsam js tr`bt`d djcc`r`mtiy ar djskrjljmbt`d

    bgbjmst sai`iy h`kbus` to`y obv` b l`mtbi jiim`ss.

    Ijme bmd ^o`ibm (8>>2), obv` kamk`ptubijs`d stjglb bs jmvaivjmgs`v`rbi jmt`rr`ibt`d `i`l`mts6

    c Jd`mtjflkbtjam bmd ibh`ijmg ac djcc`r`mk`.

    c Kuiturbi h`ij`cs tobt ijme to` ibh`i bmd to` ibh`i`d p`rsam

    ta m`gbtjv` st`r`atyp`s.

    c Ibh`i`d p`api` br` to`m kbt`garjs`d jm b wby tobt

    kr`bt`s b ki`br djstjmktjam h`tw``m us bmd to`l.

    c [tjglbtjsbtjam js s``m bs kamtjmg`mt am sakjbi struktur`s

    tobt pravjd` um`qubi bkk`ss ta sakjbi, `kamaljk bmd

    paijtjkbi paw`r. Amiy paw`rcui sakjbi graups obv` to`

    bhjijty ta kr`bt` bmd lbjmtbjm djskrjljmbtary prbktjk`s.

    [uppartjmg tojs bpprabko, [BM@ Bustrbijb obs jd`mtjcj`d b rbmg`

    ac i`v`is bt wojko stjglb ap`rbt`s ([BM@ Bustrbijb 8>>4).

    2Pmd`rstbmdjmg bmd ljsumd`rstbmdjmg

    Bm Bustrbijbm surv`y ac to` g`m`rbi kallumjty caumd tobt

    bwbr`m`ss, emawi`dg` bmd bttjtud`s djcc`r`d d`p`mdjmg am to`

    l`mtbi jiim`ss jm qu`stjam6

    c D`pr`ssjam js wjd`iy emawm bmd umd`rstaad, bmd

    kallumjty bttjtud`s br` r`ibtjv`iy h`mjgm

    c Bmxj`ty js r`kagmjs`d luko i`ss tobm d`pr`ssjam5

    kallumjty bttjtud`s br` r`ibtjv`iy h`mjgm

    c [kojzapor`mjb js wjd`iy emawm hut paariy umd`rstaad.

    Bttjtud`s tawbrd p`api` wjto skojzapor`mjb br` i`ss

    pasjtjv` tobm tawbrds ato`r kamdjtjams, pbrtjkuibriy jm

    to` warepibk` bmd jm prjvbt` spbk`s

    c Hjpaibr djsard`r js m`jto`r w`ii emawm mar umd`rstaad.

    Bttjtud`s tawbrds toas` wjto hjpaibr djsard`r br` i`ss

    pasjtjv` tobm toas` tawbrds p`api` wjto d`pr`ssjam ar

    bmxj`ty.

    Tojs r`s`brko (W`si`y Ljssjam 8>>7) ojgoijgot`d b krukjbi

    m``d ta rbjs` kallumjty bwbr`m`ss bhaut bmxj`ty bmd hjpaibr

    djsard`r, bs w`ii bs ta d`hume lytos surraumdjmg skojzapor`mjb

    bmd hjpaibr djsard`r.

    ^ibmmjmg bmd s`rvjk` d`ijv`ry

    ^aijtjkbi

    Cumdjmg biiakbtjam

    O`bito prac`ssjambis

    L`djb

    [`ic-stjglb

    I`gjsibtjv`

    Kallumjty

  • 7/28/2019 A life without stigma : A SANE Report

    6/36

    8

    [tjglb da`s mat bcc`kt `v`ryam` wjto b l`mtbi jiim`ss jm to`

    sbl` wby to`r`car . Jt kbm vbry cral p`rsam ta p`rsam bmd

    sal` graups bpp`br bcc`kt`d lar` tobm ato`rs. To`r` br`, car

    `xblpi`, d`gr``s ac stjglb bmd djskrjljmbtjam `xp`rj`mk`d hy

    p`api` wjto djcc`r`mt djbgmas`s bmd car p`api` wjtojm djcc`r`mt

    sakjbi, bg`, kuiturbi, ar r`ijgjaus graups.

    To` last r`k`mt ibrg`-skbi` Bustrbijbm kallumjty surv`yjmv`stjgbt`d vj`ws am d`pr`ssjam, skojzapor`mjb, sakjbi

    poahjb bmd past-trbulbtjk str`ss djsard`r (^T[D). ^`rk`ptjams

    ac djskrjljmbtjam, sakjbi djstbmk`, dbmg`rausm`ss bmd

    umpr`djktbhjijty w`r` g`m`rbiiy ojgo`st car skojzapor`mjb, woji`

    h`ij`cs jm to` kamdjtjam bs b sjgm ac p`rsambi w`bem`ss ar mat b

    r`bi l`djkbi jiim`ss w`r` g`m`rbiiy ojgo`r car sakjbi poahjb tobm

    car ato`r djsard`rs (X`bvi`y bmd Farl 8>22).

    X`jmcarkjmg to` djcc`r`mk`s h`tw``m jiim`ss`s, bm jmt`rmbtjambi

    study hy Jmdjbmb Pmjv`rsjty, wojko jmvaiv`d 23kaumtrj`s, caumd

    tobt wo`m kalpbr`d ta d`pr`ssjam, stjglb bgbjmst skojzapor`mjb

    js sjgmjflkbmtiy ojgo`r bkrass to` warid. Tojs study bisa iaae`dbt kuiturbi hbrrj`rs bmd kallumjty h`ij`cs, wojko pravjd` bm

    jlpartbmt kamt`xt. Car `xblpi`, jc p`api` h`ij`v` tobt l`mtbi

    jiim`ss js kbus`d hy hbd d``ds jm am`s bmk`stry ar hy `vji spjrjts,

    ar tobt sjlpiy tbiejmg bhaut l`mtbi jiim`ss kbm lbe` jt wars`,

    to`m bmy stjglb r`duktjam bktjvjty obs ta stbrt to`r` (Xaam`y `t

    bi 2::75^`skaijda `t bi 8>2;).

  • 7/28/2019 A life without stigma : A SANE Report

    7/36

    ;

  • 7/28/2019 A life without stigma : A SANE Report

    8/36

    Wobt js stjglbs

    jlpbkt1

  • 7/28/2019 A life without stigma : A SANE Report

    9/36

    0

    B ijc` wjtoaut stjglb 8

    Wobt js stjglbs jlpbkt1

    Ly l`mtbi jiim`ss js ma iamg`r to` prahi`l car l`. Jts oaw ato`r p`api` vj`w l` tobts to`

    djccjkuity. Wjtoaut emawjmg jt, ar `v`m l`bmjmg ta, J g`t b c``ijmg tobt sal`oaw Jl ac i`ss vbiu`

    tobm to`y br`, tobt ly jiim`ss js ly cbuit ar tobt J kbmmat h` trust`d, wojko js wobt r`biiy kbus`s

    l` pbjm bmd `lhbrrbssl`mt.

    [tjglb bgbjmst l`mtbi jiim`ss js kallam.

    Jts jlpbkt js s`rjaus.

    [tudj`s jm Bustrbijb bmd av`rs`bs soaw tobt stjglb js b v`ry

    kallam `xp`rj`mk`. B [BM@ Bustrbijb surv`y (8>>3) caumd

    tobt bilast tor``-qubrt`rs ac r`spamd`mts ijvjmg wjto b l`mtbi

    jiim`ss (74%) obd `xp`rj`mk`d stjglb. To`y sbjd b r`duktjam

    jm stjglb wauid o`ip to`l ta6 c``i h`tt`r bhaut to`ls`iv`s5

    lbmbg` to`jr jiim`ss h`tt`r5 g`t hbke ta ware ar study, bmd, fajm

    jm sakjbi bktjvjtj`s.

    Bustrbijbm r`s`brko blamg p`api` ijvjmg wjto b psykoatjk

    jiim`ss, suko bs skojzapor`mjb, caumd tobt bilast 4>% r`part`d

    `xp`rj`mkjmg stjglb ar djskrjljmbtjam jm to` pbst y`br biam`.

    To` prapartjam wbs ojgo`r jm c`lbi`s, wjto bilast b obic

    r`partjmg stjglb ar djskrjljmbtjam jm to` pbst y`br kalpbr`d

    wjto b tojrd ac lbi`s. Lbmy r`part`d tobt to` c`br ac stjglb

    ar djskrjljmbtjam obd stapp`d to`l dajmg sal` ac to` tojmgs

    to`y obd wbmt`d ta da, bmd av`rbii stjglb bmd djskrjljmbtjam

    wbs am` ac to` lbjm kobii`mg`s r`part`d car to` kaljmg y`br.

    (Largbm `t bi 8>22).

    [tjglb kbm h` `xp`rj`mk`d djr`ktiy, bs wo`m sal`am` js

    bvajd`d du` ta b djbgmasjs ac skojzapor`mjb, ar js pbss`d av`r

    car pralatjam sai`iy h`kbus` b lbmbg`r emaws to`y obv` obd

    d`pr`ssjam. Jt kbm bisa h` s``m jm puhijk p`rk`ptjams car

    `xblpi`, jm to` kallam bssakjbtjam ac skojzapor`mjb wjto

    vjai`mk`. Jt js stjglb tawbrds am`s`ic, oaw`v`r, wojko kbm da to`

    last obrl.

    ^`api` ijvjmg wjto l`mtbi jiim`ss wbmt to` sbl` hbsjk tojmgs bs

    `v`ryam` `is`6

    c B oal` sal`wo`r` d`k`mt ta ijv`

    c B fah ar sal`tojmg l`bmjmgcui ta da b r`bsam ta g`t

    up jm to` larmjmg

    c B ijc` warto ijvjmg crj`mds ta sobr` yaur ijc` wjto bmd

    gjv` yau oap`.

    [tjglb kbm stap p`api` wjto l`mtbi jiim`ss cral bkoj`vjmg to`s`hbsjk m``ds bmd lbmjc`sts jts`ic jm lbmy wbys, jm lbmy djcc`r`mt

    s`ttjmgs. To` autkal` js tobt p`api` lby ijv` i`ss sbtjscyjmg bmd

    kamtrjhutjmg ijv`s tobm to`y wauid ije`, bmd br` bhi` ta lbe`.

    To` kallumjty js luko paar`r bs b r`suit taa.

    B W`si`y Ljssjam study (8>>7) caumd tobt to`jr kij`mts c`it

    to`y w`r` stjglbtjs`d bmd djskrjljmbt`d bgbjmst jm b mulh`r ac

    djcc`r`mt br`bs, jmkiudjmg6

    c Jmsurbmk` kalpbmj`s lbejmg jt djcflkuit car p`api` wjto

    b l`mtbi jiim`ss ta g`t o`bito ar ijc` jmsurbmk`

    c @lpiay`rs/pat`mtjbi `lpiay`rs mat h`jmg acc`r`d

    `lpiayl`mt ar tbe`m bdvbmtbg` ac jm to` warepibk`

    c [koaai d`mj`d appartumjtj`s ar ibh`ii`d bs ejds wjto

    prahi`l h`obvjaurs

    c ^aijk` h`jmg p`rk`jv`d bs trauhi`-lbe`rs

    c Oaspjtbis h`jmg p`rk`jv`d bs b mujsbmk` bct`r r`p`btbdljssjams

    c L`djb ljsr`pr`s`mt`d jm to` l`djb, car `xblpi`,

    l`mtbi jiim`ss js act`m bssakjbt`d wjto vjai`mk`

    c Kallumjty h`jmg soumm`d, `xp`rj`mkjmg v`rhbi bmd

    poysjkbi bhus`

    c L`mtbi o`bito prac`ssjambis stbcc kbm hurm aut bmd

    hibl` to` kij`mts car to`jr h`obvjaurbi prahi`ls

    c Cbljij`s r`f`ktjmg bmd hibljmg to`l car to`jr kamdjtjam

    c Djskrjljmbtjam hy d`kjsjam-lbe`rs jm g`m`rbi.

    B M`w V`bibmd surv`y kamdukt`d bs pbrt ac to` Ije` Ljmds, Ije`

    Ljm`bmtj-djskrjljmbtjam kblpbjgm r`part`d tobt6

    c ^`api` r`part djskrjljmbtjam jm bii bsp`kts ac to`jr ijv`s

    cral lpiayl`mt bmd oausjmg ta djskrjljmbtjam cral

    crj`mds bmd cbljiy bmd to` kallumjty. Tojs r`suits jm

    p`api` c``ijmg `xkiud`d cral lbmy bktjvjtj`s. C`w carlbi

    kalpibjmts bhaut djskrjljmbtjam br` lbd`.

    c Djskrjljmbtjam, `v`m wo`m jt akkurr`d s`v`rbi y`brs bga,

    lbe`s b ibstjmg jlpr`ssjam bmd stjii bcc`kts p`api`s ijv`s

    tadby. Du` ta pbst `xp`rj`mk`s, lbmy p`api` bttrjhut`

    bmy paar s`rvjk` to`y r`k`jv` bs djskrjljmbtjam h`kbus`

    to`y obv` b l`mtbi jiim`ss.

  • 7/28/2019 A life without stigma : A SANE Report

    10/36

    3

    c To` c`br ac djskrjljmbtjam (act`m hbs`d am pbst

    `xp`rj`mk`) js bs krjppijmg bs djskrjljmbtjam jts`ic.

    C`br ac djskrjljmbtjam jmojhjts p`api` cral umd`rtbejmg

    lbmy bktjvjtj`s jm to`jr ijv`s suko bs `lpiayl`mt bmd

    jmt`rbktjmg wjto ato`rs.

    c Djskiasur` js bm jssu` bkrass bii to` br`bs ac

    djskrjljmbtjam. Wo`m p`api` djskias` tobt to`y obv`

    `xp`rj`mk` ac l`mtbi jiim`ss to`y br` tr`bt`d djcc`r`mtiy

    (act`m m`gbtjv`iy) ta wo`m to`y da mat.

    c ^`api` t`md ta h`ij`v` bmd bkt am to` kallam

    st`r`atyp`s ac p`api` wjto `xp`rj`mk` ac l`mtbi jiim`ss

    bs h`jmg jmkalp`t`mt ar dbmg`raus.

    Karrjgbm (8>>8) jd`mtjfl`s to` kalpaumdjmg bmd r`jmcarkjmg

    jlpbkts ac puhijk bmd s`ic-stjglb am to` `v`rydby ijv`s ac p`api`

    wjto l`mtbi jiim`ss.

    ^uhijk stjglb

    [t`r`atyp` M`gbtjv h`ij`c bhaut b graup

    (dbmg`rausm`ss, jmkalp`t`mk`, kobrbkt`rw`bem`ss)

    ^r`fudjk` Bgr``l`mt wjto h`ij`c bmd/ar m`gbtjv`

    `latjambi r`bktjam (bmg`r, c`br)

    Djskrjljmbtjam H`obvjar r`spams` ta pr`fudjk` (bvajdbmk`,

    wjtooaidjmg `lpiayl`mt bmd oausjmg

    appartumjtj`s, wjtooaid o`ip)

    [`ic-stjglb

    [t`r`atyp` M`gbtjv` h`ij`c bhaut to` s`ic (kobrbkt`r

    w`bem`ss, jmkalp`t`mk`)

    ^r`fudjk` Bgr``l`mt wjto ato`rs stjglb, m`gbtjv``latjambi r`bktjam (iaw s`ic-`st``l, iaw

    s`ic-`cflkbky)

    Djskrjljmbtjam H`obvjar r`spams` ta pr`fudjk` cbjis ta

    pursu` ware bmd oausjmg appartumjtj`s)

    To` jlpbkt ac stjglb kbm h` argbmjs`d jmta s`v`m r`bi warid

    dalbjms wojko bcc`kt p`api` ijvjmg wjto b l`mtbi jiim`ss bmd

    toas` woa br` kias` ta to`l6

    2 G`m`rbi kallumjty

    8 O`bito bmd ato`r s`rvjk`s

    ; @dukbtjam

    4 Warepibk`

    0 Lbss l`djb

    3 Gav`rml`mt

    7 [`ic-stjglb.

    To` caiiawjmg s`ktjams iaae bt `bko ac to` s`v`m br`bs ac jlpbkt

    jm lar` d`tbji.

    2 G`m`rbi kallumjty

    J obv` b dr`bl tobt am` dby J wamt oaid ly hr`bto `v`ry tjl` J t`ii b

    p`rsam tobt J succ`r cral hjpaibr djsard`r, tobt J wamt c``i sobl`cui jm

    kamc`ssjmg ly l`mtbi jiim`ss.

    C``ijmg tobt yau h`iamg js bm jlpartbmt oulbm m``d. Obvjmg

    crj`mds, iakbi kamm`ktjams bmd bktjvjtj`s yau `mfay, bs w`ii bs

    lbejmg b kamtrjhutjam ta yaur awm ar ta ato`rs w`iih`jmg biio`ip lbe` ijc` wartowoji`.

    Woji` to`r` obv` h``m sal` jlprav`l`mts jm emawi`dg` bhaut

    l`mtbi jiim`ss bmd umd`rstbmdjmg ac jts jlpbkt am dby-ta-dby

    ijv`s, to`r` js stjii wjd`spr`bd ljsumd`rstbmdjmg bmd jgmarbmk`,

    pbrtjkuibriy bhaut sal` djbgmas`s. Lytos suko bs tobt p`api`

    wjto d`pr`ssjam br` w`be bmd soauid fust puii to`jr sakes up,

    ar tobt bii p`api` wjto psykoatjk jiim`ss`s suko bs skojzapor`mjb

    br` umpr`djktbhi bmd ta h` c`br`d br` ourtcui bmd obrlcui bs

    w`ii bs h`jmg jmbkkurbt`. Djsp`iijmg to`s` lytos js jlpartbmt jc

    p`api` wjto l`mtbi jiim`ss br` ta h` cuiiy bkk`pt`d jmta cbljij`s,

    warepibk`s bmd kallumjtj`s.

    Bustrbijbm bmd av`rs`bs surv`ys suppart to` m``d car kallumjty

    `dukbtjam bmd obv` jd`mtjfl`d b wjd` rbmg` ac pbrtjkuibr

    ljsumd`rstbmdjmgs tobt m``d ta h` tbkei`d.

    To` 8>2;Mbtjambi L`mtbi O`bito Kalljssjam r`part, Kbm

    w` tbie . . . bhaut l`mtbi o`bito bmd sujkjd`, hbs`d am jmcarlbi

    graup djskussjams braumd Bustrbijb, s`t aut ta r`kr`bt` to`

    kamv`rsbtjams Bustrbijbms br` obvjmg bhaut l`mtbi o`bito bmd

    sujkjd` bt oal`, bt ware bmd wjto to`jr crj`mds. Mbtjambi L`mtbi

    O`bito Kalljssjam`r, Fbm`t L`bgo`r, sbys to` study r`jmcark`s

    tobt w` br` stjii struggijmg ta lbe` s`ms` ac l`mtbi jiim`ss bmd

    sujkjd`, bmd tobt to` stjglb bssakjbt`d wjto bkk`ssjmg to` l`mtbi

    o`bito syst`l js am` ac to` hjgg`st hbrrj`rs ta tr`btl`mt.

    To` W`si`y Ljssjam study (8>>7) caumd tobt am` jm tor`` (;8%)

    wauid mat c``i kalcartbhi` warejmg wjto b kaii`bgu` woa obs

    l`mtbi jiim`ss. Twa-tojrds (33%) wauid mat h` kalcartbhi`

    wjto to`jr kojid sobrjmg b umjt wjto sal`am` woa obd b l`mtbi

    jiim`ss, bmd 72% djd mat h`ij`v` p`api` wjto l`mtbi jiim`ss kauid

    h` trust`d jm pasjtjams ac ojgo r`spamsjhjijty.

    M`gbtjv` bttjtud`s w`r` lar` kallam blamg r`spamd`mts

    3>y`brs bmd aid`r, wjtoaut b umjv`rsjty `dukbtjam, ar cral b

    oaus`oaid wjto bm jmkal` i`ss tobm $0>,>>>b y`br.To` Bustrbijbm Mbtjambi [urv`y ac L`mtbi O`bito Ijt`rbky bmd

    [tjglbcaumd tobt stbt`l`mts wjto wojko r`spamd`mts w`r`

    last ije`iy ta bgr`` ar stramgiy bgr`` jmvaiv`d b p`rk`ptjam

    ac ato`r p`api`s h`ij`cs6 tobt p`api` wjto l`mtbi jiim`ss w`r`

    umpr`djktbhi`, tobt toas` bcc`kt`d wauid mat t`ii bmyam` bhaut

    to`jr djbgmasjs, bmd tobt last ato`r p`api` wauid mat `lpiay

    sal`am` wjto to` prahi`l (X`bvi`y bmd Farl 8>22).

    Jm r`ibtjam ta d`pr`ssjam, to` flmdjmgs ac b s`rj`s ac h`yamdhiu`

    kallumjty surv`ys jmdjkbt` tobt kobmg` js obpp`mjmg bitoaugo

    to`r` js stjii b iamg wby ta ga. To` p`rk`mtbg` ac p`api` woa

    bgr``d tobt p`api` wjto s`v`r` d`pr`ssjam br` umr`ijbhi`r`duk`d cral 33% jm 8>>8ta 08% jm 8>>?. Toas` woa

    bgr``d wjto to` stbt`l`mt tobt p`api` wjto s`v`r` d`pr`ssjam

  • 7/28/2019 A life without stigma : A SANE Report

    11/36

    7

    br` umpr`djktbhi` r`duk`d cral 7?% ta 3?%. Bgr``l`mt tobt

    p`api` wjto s`v`r` d`pr`ssjam soauid puii to`ls`iv`s tag`to`r

    r`duk`d cral ;3% ta 84% jm 8>>?(h`yamdhiu` 8>22).

    To`s` flmdjmgs br` `koa`d jm av`rs`bs studj`s, suko bs b r`k`mt

    surv`y ac bttjtud`s ta l`mtbi jiim`ss jm to` PE wojko r`part`d

    tobt djr`kt sakjbi kamtbkt wjto p`api` wjto l`mtbi o`bito

    prahi`ls js to` last `cc`ktjv` wby ta kobii`mg` stjglb bmdkobmg` puhijk bttjtud`s (D`pt ac O`bito 8>2>).

    8 O`bito bmd ato`r s`rvjk`s

    [al`tjl`s murs`s . . . damt `mkaurbg` yau ta da sal`tojmg m`w ar t`ii

    yau mat ta ga car b fah. To`y saw to` s``ds ac dauht.

    Wo`m w` br` umw`ii, w` `xp`kt ta h` tr`bt`d wjto

    umd`rstbmdjmg bmd r`sp`kt hy p`api` warejmg jm o`bito bmd

    kallumjty s`rvjk`s. Pmcartumbt`iy tojs js mat biwbys to` kbs`

    car p`api` wjto l`mtbi jiim`ss, woa cr`qu`mtiy r`part tobt to`y

    c``i stjglbtjs`d.

    O`bito bmd l`mtbi o`bito s`rvjk`s

    B L`mtbi O`bito Kaumkji ac Bustrbijb study (8>22) caumd tobt

    p`api` wjto l`mtbi jiim`ss r`part`d sjljibr i`v`is ac stjglb cral

    o`bito prac`ssjambis bs cral to` g`m`rbi kallumjty.

    [al` ac to` studys e`y flmdjmgs br` tobt6

    c Bilast 8:% r`part`d tobt b o`bito prac`ssjambi obd

    soumm`d to`l. To`s` flgur`s ras` ta av`r 0>%

    car p`api` wjto past-trbulbtjk str`ss djsard`r bmd

    hard`rijm` p`rsambijty djsard`r.

    c Av`r ;4% obd h``m bdvjs`d hy b o`bito prac`ssjambi taiaw`r to`jr `xp`ktbtjams car bkkalpijsol`mt jm ijc`.

    c Av`r 44% bgr``d tobt o`bito prac`ssjambis tr`btjmg

    to`l car b poysjkbi djsard`r h`obv`d djcc`r`mtiy wo`m

    to`y djskav`r`d to`jr ojstary ac b l`mtbi jiim`ss.

    Bs Ebtoi``m Grjcfltos ac to` BMP K`mtr` car L`mtbi O`bito

    X`s`brko wrjt`s jm to` studys car`ward6

    Jt js umtojmebhi` tobt o`bito prac`ssjambis wauid stjglbtjs` Bustrbijbms

    wjto b poysjkbi kamdjtjam suko bs kbmk`r ar b o`brt kamdjtjam. Oaw`v`r,

    to`r` js b wjd`spr`bd h`ij`c tobt l`mtbi o`bito kamsul`rs mkaumt`r

    stjglbtjsjmg bttjtud`s cral o`bito prac`ssjambis. [uko stjglb pas`s b

    suhstbmtjbi rjse ta to` w`iih`jmg ac kamsul`rs wjto b l`mtbi jiim`ss. Jt js

    b pat`mtjbi hbrrj`r ta vjtbi o`ip-s``ejmg cral o`bito prac`ssjambis, jt kbm

    curto`r `xbk`rhbt` b kamsul`rs psykoaiagjkbi djstr`ss, bmd jt lby r`duk`

    kbr``r appartumjtj`s.

    Ato`r o`bito s`rvjk`s br` mat biwbys h`tt`r. [al` p`api` r`part

    djsljssjv` bttjtud`s cral g`m`rbi prbktjtjam`rs, car `xblpi`,

    wo`r`hy pr`s`mtbtjams ac poysjkbi sylptals w`r` bssul`d ta

    h` bii jm to` ljmd bs am` PE study r`parts (Iyams `t bi, 8>>:).

    Tojs js `sp`kjbiiy kamk`rmjmg, bs `vjd`mk` sugg`sts p`api` wjto

    l`mtbi jiim`ss br` bt gr`bt`r rjse cral poysjkbi o`bito prahi`ls,

    jmkiudjmg kbrdjavbskuibr djs`bs`, djbh`t`s, ah`sjty bmd

    r`spjrbtary djs`bs`5 to`y bisa obv` b ojgo`r rjse ac pr`lbtur`

    d`bto (Kagoibm `t bi 8>>2).

    To` apjmjams ac suppart ware`rs bhaut tr`btl`mt bmd r`kav`ry

    w`r` caumd sjljibr ta toas` o`id hy to` g`m`rbi puhijk jm bmato`r

    PE study (Krjsp `t bi 8>>>). Oaw`v`r, to`jr apjmjams bhaut

    dbmg`rausm`ss w`r` djcc`r`mt c`w`r h`ij`v`d tobt p`api` wjto

    l`mtbi jiim`ss w`r` vjai`mt. Lbmy suppart ware`rs (?3.0%) obd

    prjar p`rsambi emawi`dg` ac l`mtbi jiim`ss. Woji` sp`mdjmg tjl`

    wjto p`api` wjto l`mtbi jiim`ss kbm ware ta kobmg` bttjtud`s,

    to` butoars bisa mat` tobt sal` suppart ware`rs da mat biwbysflmd jt `bsy ta tbie ta p`api` wjto l`mtbi jiim`ss, bmd tobt ibke ac

    bkemawi`dg`l`mt ac to`s` djcflkuitj`s kauid i`bd ta c``ijmgs ac

    p`rsambi jmbd`qubky, p`robps r`suitjmg jm bvajdbmk`.

    Jt js jlpartbmt ta bkemawi`dg` tobt o`bito bmd kallumjty

    suppart ware`rs lby bisa `xp`rj`mk` stjglbtjsjmg bttjtud`s bmd

    djskrjljmbtary h`obvjaur. Tojs lby r`suit jm iaw`r r`krujtl`mt

    bmd r`t`mtjam rbt`s jm to`s` fahs. Bs w`ii bs h`jmg tbrg`ts car

    stjglb-r`duktjam ware to`r`car , to`s` graups bmd s`ttjmgs wjii

    bisa h` h`m`flkjbrj`s ac jt.

    Oausjmg

    ^`api` wjto l`mtbi jiim`ss lby h` stjglbtjs`d bmd djskrjljmbt`d

    bgbjmst hy m`jgohaurs6 to`y lby . . . bt h`st h` gjv`m to` kaid

    soauid`r bmd bt warst h` vjktjljs`d hy ato`r t`mbmts (L`mtbi

    O`bito Kallumjty Kabijtjam BKT 8>>0).

    D`k`mt, s`kur` bmd bccardbhi` oausjmg, wjto suppart bs m``d`d,

    js cumdbl`mtbi ta r`kav`ry cral l`mtbi jiim`ss, y`t tojs js jm

    soart suppiy bmd act`m mat biwbys bvbjibhi` ta p`api` wjto

    l`mtbi jiim`ss.

    To` Bustrbijbm Hur`bu ac [tbtjstjks r`parts tobt p`api` woa

    br` ijvjmg wjto b l`mtbi o`bito prahi`l flmd jt obrd`r ta g`tbmd e``p to`jr awm oal` kalpbr`d ta to` g`m`rbi papuibtjam5

    c`w r awm to`jr awm oal` ar br` pbyjmg acc b lartgbg`, lar`

    r`mt to`jr oal`s bmd to`jr m``d car oausjmg suppart js grawjmg.

    (Bustrbijbm Hur`bu ac [tbtjstjks, 8>>:).

    B 8>>?surv`y ac p`api` ijvjmg wjto l`mtbi jiim`ss caumd tobt

    m`briy :>% h`ij`v`d to`y obd h``m djskrjljmbt`d bgbjmst bt

    sal` tjl` jm r`gbrd ta oausjmg, pbrtjkuibriy prjvbt` r`mtbi

    bkkalladbtjam, carkjmg to`l ta bkk`pt umsbc` ar suhstbmdbrd

    oausjmg aptjams. Braumd b tojrd (;4%) obd kamk`rms bhaut

    h`kaljmg oal`i`ss jm to` cutur`, bmd 47% w`r` iaaejmg car

    sal`wo`r` `is` ta ijv`. Djcflkuity flmdjmg sujtbhi` oausjmg wbsbm amgajmg kamk`rm ([BM@ Bustrbijb 8>>?).

    Bttjtud`s ac ibmdiards, bg`mts bmd bkkalladbtjam ware`rs

    umdauht`diy jmu`mk` oausjmg autkal`s. B study jm to` P[

    `xbljm`d wobt `cc`kt o`brjmg tobt sal`am` obs b l`mtbi jiim`ss

    obs am ahtbjmjmg kallumjty bkkalladbtjam. Jm b sblpi`

    ac 23>p`api` bdv`rtjsjmg r`mtbi prap`rty, t`i`poam` kbiis

    car obic to` sblpi` lbd` sjlpi` `mqujrj`s bs ta bvbjibhjijty5

    car to` ato`r obic, sjljibr `mqujrj`s w`r` lbd` hy sal`am`

    ast`msjhiy r`k`jvjmg psykojbtrjk tr`btl`mt hut saam ta r`qujr`

    bkkalladbtjam. Car p`api` toaugot ta obv` b l`mtbi jiim`ss,

    raals w`r` sjgmjflkbmtiy lar` ije`iy ta h` d`skrjh`d bsumbvbjibhi` (^bg` 2::;).

  • 7/28/2019 A life without stigma : A SANE Report

    12/36

    ?

    ; @dukbtjam

    J wbs djbgmas`d wjto AKD wo`m J wbs 2;bmd obv` cbk`d bii typ`s ac

    stjglb av`r to` y`brs. Lbjmiy kibsslbt`s lbejmg cum ac l` bmd to`

    sylptals ac ly jiim`ss. Jt obd b oug` cc`kt am ly kamfld`mk` bmd kbm h`

    am` ac to` obrd`st pbrts ac d`bijmg wjto b l`mtbi o`bito prahi`l.

    Tor``-qubrt`rs ac p`api` woa d`v`iap l`mtbi jiim`ss da sa

    h`tw``m to` bg`s ac 23bmd 80y`brs. X`dukjmg stjglb jmskoaais, TBC@ bmd ato`r kaii`g`s, bmd umjv`rsjtj`s js bm jmt`grbi

    pbrt ac stjglb r`duktjam ware jc w` br` ta `mkaurbg` lar`

    yaumg p`api` ta c``i AE bhaut bsejmg car o`ip bmd, wo`m

    m`k`ssbry, bkk`ptjmg amgajmg tr`btl`mt. Jt js bisa krjtjkbi jc w`

    wbmt crj`mds, c`iiaw stud`mts, t`bko`rs bmd ato`rs ta pravjd`

    to`l wjto umd`rstbmdjmg bmd suppart. Tojs js b grawjmg

    jssu`. Jm Zaumg Bustrbijbms6 To`jr O`bito bmd W`iih`jmg, to`

    Bustrbijbm Jmstjtut` ac O`bito bmd W`icbr` (8>>7) r`part`d tobt

    psykoaiagjkbi djstr`ss wbs jmkr`bsjmg, wjto av`r 80% ac p`api`

    bg`d 2?-84obvjmg b l`mtbi djsard`r. Ac sp`kjbi kamk`rm js tobt

    amiy braumd am` jm caur (88%) ac yaumg p`api` `xp`rj`mkjmg bl`mtbi o`bito prahi`l saugot prac`ssjambi o`ip.

    Jts `bsy ta s`` woy stjglb lby h` bssakjbt`d wjto tojs iaw rbt`

    ac o`ip-s``ejmg. X`s`brko kbrrj`d aut jm to` PE caumd tobt m`briy

    am` jm 2>yaumg p`api` tojme tobt kibsslbt`s wjto b l`mtbi

    o`bito prahi`l soauid mat h` bt to`jr skoaai, woji` to` sbl`

    prapartjam sbjd to`y wauid stap h`jmg crj`mds wjto b p``r woa

    obd b l`mtbi o`bito prahi`l (Tjl` ta kobmg` 8>>?).

    To` r`s`brko caumd tobt mjm` aut ac 2>yaumg p`api` woa

    obv` b l`mtbi o`bito prahi`l r`part`d `xp`rj`mkjmg m`gbtjv`

    tr`btl`mt bs b r`suit ac to`jr l`mtbi jiim`ss. Act`m, luko ac to`

    djskrjljmbtjam to`y cbk` kal`s cral toas` to`y ljgot m``dta turm ta flrst jmkiudjmg crj`mds (33%), pbr`mts (04%) bmd,

    soakejmgiy, t`bko`rs bmd i`ktur`rs (4:%). Jt js ki`br, to`r`car`

    tobt to` bttjtud`s ac pbr`mts, p``rs bmd t`bko`rs act`m m``d ta h`

    bddr`ss`d. [jljibr rbt`s w`r` r`part`d jm to` P[.

    Jm Bustrbijb, skoaais obv` iamg h``m b s`ttjmg car bttjtud` bmd

    h`obvjaur kobmg` tawbrds l`mtbi jiim`ss jm stud`mts. To`

    Ljmd Lbtt`rs pragrbl obs h``m jm ap`rbtjam car av`r 2>y`brs

    bmd, bs pbrt ac jts woai`-ac-skoaai bpprabko ta l`mtbi o`bito

    pralatjam, iaaes bt stjglb r`duktjam jm b vbrj`ty ac wbys,

    jmkiudjmg kurrjkuiul lbt`rjbis bs w`ii bs t`bko`r `dukbtjam bmd

    r`saurk`s. B sjljibr pragrbl, Ejdslbtt`r, ap`rbt`s car prjlbryskoaais.

    To` `dukbtjam warecark` js bisa vuim`rbhi` ta stjglb. Am`

    study caumd tobt fust 4:>prac`ssjambi bmd suppart stbcc aut

    ac 8>>,3>0 `dukbtjam `lpiay``s (>.>>8%) obd r`part`d b

    l`mtbi jiim`ss jm to` PE. Bs am` jm sjx Hrjtams ( 27%) `xp`rj`mk`s

    sal` carl ac d`pr`ssjam ar bmxj`ty bt bmy am` tjl`, bkkardjmg

    ta D`pbrtl`mt ac O`bito flgur`s, to` djskiasur` rbt`s sugg`st b

    ki`br kbs` ac umd`r-r`partjmg (@qubijty Kobii`mg` Pmjt 8>28).

    J susp`kt jmdjvjdubis da mat wbmt ta soaw w`bem`ss ar vuim`rbhjijty.

    To`r` br` v`ry c`w akkupbtjams wo`r` p`api` c``i sbc` maugo ta r`partsal`tojmg h`kbus` to`r` js b stjglb bssakjbt`d wjto l`mtbi o`bito

    bmd jt js ki`briy sal`tojmg w` obv` mat av`rkal` jm bkbd`ljb. ^`api`

    c``i jt ljgot bcc`kt to`jr pralatjam kobmk`s ar to` kr`djhjijty ac to`

    skj`mtjflk ware to`y da. Kbry Kaap`r, ^rac`ssar ac Argbmjsbtjambi

    ^sykoaiagy bmd O`bito, Ibmkbst`r Pmjv`rsjty.

    4 Warepibk`

    Jc sal`am` bt b fah jmt`rvj`w xpibjms b twa y`br gbp jm to`jr r`sul` hy

    l`mtjamjmg ko`lato`rbpy, to`y wjii ije`iy h` o`rbid`d bs b survjvar bmd

    to`jr kobmk`s bt to` fah typjkbiiy wauid mat h` bcc`kt`d. Hut jc to` sbl`

    p`rsam, wjto to` `xbkt sbl` qubijflkbtjams bmd lbmm`r ac jmt`rbktjmg

    `xpibjms b gbp bmd l`mtjams b psykojbtrjk oaspjtbijzbtjam, tojmgs lby h`

    b ijtti` djcc`r`mt.

    Obvjmg b fah js lar` tobm b saurk` ac r`v`mu`. Jt o`ips d`flm`

    woa yau br` bs b p`rsam, pravjd`s crj`mdsojps bmd gjv`s yau

    stbtus jm to` kallumjty. Bustrbijb, biamg wjto lbmy ato`r

    kaumtrj`s, maw obs `lpiayl`mt `qujty i`gjsibtjam jm pibk` ta

    prat`kt to` rjgots ac p`api` wjto djsbhjijtj`s bmd ta r`lav`

    hbrrj`rs ta to`jr `kamaljk pbrtjkjpbtjam. Z`t d`spjt` tojsi`gjsibtjam, djsbhi`d `lpiay``s jm g`m`rbi br` lar` ije`iy ta

    h` pbjd hy to` oaur, i`ss ije`iy ta h` b l`lh`r ac b umjam,

    i`ss ije`iy ta r`k`jv` h`m`flts suko bs `lpiay`r pravjd`d

    o`bito jmsurbmk` bmd p`msjam pibms, bmd i`ss ije`iy ta h` jm

    prac`ssjambi, t`komjkbi, ar lbmbg`rjbi fahs ([kour `t bi 8>>:).

    D`spjt` to` `ccarts ac Djsbhjijty @lpiayl`mt [`rvjk`s bmd ato`r

    sp`kjbijs`d bg`mkj`s, um`lpiayl`mt rbt`s r`lbjm v`ry ojgo

    blamg p`api` s`rjausiy bcc`kt`d hy l`mtbi jiim`ss.

    Ibrg`-skbi` papuibtjam surv`ys obv` kamsjst`mtiy `stjlbt`d to`

    um`lpiayl`mt rbt` blamg p`api` wjto l`mtbi jiim`ss ta h`

    tor`` ta flv` tjl`s ojgo`r tobm to`jr mam-djsbhi`d kaumt rpbrts.To` PE Mbtjambi Ibhaur Cark` [urv`y caumd tobt to` prapartjam

    ac to` bduit papuibtjam woa w`r` `lpiay`d wbs bhaut 70%5

    car p`api` wjto poysjkbi o`bito prahi`ls to` flgur` wbs bhaut

    30%, y`t car p`api` wjto lar` s`v`r` l`mtbi o`bito prahi`ls

    amiy bhaut 8>% w`r` `lpiay`d. @v`m car p`api` wjto lar`

    kallam carls ac l`mtbi jiim`ss, suko bs d`pr`ssjam, amiy bhaut

    obic br` kalp`tjtjv`iy `lpiay`d (Acflk` car Mbtjambi [tbtjstjks

    8>28). Wo`m jm `lpiayl`mt, obvjmg b l`mtbi jiim`ss lby bisa

    ijljt kbr``r bdvbmk`l`mt bs `lpiay`rs br` i`ss ije`iy ta acc`r

    pralatjam ([tubrt 8>>3). Jm to` P[, am` jm tor`` p`api` wjto

    l`mtbi jiim`ss r`part`d h`jmg turm`d dawm car b fah amk` to`jr

    psykojbtrjk stbtus h`kbl` emawm. Jm sal` kbs`s, fah acc`rsw`r` wjtodrbwm wo`m b psykojbtrjk ojstary wbs r`v`bi`d

    (Wboi 2:::).

    Z`t `lpiayjmg b p`rsam woa obs b l`mtbi jiim`ss kbm h`m`flt

    hato to` fah s``e`r bmd `lpiay`r. Wjto bppraprjbt` tr`btl`mt

    bmd suppart, p`api` woa obv` b l`mtbi jiim`ss kbm h` iaybi

    bmd praduktjv` stbcc l`lh`rs, acc`r luko-m``d`d sejiis bmd

    vbiubhi` kamtrjhutjams jm to` warepibk`. @lpiay`r bttjtud`s piby

    bm jlpartbmt rai` bmd to`s` s``l ta h` jlpravjmg lad`stiy jm

    Bustrbijb. X`s`brko kalljssjam`d hy WJ[@ @lpiayl`mt (8>28),

    caumd tobt ac to` 804slbii bmd l`djul-sjz`d `mt`rprjs`s ([L@s)

    surv`y`d6

  • 7/28/2019 A life without stigma : A SANE Report

    13/36

    :

    c ;8% ac `lpiay`rs wauid kamsjd`r ojrjmg b p`rsam woa

    obs b l`mtbi jiim`ss.

    c 3?% ac `lpiay`rs woa obd `lpiay`d sal`am` woa obs

    b l`mtbi jiim`ss stjii da.

    c 74% ac `lpiay`rs d`skrjh`d to`jr `xp`rj`mk` bs pasjtjv`.

    c 40% ac bii ojrjmg lbmbg`rs obd b crj`md, cbljiy l`lh`r

    ar sal`am` kias` ta to`l woa obs b l`mtbi jiim`ss.

    D`kjdjmg wo`to`r ar mat ta t`ii `lpiay`rs bhaut b l`mtbi

    jiim`ss js bisa b lbfar jssu`. Bm Bustrbijbm surv`y caumd tobt

    av`r b tojrd (;?%) obd mat dam` sa. Lar` tobm obic (0;%) ac

    bii r`spamd`mts obd bisa `xp`rj`mk`d stjglb bt sal` tjl` bt

    ware ([BM@ Bustrbijb 8>22). To` lbjm r`bsams gjv`m car mam-

    djskiasur` w`r` `lhbrrbssl`mt bmd c`br ac djskrjljmbtjam hy

    `lpiay`rs ar ato`rs bt ware mat wbmtjmg ta rjse iasjmg to`jr

    fah ar ta h` tr`bt`d djcc r`mtiy sjlpiy h`kbus` to`y taid sal`am`

    to`y obd b l`mtbi jiim`ss.

    To` jmtraduktjam ac b mulh`r ac warepibk` l`mtbi o`bito

    pragrbls jm Bustrbijb js mkaurbgjmg bs am` ac to`jr lbjm

    ahf`ktjv`s js ta jlprav` umd`rstbmdjmg bmd r`duk` stjglb

    bssakjbt`d wjto l`mtbi jiim`ss blamg `lpiay`rs, lbmbg`rs bmd

    ka-ware`rs (h`yamdhiu` 8>2;5 Ljmdcui @lpiay`r 8>2;).

    @lpiay``s wjto l`mtbi o`bito prahi`ls lby bisa `xp`rj`mk`

    stjglb bmd djskrjljmbtjam cral ka-ware`rs amk` to`jr l`mtbi

    jiim`ss h`kal`s emawm. [al` r`part h`jmg tbrg`ts car

    umpi`bsbmt ar m`gbtjv` kall`mts cral warelbt`s woa obd

    pr`vjausiy h``m suppartjv` bmd crj`mdiy. Obic ac to` kalp`tjtjv`

    fahs bkqujr d hy p`api` wjto b s`rjaus l`mtbi jiim ss wjii `md

    umsbtjscbktarjiy bs b r`suit ac prahi`ls tobt akkur amk` to` fah js

    jm pragr`ss, ibrg`iy bs b r`suit ac jmt`rp`rsambi djcflkuitj`s (Kurr

    8>>3).

    @qubi appartumjty i`gjsibtjam jm Bustrbijb js rbr`iy us`d hy p`api`

    wjto l`mtbi jiim`ss jm r`ibtjam ta `lpiayl`mt, bmd wo`m jt js

    us`d, to`r` br` ljx`d r`suits. [al` r`bsams woy c`w p`api`

    lbe` b kalpibjmt ac warepibk` djskrjljmbtjam jm Bustrbijb

    obv` h``m jd`mtjfl`d hy [BM@ Bustrbijb (8>22). To` lbfarjty

    ac r`spamd`mts ta to` surv`y am sakjbi jmkiusjam r`part`d

    `xp`rj`mkjmg djskrjljmbtjam bt sal` tjl` h`kbus` to`y obv` b

    l`mtbi jiim`ss (3:%). D`spjt` tojs, b sjljibr prapartjam (72%)

    djd mat emaw wo`r` ta lbe` b kalpibjmt, bmd w`r` umbhi`

    ta mbl` b sjmgi` oulbm rjgots bg`mky. Ac to` c`w (3%) woa

    djd bpprabko b hady suko bs to` Bustrbijbm Oulbm Xjgots

    Kalljssjam (BOXK), to` lbfarjty (?2%) djd mat prak``d wjto b

    kalpibjmt bs to` prak`ss wbs taa kalpi`x bmd str`sscui, ar to`y

    djd mat flmd to` bg`mky o`ipcui.

    [al` kalpibjmts obv` oaw`v`r h``m upo`id bmd, `mkaurbgjmgiy,

    b kamkjijbtjam prak`ss js maw hrjmgjmg bhaut sal` pasjtjv`

    autkal`s. Am` BOXK kbs` r`part kamk`rms b walbm wjto

    bmxj`ty djsard`r woa kalpibjm`d tobt bppijkbtjams car

    puhijk s`rvjk` pralatjam obd h``m r`f`kt`d h`kbus` so` obd

    `xp`rj`mk`d bmxj`ty bttbkes. To` lbtt`r wbs r`saiv`d wo`m

    to` `lpiay`r bgr``d ta bssjst o`r jm drbctjmg b m`w bppijkbtjam

    car bdvbmk`l`mt5 ta pravjd` o`r wjto praf`kt ware wojko

    wauid str`mgto`m o`r bppijkbtjam5 brrbmg` car bm jmd`p`md`mt

    kalljtt`` ta kamsjd`r o`r bppijkbtjam5 bkk`pt to` bppijkbtjam

    jc tojs wbs r`kall`md`d hy to` jmd`p`md`mt kalljtt``5 bmd

    brrbmg` trbjmjmg car r`i`vbmt stbcc am l`mtbi o`bito jssu`s jm to`

    warepibk` (Bustrbijbm Oulbm Xjgots Kalljssjam 8>>3).

    Lbmy lar` p`api` iadg` kalpibjmts jm to` P[B5 l`mtbi

    djsard`rs br` to` s`kamd last kallam hbsjs car kobrg`s ac

    djskrjljmbtjam bmd warepibk` obrbssl`mt umd`r to` Bl`rjkbmswjto Djsbhjijtj`s Bkt. To` sukk`ss rbt`, oaw`v`r, js iaw. Ac 83;

    djsbhjijty kbs`s hraugot ta trjbi jm 8>>4, amiy 8% ac to`

    d`kjsjams cbvaur`d to` `lpiay``, 74% cbvaur`d to` `lpiay`r,

    bmd 84% w`r` umr`saiv`d ([ko`jd 2:::).

    0 Lbss l`djb

    J wbs djbgmas`d wjto skojzapor`mjb b d`kbd` bga bmd jm ly s`brko

    ta umd`rstbmd ly m`w jiim`ss, to` l`djb acc`r`d l` b se`w`d vbmtbg`

    pajmt wo`r` jt bpp`br`d skojzapor`mjb wbs sjlpiy b ijk mk` car hbd

    h`obvjaur. Maw, am to` jmsjd` iaaejmg aut, J r`kagmjs` wobt bm jmbkkurbt`

    partrbybi tojs js, to` xk`ptjam rbto`r tobm to` rui`. Ije` lbmy ijvjmg

    wjto skojzapor`mjb, J wbs b vjktjl ac vjai`mk` bmd bhus` rbto`r tobm to`

    p`rp`trbtar.

    Bustrbijbms br` bvjd l`djb us`rs vjb to` Jmt`rm`t bs w`ii bs

    t`i`vjsjam, kjm`lb, vjd`a, bmd prjmt. L`djb prac`ssjambis br`

    jlpartbmt biij`s jm o`ipjmg ta r`duk` stjglb. Kallumjty

    bttjtud`s bmd apjmjams br` sobp`d hy wobt p`api` kamsul` jm

    to` l`djb (jmkiudjmg bdv`rtjsjmg). To` l`djb js bisa b prjlbry

    saurk` ac emawi`dg` bhaut l`mtbi jiim`ss.

    To` ibmgubg` us`d bmd jlbg`s trbdjtjambiiy pr`s`mt`d, oaw`v`r,

    br` act`m jmbkkurbt`, s`msbtjambi, umhbibmk`d bmd st`r`atypjkbi.To`s` stjglbtjsjmg r`pr`s`mtbtjams obv` b r`bi bmd pracaumd

    `cc`kt am p`api` ijvjmg wjto b l`mtbi jiim`ss, kbusjmg gr`bt

    djstr`ss bmd djstartjmg kallumjty bttjtud`s. Sjai`mt ar djsturh`d

    h`obvjaurs br` taa act`m ijme`d `xkiusjv`iy ta l`mtbi jiim`ss.

    B r`k`mt study caumd tobt m`w starj`s bhaut lbss soaatjmgs

    jmvaivjmg b soaat`r wjto l`mtbi jiim`ss o`jgot`m r`bd`rs m`gbtjv`

    bttjtud`s tawbrd p`rsams wjto s`rjaus l`mtbi jiim`ss jm g`m`rbi

    (LkGjmty t bi 8>2;).

    Wo`m`v`r J s`` b lbss lurd`r r`part`d jm to` l`djb ly flrst toaugot js

    ta lbe` b sji`mt prby`r6 pi`bs` damt i`t to` p`rsam obv` b l`mtbi jiim`ss.

    Jl sjke bmd tjr`d ac ijvjmg wjto to` sobl` ac to` ibh`i J kbrry wjto l`ije` to` lbre ac Kbjm am ly car`o`bd.

    Kojidr`m br` pbrtjkuibriy `xpas`d ta to`s` l`ssbg`s. Car

    `xblpi`, b PE study wojko sblpi`d am` w``e ac kojidr`ms

    t`i`vjsjam, caumd tobt bilast obic (43%) ac 28?pragrbls

    kamtbjm`d am` ar lar` r`c`r`mk`s ta l`mtbi jiim`ss. T`rls suko

    bs krbzy, lbd bmd iasjmg yaur ljmd w`r` kallamiy us`d ta

    d`mat` iasjmg kamtrai. [jx kobrbkt`rs w`r` jd`mtjfl`d bs h`jmg

    kamsjst`mtiy partrby`d bs l`mtbiiy jii. To`s` w`r` bilast tatbiiy

    d`vajd ac pasjtjv` kobrbkt`rjstjks. Wjisam `t bi 8>>>).

    ^`api` ijvjmg wjto l`mtbi jiim`ss br` bkut`iy bwbr` ac to`

    jmu`mk` ac to` l`djb am kallumjty bttjtud`s bs b woai`.

    B surv`y ac ;07Bustrbijbms wjto l`mtbi jiim`ss caumd tobt

  • 7/28/2019 A life without stigma : A SANE Report

    14/36

    2>

    r`spamd`mts w`r` aptjljstjk tobt stjglb kauid h` r`duk`d bmd

    r`gbrd`d tbkeijmg stjglb jm to` l`djb bs bm urg`mt m``d ([BM@

    Bustrbijb 8>>7).

    Jm r`k`mt y`brs to`r` obv` h``m jlprav`l`mts jm Bustrbijbm

    l`djb r`pr`s`mtbtjam ac l`mtbi jiim`ss. W` stjii obv` b iamg wby

    ta ga, oaw`v`r. B Pmjv`rsjty ac L`ihaurm` study pr`pbr`d car to`

    Ljmdcrbl` L`djb Jmjtjbtjv`, kamkiud`d tobt to`r` js b t`md`mkycar m`ws l`djb ta pr`s`mt l`mtbi jiim`ss`s jm b wby tobt

    pralat`s stjglb (car `xblpi`, hy kambtjmg jt wjto vjai`mk` bmd

    krjl`) ar p`rp`tubt`s lytos bhaut l`mtbi jiim`ss (car `xblpi`,

    hy pr`s`mtjmg jmcarlbtjam tobt js jmbkkurbt` bhaut tr`btl`mt bmd

    pragmasjs). Tojs study bisa caumd djcc`r`mk`s d`p`mdjmg am to`

    typ` ac djsard`r pr`s`mt`d.

    Pmdjcc`r`mtjbt`d l`mtbi djsard`rs (wo`r` to` jiim`ss ar

    jiim`ss`s js mat sp`kjfl`d) bmd skojzapor`mjb bpp`br`d ta

    r`k`jv` to` paar`st tr`btl`mt jm to` l`djb. M`ws starj`s

    kjtjmg skojzapor`mjb av`r b 28-lamto p`rjad w`r` kad`d car

    to` pr`s`mk` ac stjglbtjsjmg kav`rbg` bmd car stary bttrjhut`stobt ljgot kamtrjhut` ta jt. Sjai`mk` c`btur`d jm 47% ac starj`s

    bmd 43% w`r` fudg`d ta h` stjglbtjsjmg. ^`api` jd`mtjfl`d bs

    skojzapor`mjk w`r` av`rwo`iljmgiy r`part`d bs lbi` bmd bs

    p`rp`trbtars rbto`r tobm vjktjls ac vjai`mk`. Bmbiysjs jmdjkbt`d

    tobt lar` stjglbtjsjmg starj`s t`md`d ta bpp`br jm tbhiajd

    saurk`s, ta r`c`r ta car`jgm `v`mts bmd suhstbmk` us`, bmd ta

    r`pr`s`mt p`api` djbgmas`d wjto skojzapor`mjb bs yaumg bmd

    lbi`. To`r` js, m`v`rto`i`ss, sal` `vjd`mk` tobt r`partjmg

    prbktjk`s obv` jlprav`d av`r tjl`. (^jrejs bmd Crbmkjs 8>28).

    Bmbiysjs ac r`parts ta [BM@ Bustrbijbs [tjglbWbtko pragrbl

    suppart to`s` flmdjmgs, wjto skojzapor`mjb act`m r`pr`s`mt`djm bm jmbkkurbt`, s`msbtjambijs`d wby, bmd bssakjbt`d wjto

    vjai`mk`. D`pr`ssjam js cbr lar` ije`iy ta h` r`part`d r`spamsjhiy

    bmd pasjtjv`iy, woji` ato`r kamdjtjams r`k`jv` ijtti` kav`rbg`

    ([BM@ Bustrbijb 8>2>).

    B study kamdukt`d car to` [kattjso bmtj-stjglb kblpbjgm,

    [ojct, caumd tobt l`djb r`pr`s`mtbtjams ac l`mtbi jiim`ss w`r`

    stramgiy bssakjbt`d wjto vjai`mk` bmd dbmg`r ([ojct 8>2>). Ac

    74pragrbls wjto staryijm`s am l`mtbi o`bito jssu`s, to`r` w`r`

    jmstbmk`s ac6

    c vjai`mk` ta ato`rs ;;

    c ato`r typ`s ac obrl 4?

    c s`ic-obrl 0;

    c sylpbto tjk partrbybi ;;

    Jt js bisa h`jmg r`kagmjs`d tobt to` l`djb kbm piby b pasjtjv`

    rai` jm r`bkojmg aut ta lbmy djcc`r`mt budj`mk`s ta jlprav`

    bttjtud`s bmd pralat` l`mtbi o`bito ijt`rbky. Lbss l`djb

    stjglb r`duktjam kblpbjgms, w`h-hbs`d l`mtbi o`bito ijt`rbky

    pragrbls bmd dakul`mtbry flils obv` bii kamtrjhut`d ta o`ipjmg

    r`duk` stjglb bmd djskrjljmbtjam, bmd pralat` kallumjty

    umd`rstbmdjmg bmd bkk`ptbmk`. Tojs js pbrtjkuibriy to` kbs`

    jc to`y jmkiud` p`rsambijs`d starj`s (bs appas`d ta `dukbtjambiam`).

    Jrr`spamsjhi` l`djb r`partjmg ac sujkjd` obs h``m soawm

    ta trjgg`r sujkjdbi h`obvjaur, hut to` jmu`mk` ac sujkjd`

    r`partjmg lby mat h` r`strjkt`d ta obrlcui `cc`kts5 kav`rbg` ac

    pasjtjv` kapjmg jm bdv`rs` kjrkulstbmk`s, suko bs jt`ls bhaut

    kapjmg wjto sujkjdbi jd`btjam, lby obv` prat`ktjv` `cc`kts.

    (Mj`d`rerat`mtobi`r, T `t bi 8>2>).

    3 Gav`rml`mt

    Cumdjmg

    To` i`v`i ac cumdjmg pravjd`d car l`mtbi o`bito djr`ktiy bcc`kts

    to` bvbjibhjijty bmd qubijty ac s`rvjk`s tobt br` bvbjibhi` ta

    pravjd` tr`btl`mt bmd suppart car p`api` wjto l`mtbi jiim`ss.

    Bs w`ii bs jlpravjmg autkal`s bmd qubijty ac ijc`, `cc`ktjv`

    tr`btl`mt car l`mtbi jiim`ss js bisa jlpartbmt ta r`duk` stjglb

    bssakjbt`d wjto sylptals ac jiim`ss.

    ^aijky-lbe`rs obv` um`mvjbhi` d`kjsjams ta lbe` bhaut wo`r`

    ijljt`d r`saurk`s br` biiakbt`d. To`jr bttjtud`s br` ije`iy tabcc`kt to`s` d`kjsjams, biamg wjto gav`rml`mt prjarjtj`s bmd

    p`rk`ptjams ac wobt vat`rs wbmt. Jmt`rmbtjambiiy, l`mtbi jiim`ss

    js rbr`iy s``m bs b ojgo prjarjty, sa jt js w`ikal` tobt r`k`mt

    gav`rml`mts jm Bustrbijb obv` biiakbt`d sal` bddjtjambi cumdjmg

    jm tojs br`b. To` H`tt`r Bkk`ss bmd ^`rsambi O`ip`rs bmd

    L`mtars pragrbls, o`bdspbk`, bmd `briy jmt`rv`mtjam k`mtr`s br`

    bii w`ikal` jmjtjbtjv`s.

    To` 8>28X`part Kbrdcral to` Mbtjambi L`mtbi O`bito

    Kalljssjam kamkiud`s to`r` js ijtti` ar ma bkkaumtbhjijty car

    to` $3.;hjiijam Bustrbijb sp`mds am l`mtbi o`bito bmmubiiy.

    To` r`part bisa mat`s tobt l`mtbi o`bito sp`mdjmg obs jmkr`bs`dhy 4.0% p`r bmmul h`tw``m 8>>0->3bmd 8>>:-2>. Jm b

    r`spams` ta to` X`part Kbrd, oaw`v`r, jt wbs mat`d tobt av`rbii

    o`bito `xp`mdjtur` obs jmkr`bs`d hy braumd ?.0% p`r bmmul

    av`r to` sbl` p`rjad, l`bmjmg tobt l`mtbi o`bitos sobr` ac to`

    o`bito hudg`t js sorjmejmg mat grawjmg (Xas`mh`rg 8>28).

    Cumdjmg jm`qujtj`s h`tw``m poysjkbi bmd l`mtbi jiim`ss`s br`

    jmt`rmbtjambi. B PE r`part, Oaw L`mtbi Jiim ss Ias`s Aut jm to`

    MO[, caumd tobt b djsprapartjambt iy slbii blaumt ac cumdjmg

    wbs biiakbt`d ta tr`btl`mt ac l`mtbi jiim`ss kalpbr`d wjto

    poysjkbi jiim`ss. D`spjt` bkkaumtjmg car 8;% ac to` tatbi hurd`m

    ac djs`bs` bmd to` `xjst`mk` ac kast-`cc`ktjv` tr`btl`mts, l`mtbijiim`ss r`k`jv`s amiy 2;% ac MO[ o`bito `xp`mdjtur` (I[@ 8>28).

    To` umd`r-tr`btl`mt ac p`api` s`v`r`iy bcc`kt`d hy l`mtbi

    jiim`ss`s js b gibrjmg kbs` ac o`bito jm`qubijty.

    I`gjsibtjam

    Jm last pbrts ac Bustrbijb jt js umibwcui umd`r bmtj-djskrjljmbtjam

    i`gjsibtjam ta vjijcy p`api` am to` graumds ac rbk`, r`ijgjam,

    s`xubijty ar g`md`r jd`mtjty. Oaw`v`r umd`r kurr`mt Bustrbijbm

    i`gjsibtjam (bpbrt cral Tbslbmjb), p`api` wjto b l`mtbi jiim`ss

    ar ato`r djsbhjijty da mat `mfay tojs prat`ktjam.

  • 7/28/2019 A life without stigma : A SANE Report

    15/36

    22

    Jmsurbmk` jmdustry

    To` Djsbhjijty Djskrjljmbtjam Bkt 2::8pravjd`s bm `xk`ptjam

    car jmsurbmk` kalpbmj`s ta djskrjljmbt` bgbjmst p`api` wjto

    l`mtbi jiim`ss ar ato`r djsbhjijty am to` graumds ac bktubrjbi

    ar stbtjstjkbi dbtb ar wo`r` jt js r`bsambhi`, obvjmg r`gbrd ta

    ato`r r`i`vbmt cbktars. To`r` br` r`bsams ta h`ij`v` tojs i`gbi

    `xk`ptjam js h`jmg `xpiajt`d oaw`v`r. X`s`brko kamdukt`d hy

    h`yamdhiu` bmd to` L`mtbi O`bito Kaumkji ac Bustrbijb (LOKB)bmd obs caumd tobt p`api` wjto b l`mtbi jiim`ss br` r`guibriy

    djskrjljmbt`d bgbjmst umr`bsambhiy wo`m to`y bppiy car

    jmsurbmk`.

    To`jr r`part (h`yamdhiu` bmd LOKB 8>22) d`skrjh`s lbmy

    djsturhjmg kbs`s ac umcbjr tr`btl`mt hy jmsur`rs, woa act`m

    r`f`kt p`api` wjto l`mtbi jiim`ss wo`m to`y try ta purkobs` ijc`

    jmsurbmk`, jmkal` prat`ktjam jmsurbmk`, tatbi bmd p`rlbm`mt

    djsbhjijty jmsurbmk`, ar trbv`i jmsurbmk`. Kibjls bssakjbt`d wjto

    l`mtbi jiim`ss br` act`m `xpijkjtiy `xkiud`d jm lbmy jmsurbmk`

    paijkj`s.

    Jmsur`rs damt s``l ta pass`ss `v`m b hbsjk emawi`dg` ac

    l`mtbi o`bito jssu`s, kall`mts Crbme Rujmibm K@A ac to`

    L`mtbi O`bito Kaumkji jm to` r`part. Fust s``jmg b kaums`iiar

    js bppbr`mtiy r`gbrd`d hy jmsurbmk` kalpbmj`s bs b lbfar

    rjse `v`m jc sal`am` obs m`v`r h``m djbgmas`d wjto b l`mtbi

    jiim`ss.

    7 [`ic-stjglb

    [`ic-stjglb js b hurd`m. Ly l`mtbi jiim`ss djbgmasjs bmd tr`btl`mt i`ct l`

    wjto b v`ry djcflkuit c``ijmg ac cbjiur`.Fust h`kbus` sal`am` obs b l`mtbi jiim ss da`smt l`bm to y

    damt sobr` kallam kallumjty bttjtud`s ta l`mtbi jiim`ss.

    [`ic-stjglb kbm h` to` last obrlcui carl ac stjglb. Wo`m

    sal`am` s`ic-stjglbtjs`s, to`y tbe` am m`gbtjv` bmd jmbkkurbt`

    st`r`atyp`s bmd bkk`pt tobt p`api` wjto l`mtbi jiim`ss br` ac

    i`ss vbiu` ta sakj`ty ar ta to`ls`iv`s. To` c`br ac h`jmg r`f`kt`d

    kbm to`m stap sal`am` cral gajmg aut, sakjbijsjmg, iaaejmg car b

    fah, ar tbejmg pbrt jm to`jr iakbi kallumjty.

    ^`api` to`m stbrt ta s`` wobt to`y h`ij`v` to`jr p`rk`ptjam

    h`kal`s r`bijty jm b v`ry vjkjaus kyki`. Gacclbm kall`mts

    tobt to` djcc`r`mk` h`tw``m b stjglbtjs`d p`rsam bmd sal`am`woa jsmt js b qu`stjam ac p`rsp`ktjv`, mat r`bijty. [tjglb (ije`

    h`buty) kbm h` jm to` `y` ac to` h`oaid`r (Gacclbm, @ 2:3;).

    [`ic-stjglb js kallam. Bm jmt`rmbtjambi study ac 7;8p`api`

    ijvjmg wjto skojzapor`mjb caumd tobt av`r am` tojrd bmtjkjpbt`d

    djskrjljmbtjam jm fah-s``ejmg. Bmato`r 24-kaumtry study ac

    p`api` wjto skojzapor`mjb woa w`r` l`lh`rs ac l`mtbi o`bito

    argbmjsbtjams caumd tobt bilast obic (48%) r`part`d lad`rbt`

    ar ojgo i`v`is ac s`ic-stjglb. Bilast 7>% r`part`d lad`rbt` ta

    ojgo i`v`is ac p`rk`jv`d djskrjljmbtjam bmd tojs wbs sjgmjflkbmtiy

    bssakjbt`d wjto ojgo`r r`part`d s`ic-stjglb (Hraobm `t bi 8>2>).

    [`ic-stjglb kbus`s obrl. Lbmy studj`s obv` soawm tobt p`api`

    wjto l`mtbi jiim`ss woa s`ic-stjglbtjs` br` lar` jsaibt`d,

    bij`mbt`d, bmd sakjbiiy wjtodrbwm tobm toas` woa br` mat s`ic-

    stjglbtjsjmg. [akjbi jsaibtjam act`m jmvaiv`s wjtodrbwbi cral,

    bmd prahi`ls wjto, crj`mds bmd cbljiy. Jt bisa jmkiud`s bvajdjmg

    `lpiayl`mt-s``ejmg car c`br ac r`f`ktjam bmd cbjiur`. Obvjmg

    c`w`r sakjbi suppart m`twares to`m l`bms tobt p`api` woa

    s`ic- stjglbtjs` br` i`ss ije`iy tobm ato`rs ta r`k`jv` suppart fustwo`m to`y m``d jt.

    Bct`r h`jmg taid wobt yau obv`, yau h`gjm ta c``i sobl`, c`br, kamcusjam.

    Zau obv` b s`ms` ac iass. Zau damt emaw oaw tojs js gajmg ta jlpbkt am

    yaur ijc`, bcrbjd ato`r p`api ljgot flmd aut. Zau stbrt ta jsaibt` yaurs`ic

    cral ato`rs bmd `v`mtubiiy cral sakj`ty.

    Bmato`r kams`qu`mk` car p`api` wjto l`mtbi jiim`ss bmd s`ic-

    stjglb js tobt to`y br` i`ss ije`iy ta s``e tr`btl`mt car sylptals

    tobm br` p`api` wjtoaut s`ic-stjglb, i`ss ije`iy ta kaap`rbt` wjto

    tr`btl`mt, br` lar` ije`iy ta obv` wars`mjmg ac sylptals bmd

    obv` prahi`ls wjto r`kav`ry (^`t`rsam `t bi 8>>?).X`s`brko am s`ic-stjglb jm to` P[ caumd tobt stjglb braus`d

    stramg `latjams, rbmgjmg cral ourt ta bmg`r, wojko p`api`

    s`idal vajk`d car c`br to`y wauid h` jgmar`d ar tobt jt wauid

    h` tbe`m bs `vjd`mk` ac l`mtbi jmstbhjijty. To` lbfarjty (72%)

    r`part`d mat djskiasjmg l`mtbi jiim`ss am fah bppijkbtjams car

    c`br ac djskrjljmbtjam. Tojs act`m i`ct p`api` c``ijmg warrj`d jm

    kbs` to`y w`r` caumd aut. Tojs bddjtjambi c`br bmd bmxj`ty kbm

    to`m wars`m `xjstjmg jiim`ss bmd siaw r`kav`ry (Wboi 2:::).

    Mat `v`ryam` wjto l`mtbi jiim`ss `xp`rj`mk`s s`ic-stjglb.

    H`jmg lbi`, aid`r, obvjmg i`ss `dukbtjam, h`jmg harm av`rs`bs,

    bmd paar`r emawi`dg` bhaut d`pr`ssjam br` bii jmd`p`md`mtiybssakjbt`d wjto gr`bt`r p`rsambi d`pr`ssjam stjglb (Grjcfltos `t

    bi 8>>?).

    To` ibmdlbre M`w V`bibmd r`part am s`ic-stjglb,

    Cjgotjmg [obdaws (^`t`rsam `t bi 8>>?), jd`mtjfl`d `jgot

    r`kall`mdbtjams ta djsrupt to` kyki` ac stjglb bmd

    djskrjljmbtjam bt b kallumjty bs w`ii bs p`rsambi i`v`i6

    c r`kagmjs` to` kamtrjhutjam ac Up`api` wjto\ l`mtbi

    jiim`ss bmd cast`r i`bd`rsojp

    c k`i`hrbt` bmd bkk`pt djcc`r`mk`

    c bcflrl oulbm rjgots

    c `mkaurbg` djskiasur`

    c `mkaurbg` r`kav`ry-arj`mt`d prbktjk`s

    c `mkaurbg` lpaw`rl`mt

    c suppart p``r suppart s`rvjk`s

    c kobii`mg` bttjtud`s bmd h`obvjaur.

  • 7/28/2019 A life without stigma : A SANE Report

    16/36

    [tjglb bmd

    paijky

  • 7/28/2019 A life without stigma : A SANE Report

    17/36

    2;

    Bustrbijb

    Bustrbijb obs iamg r`kagmjs`d to` jlpartbmk` ac stjglb

    r`duktjam, bmd tojs js bkemawi`dg`d jm lbmy gav`rml`mt

    pibms bmd strbt`gj`s. Kbrryjmg to`s` gaad jmt`mtjams toraugo

    jmta prbktjk` obs h``m b kobii`mg` oaw`v`r.

    Am` ac to` caur bjls ac to`Mbtjambi L`mtbi O`bito ^aijky js ta

    r`duk` to` jlpbkt ac l`mtbi o`bito prahi`ls bmd l`mtbi

    jiim`ss, jmkiudjmg to` `cc`kts ac stjglb am jmdjvjdubis, cbljij`s

    bmd to` kallumjty (Kallamw`bito ac Bustrbijb 8>>?).

    To` Caurto Mbtjambi L`mtbi O`bito ^ibmijsts [akjbi jmkiusjam bmd

    r`kav`ry bs b prjarjty, wjto b lbjm bktjam br`b ta jlprav`

    kallumjty bmd s`rvjk` umd`rstbmdjmg bmd bttjtud`s toraugo

    b sustbjm`d bmd kalpr`o`msjv` mbtjambi stjglb r`duktjam

    strbt`gy (Kallamw`bito ac Bustrbijb 8>>:).

    To` m``d car amgajmg stjglb r`duktjam kblpbjgm ware wbscurto`r lpobsjs`d jm Ware Wbmt`d6 L`mtbi O`bito bmd Warecark`

    ^brtjkjpbtjam, b r`part ac to` Oaus` ac X`pr`s`mtbtjv`s [tbmdjmg

    Kalljtt`` am @dukbtjam bmd @lpiayl`mt (Kallamw`bito ac

    Bustrbijb, 8>28). B prjmkjpi` r`kall`mdbtjam ac to` r`part wbs

    tobt to` Bustrbijbm gav`rml`mt kaardjmbt` b kalpr`o`msjv`

    bmd luitj-cbk`t`d mbtjambi `dukbtjam kblpbjgm ta tbrg`t

    stjglb bmd r`duk` djskrjljmbtjam bgbjmst p`api` wjto b l`mtbi

    jiim`ss jm Bustrbijbm skoaais, warepibk`s bmd kallumjtj`s.

    Jt kamkiud`d tobt to` kblpbjgm soauid6

    c jmkiud` jmvaiv`l`mt cral to` puhijk, prjvbt` bmd

    kallumjty s`ktars, `dukbtjambi jmstjtutjams, `lpiay`rsbmd b rbmg` ac ato`r stbe`oaid`rs, jmkiudjmg jmdjvjdubis

    wjto l`mtbi jiim`ss`s, cbljij`s bmd kbr`rs, bmd

    c kalpi`l`mt xjstjmg gav`rml`mt-cumd`d dukbtjam

    bmd bwbr`m`ss kblpbjgms am d`pr`ssjam bmd laad

    djsard`rs, wjto bm jmkiusjam ac psykoatjk jiim`ss`s.

    Bustrbijbs flrst r`part kbrd am l`mtbi o`bito, B Kamtrjhutjmg

    Ijc`, bisa mat`d stjglb r`duktjam bs b e`y prjarjty car bktjam

    (Mbtjambi L`mtbi O`bito Kalljssjam 8>28)6

    To` rai` ac stjglb ar djskrjljmbtjam `xp`rj`mk`d ar p`rk`jv`d hy p`api`

    ijvjmg wjto b l`mtbi o`bito djcflkuity jm tryjmg ta bkk`ss s`rvjk`s ar

    wo`m usjmg s`rvjk`s, bisa obs bm jlpbkt upam oaw to`y kamm`kt wjto

    to` s`rvjk`s to`y m``d bmd to`r`car` upam to` appartumjtj`s car to`jr

    r`kav`ry.

    To`r` js bisa b d`lamstrbhi` jlpbkt cral l`mtbi o`bito-hbs`d

    djskrjljmbtjam. To`s` br` jssu`s ac s`ic-stjglb bmd djskrjljmbtjam

    `xp`rj`mk`d cral b p`rsams kallumjty bmd o`bito prac`ssjambis, wojko

    bcc`kt b wjiijmgm`ss ta s``e o`bito suppart.

    Jmkr`bsjmg bkk`ss ta suppart car d`pr`ssjam obs h``m soawm ta r`duk`

    sujkjd`s bmd tojs lust h` b prjlbry cakus ac aur `ccarts hy `msurjmg kbr`

    js bvbjibhi` hy h`tt`r umd`rstbmdjmg oaw ta r`lav` hbrrj`rs bmd r`duk`

    to` stjglb bmd djskrjljmbtjam tobt pr`v`mts p`api` cral s``ejmg o`ip.

    To` Kalljssjams carwbrd ware pragrbl jmkiud`s `xbljmjmg

    oaw Bustrbijbms r`biiy tojme bmd c``i bhaut l`mtbi o`bito,

    l`mtbi jiim`ss bmd sujkjd`, jmkiudjmg stjglb bmd djskrjljmbtjam.

    M`w V`bibmd

    To`r` obs h``m stramg kalljtl`mt ta l`mtbi o`bito jm M`w

    V`bibmd, jmkiudjmg cumdjmg ta r`dukjmg stjglb. T` Tbouou

    Jlpravjmg L`mtbi O`bito8>>0-8>20(Ljmjstry ac O`bito 8>>0),

    M`w V`bibmds l`mtbi o`bito bmd bddjktjam pibm, stbt`s tobt6

    c l`mtbi o`bito bmd bddjktjam prahi`ls, suko bs

    d`pr`ssjam, bmxj`ty djsard`rs, bmd suhstbmk` ljsus`

    kbm r`duk` bm jmdjvjdubis s`ms` ac h`iamgjmg bmd

    pbrtjkjpbtjam jm sakj`ty5

    c stjglb bmd djskrjljmbtjam kbm h` hato b kams`qu`mk`

    bmd b kbus` ac sakjbi `xkiusjam, bmd b lbfar hbrrj`r ta

    sukk`sscui pbrtjkjpbtjam jm sakj`ty car `xkiud`d graups

    bmd jmdjvjdubis5 bmd tobt rjse cbktars bmd pralatjmg

    prat`ktjv` cbktars tobt str`mgto`m kallumjtj`s suko

    bs mobmk`d kuiturbi bwbr`m`ss, s`msjtjvjty, bmd

    pralatjmg bkk`ss ta to` r`saurk`s ac lbjmstr`blsakj`ty ta `mkaurbg` cuii pbrtjkjpbtjam jm sakj`ty br`

    jlpartbmt car l`mtbi o`bito.

    B ijc` wjtoaut stjglb ;

    [tjglb bmd paijky

    L`mtbi o`bito paijkj`s jm Bustrbijb bmd kalpbrbhi` kaumtrj`s obv` bkemawi`dg`d to` m``d tatbkei` stjglb, hut to` kobii`mg` r`lbjms ta trbmsibt` to`s` paijkj`s jmta `cc`ktjv` bktjam.

  • 7/28/2019 A life without stigma : A SANE Report

    18/36

    24

    Kbmbdb

    Bs b kams`qu`mk` ac b ibmdlbre r`part cral to` Kbmbdjbm

    [`mbt`, Aut ac to` [obdaws bt Ibst6 Trbmscarljmg L`mtbi O`bito,

    L`mtbi Jiim`ss bmd Bddjktjam [`rvjk`s jm Kbmbdb(Gav`rml`mt ac

    Kbmbdb 8>>?), to` c`d`rbi gav`rml`mt pravjd`d cumdjmg car

    bm jmd`p`md`mt l`mtbi o`bito kalljssjam wjto b lbmdbt` ta

    d`v`iap b mbtjambi l`mtbi o`bito strbt`gy, b2>

    -y`br bmtj-stjglb strbt`gy bmd b emawi`dg` `xkobmg` k`mtr`. I`bd`rs bmd

    argbmjsbtjams cral bkrass to` kaumtry br` hraugot tag`to`r ta

    bkk`i`rbt` to`s` kobmg`s. Jm 8>>:to` Kalljssjam ibumko`d

    Ap`mjmg Ljmds, to` ibrg`st syst`lbtjk `ccart ta r`duk` to` stjglb

    ac l`mtbi jiim`ss jm Kbmbdjbm ojstary.

    Pmjt`d Ejmgdal

    To` Hrjtjso gav`rml`mt dakul`mt Ma O`bito wjtoaut L`mtbi

    O`bito6 b krass-gav`rml`mt l`mtbi o`bito autkal`s strbt`gy car p`api`

    ac bii bg`s, obs sjx sobr`d ahf`ktjv`s ta jlprav` l`mtbi o`bito

    autkal`s car jmdjvjdubis bmd to` papuibtjam bs b woai`.

    Am` ahf`ktjv` js tobt c`w`r p`api` wjii `xp`rj`mk` stjglb

    bmd djskrjljmbtjam (D`pbrtl`mt ac O`bito 8>22). B ki`br

    kalljtl`mt js lbd` ta kobii`mg` stjglb hy suppartjmg bmd

    warejmg bktjv`iy wjto to` Tjl` ta Kobmg`pragrbl bmd ato`rs.

    To` Tjl` ta Kobmg`kblpbjgm js b kalpr`o`msjv` bmtj-stjglb

    kblpbjgm rum hy l`mtbi o`bito kobrjtj`s, Ljmd bmd X`tojme

    L`mtbi Jiim`ss. Tojs js to` hjgg`st btt`lpt y`t jm to` kaumtry

    ta `md to` djskrjljmbtjam tobt surraumds l`mtbi o`bito. To`

    flrst pobs` rbm cral 8>>7-8>22wjto cumdjmg cral to` Hjg

    Iatt`ry Cumd bmd Kaljk X`ij`c. To` s`kamd pobs`, cumd`d hy

    to` D`pbrtl`mt ac O`bito, wjii rum umtji Lbrko 8>20(Tjl` ta

    Kobmg` 8>2;).

    [katibmd i`d to` wby jm to` PE wo`m jt ibumko`d to` kblpbjgm

    s`` l`jm 8>>8. @stbhijso`d ta `md stjglb bmd djskrjljmbtjam

    bgbjmst p`api` xp`rj`mkjmg l`mtbi o`bito prahi`ls, s`` l`

    js cuiiy cumd`d hy to` [kattjso Gav`rml`mt bmd kamdukt`d hy

    bm biijbmk` ac flv` l`mtbi o`bito argbmjsbtjams. To` L`mtbi

    O`bito [trbt`gy car [katibmd 8>28-20 jmkiud`s bs am` ac jts s`v`m

    to`l`s, @xt`mdjmg to` bmtj-stjglb bg`mdb ta jmkiud` curto`r

    ware am djskrjljmbtjam. Jt lbe`s b kalljtl`mt ta ware wjto

    to` lbmbg`l`mt graup ac s`` l`bmd to` [kattjso Bssakjbtjam

    car L`mtbi O`bito . . . bmd ato`r pbrtm`rs ta d`v`iap to`

    strbt`gjk djr`ktjam car s`` l`car to` p`rjad cral 8>2;amwbrds.

    ([kattjso Gav`rml`mt 8>28)

    Pmjt`d [tbt`s ac Bl`rjkb

    Jm 8>>7b puhijk bwbr`m`ss bdv`rtjsjmg kblpbjgm, Wobt b

    Djcc`r`mk` b Crj`md Lbe`swbs ibumko`d hy to` [uhstbmk` Bhus`

    bmd L`mtbi O`bito [`rvjk`s Bdljmjstrbtjam jm pbrtm`rsojp

    wjto to` Bd Kaumkji. Tojs wbs d`sjgm`d ta d`kr`bs` m`gbtjv`

    bttjtud`s ta l`mtbi jiim`ss bmd `mkaurbg` yaumg p`api`

    ta suppart crj`mds woa obv` b l`mtbi o`bito prahi`l.Tojs kblpbjgm js ma iamg`r bktjv`, bmd to`r` js ma kurr`mt

    kalpr`o`msjv` mbtjambi kblpbjgm jm to` P[.

    Caiiawjmg r`k`mt trbgjk skoaai soaatjmgs, ^r`sjd`mt Ahblb

    jssu`d b djr`ktjv` ta ibumko b mbtjambi kamv`rsbtjam ta

    jmkr`bs` umd`rstbmdjmg bhaut l`mtbi o`bito. [tr`ssjmg tobt

    to` vbst lbfarjty ac p`api` wjto l`mtbi o`bito kamdjtjams

    br` mat vjai`mt, to` ^r`sjd`mt kalljtt`d ojs Bdljmjstrbtjam

    ta kaardjmbtjmg bktjam ta r`duk` stjglb bmd `mkaurbg`

    `briy jmt`rv`mtjam. Bs pbrt ac tojs jmjtjbtjv`, b Wojt` Oaus`

    kamc`r`mk` am l`mtbi o`bito wbs o`id jm Fum` 8>2;, ta wojko

    [BM@ Bustrbijb K@A, Fbke O`bto, wbs jmvjt`d ta kamtrjhut`.

  • 7/28/2019 A life without stigma : A SANE Report

    19/36

    20

  • 7/28/2019 A life without stigma : A SANE Report

    20/36

    Wobt js h`jmg

    dam`1

  • 7/28/2019 A life without stigma : A SANE Report

    21/36

    27

    Bustrbijb

    Ljmdcrbl` Mbtjambi L`djb Jmjtjbtjv

    Ljmdcrbl` `mkaurbg`s r`spamsjhi`, bkkurbt` bmd s`msjtjv`

    r`pr`s`mtbtjam ac l`mtbi jiim`ss bmd sujkjd` jm to` Bustrbijbm

    lbss l`djb. To` jmjtjbtjv` jmvaiv`s hujidjmg b kaiibharbtjv`

    r`ibtjamsojp wjto to` l`djb bmd ato`r s`ktars tobt jmu`mk`

    to` l`djb (suko bs e`y saurk`s car m`ws starj`s) bmd js cumd`d

    hy to` Bustrbijbm Gav`rml`mt, Mbtjambi [ujkjd` ^r`v`mtjam

    ^ragrbl.

    To` Ljmdcrbl` @dukbtjam bmd Trbjmjmg pragrbljs lbmbg`d hy to`

    Oumt`r Jmstjtut` ac L`mtbi O`bito, bmd wares wjto to` caiiawjmg

    s`ktars6

    c M`ws l`djbc L`mtbi o`bito bmd sujkjd` pr`v`mtjam s`ktar

    c Pmjv`rsjtj`s

    c Bustrbijbm flil, t`i`vjsjam, bmd to`btr`

    c ^aijk`.

    Ljmdcrbl` pravjd`s bkk`ss ta up-ta-dbt`, `vjd`mk`-hbs`d

    jmcarlbtjam ta suppart to` r`partjmg, partrbybi bmd

    kallumjkbtjam bhaut sujkjd` bmd l`mtbi jiim`ss.

    To` [BM@ L`djb K`mtr`js lbmbg`d hy [BM@ Bustrbijb, bmd

    pravjd`s to` l`djb bmd to` l`mtbi o`bito s`ktar wjto dby-ta-dby

    gujdbmk` bhaut r`partjmg bmd partrbybi ac l`mtbi jiim`ss bmdsujkjd`-r`ibt`d jssu`s. To` [BM@ L`djb K`mtr` bkoj`v`s tojs hy

    pravjdjmg b am`-stap s`rvjk` ac jmcarlbtjam, `xp`rt kall`mt,

    bdvjk` bmd r`c`rrbi.

    To` [tjglbWbtko pragrbl, bm jmt`grbi pbrt ac to` [BM@ L`djb

    K`mtr`, vajk`s kallumjty c``dhbke bhaut r`pr`s`mtbtjams wjtojm

    to` l`djb tobt stjglbtjs` l`mtbi jiim`ss ar jmbdv`rt`mtiy pralat`

    s`ic-obrl bmd sujkjd`. [tjglbWbtko bisa pravjd`s pasjtjv`

    c``dhbke ta to` l`djb bhaut bkkurbt` bmd r`spamsjhi` partrbybis

    ac l`mtbi jiim`ss bmd sujkjd` wojko o`ip hr`be dawm stjglb bmd

    jmkr`bs` umd`rstbmdjmg ac l`mtbi jiim`ss.

    To` L`djb Lamjtarjmg praf`ktjmvaiv`s twa ibrg`-skbi` l`djb

    lamjtarjmg praf`kts kamdukt`d hy to` Pmjv`rsjty ac L`ihaurm`

    bmd to` Pmjv`rsjty ac Kbmh`rrb. To`s` obv` soawm tobt wo`mkalpbr`d ta r`partjmg jm to` 8>>>-8>>2p`rjad, r`partjmg

    jm 8>>3-8>>7soaw`d kamsjd`rbhi` jlprav`l`mt. Bkrass

    bii l`djb, hato sujkjd` bmd l`mtbi o`bito jt`ls jmkr`bs`d jm

    vaiul`, wjto bppraxjlbt`iy b twa-bmd-b-obic-caid jmkr`bs` ac

    r`spamsjhi` r`parts, jmkr`bsjmg cral 07%ta 70% (^jrejs `t bi

    8>>?).

    h`yamdhiu`

    To` mbtjambi d`pr`ssjam bmd bmxj`ty jmjtjbtjv` h`yamdhiu`, js

    bm jmd`p`md`mt, mat-car-praflt argbmjsbtjam warejmg ta jmkr`bs`

    bwbr`m`ss bmd umd`rstbmdjmg ac to`s` kamdjtjams jm Bustrbijbbmd ta r`duk` to` bssakjbt`d stjglb. @stbhijso`d jm 8>>>,

    h`yamdhiu` js bm jmjtjbtjv` ac to` C`d`rbi, [tbt` bmd T`rrjtary

    gav`rml`mts, bisa suppart`d hy to` g`m`rasjty ac jmdjvjdubis,

    karparbt` Bustrbijb bmd Lav`lh`r. X`dukjmg stjglb bmd

    djskrjljmbtjam js b e`y bjl ac h`yamdhiu`. [p`kjflk ahf`ktjv`s

    br` ta6

    c r`duk` stjglbtjsjmg bttjtud`s surraumdjmg d`pr`ssjam

    bmd bmxj`ty wjtojm to` kallumjty toraugo pralatjmg

    p`rsambi `xp`rj`mk`s bmd `dukbtjam

    c r`duk` to` i`v`is ac s`ic-stjglb

    c r`duk` to` djskrjljmbtjam `xp`rj`mk`d hy p`api` wjtod`pr`ssjam bmd bmxj`ty toraugo i`bd`rsojp bmd suppart

    car kobmg`s jm bttjtud`s, paijkj`s, prbktjk`s bmd syst`ls

    c jmkr`bs` bwbr`m`ss ac djskrjljmbtjam bs b rjse-cbktar car

    d`pr`ssjam bmd bmxj`ty toraugo kblpbjgms, pragrbls,

    paijky bmd bdvakbky.

    Car av`r 22y`brs, h`yamdhiu` obs kamdukt`d b D`pr`ssjam Lamjtar

    surv`y `v`ry twa y`brs ta l`bsur` kobmg`s jm kallumjty

    bwbr`m`ss, emawi`dg` bmd umd`rstbmdjmg ac d`pr`ssjam bmd

    bmxj`ty jm to` kallumjty.

    B ijc` wjtoaut stjglb 4

    Wobt js h`jmg dam`1

    B s`i`ktjam ac pragrbls cral braumd to` warid pravjd` oap` car `cc`ktjv` bktjam ta kalhbt stjglb

    bmd djskrjljmbtjam bgbjmst p`api` bcc`kt`d hy l`mtbi jiim`ss.

  • 7/28/2019 A life without stigma : A SANE Report

    22/36

    2?

    To` 8>28 h`yamdhiu` bmmubi r`part mat`s tobt woji` to`r`

    obv` h``m sjgmjflkbmt jlprav`l`mts jm bwbr`m`ss, emawi`dg`

    bmd bttjtud`s surraumdjmg d`pr`ssjam av`r tjl`, to`r` js stjii

    raal car jlprav`l`mt am sal` jssu`s jmkiudjmg jmkr`bsjmg

    bwbr`m`ss bmd umd`rstbmdjmg bhaut bmxj`ty djsard`rs bmd sal`

    bttjtud`s jmkiudjmg stjglb (h`yamdhiu` 8>28).

    To`r` js b rbmg` ac bktjvjtj`s car yaumg p`api` jm Bustrbijb.

    Ljmd Lbtt`rs(s`kamdbry skoaais)

    Ejds Lbtt`r(prjlbry skoaais)

    To`s` skoaai-hbs`d pragrbls br` d`sjgm`d ta pralat`

    jmkiusjam, l`mtbi o`bito, bmd rbjs` bwbr`m`ss ac wo`m bmd oaw

    ta s``e o`ip car l`mtbi o`bito djcflkuitj`s. Woji` mat sp`kjflkbiiy

    ijstjmg stjglb r`duktjam bs b lbfar cakus ac to`jr pragrbls,

    to`s` br` bii jlpartbmt pr`-r`qujsjt s ta stjglb r`duktjam.

    Ljmd Lbtt`rs bmd EjdsLbtt`r br` cumd`d hy to` Bustrbijbm

    Gav`rml`mt, D`pbrtl`mt ac O`bito bmd Bg`jmg.

    Jmspjr` CaumdbtjamJmspjr`s r`bkoaut.kal bgsojp s`rvjk`, jmkr`bs`s yaumg p`api`s

    emawi`dg` ac l`mtbi o`bito bmd w`iih`jmg, jmkr`bs`s to`jr o`ip-

    s``ejmg sejiis bmd `msur`s tobt to`y c``i i`ss biam`. X`bkoaut

    kbm h` bkk`ss`d bmamylausy, acc`rs o`ip bmd suppart 84oaurs

    b dby, bmd js bkk`ssjhi` ta yaumg Bustrbijbms jm r`lat` r`gjams,

    biiawjmg toausbmdjmg ac yaumg p`api` ta h` o`ip`d bt bmy am`

    tjl`.

    L`mtbi O`bito Cjrst Bjd (LOCB)

    LOCB js to` o`ip pravjd`d ta sal`am` woa js d`v`iapjmg b

    l`mtbi o`bito prahi`l, ar woa js jm b l`mtbi o`bito krjsjs,

    umtji bppraprjbt` prac`ssjambi tr`btl`mt js r`k`jv`d ar to` krjsjs

    r`saiv`s. To` LOCB kaurs` t`bko`s l`lh`rs ac to` kallumjty

    oaw ta bssjst wo`m sal`am` m``ds o`ip jm tojs wby. L`mtbi

    o`bito flrst bjd strbt`gj`s br` tbugot jm `vjd`mk`-hbs`d trbjmjmg

    pragrbls bmd kamdukt`d hy LOCB Jmstruktars bkrass Bustrbijb.

    To` LOCB trbjmjmg bmd r`s`brko pragrbl js grawjmg jm

    papuibrjty jm Bustrbijb bmd obs maw h``m bdbpt`d car us`

    wjto sp`kjflk kallumjtj`s bmd jm lbmy kaumtrj`s av`rs`bs.

    ^brtm`rsojps br` vjtbi ta LOCB bmd kaurs`s br` d`ijv`r`d hy

    b wjd` vbrj`ty ac argbmjsbtjams. Jt obs h``m w`ii `vbiubt`d jm

    s`v`rbi trjbis cral to` pragrbls jmk`ptjam jm 8>>2. To`s` obv`

    soawm kamsjst`mtiy tobt pbrtjkjpbmts br`6

    c h`tt`r bhi` ta jd`mtjcy l`mtbi jiim`ss

    c lar` kamfld`mt jm acc`rjmg o`ip

    c lar` ije`iy ta r`kall`md prac`ssjambi o`ip

    c lar` emawi`dg`bhi` bhaut to` `vjd`mk`-hbs`d

    tr`btl`mts car l`mtbi jiim`ss

    c lar` r`bijstjk bmd i`ss stjglbtjsjmg bttjtud`s tawbrds

    p`api` wjto l`mtbi o`bito prahi`ls

    c sustbjmjmg to` h`m`flts ac to` pragrbl av`r tjl`.

    Twa [tbt`s jm Bustrbijb, Ru``msibmd bmd [auto Bustrbijb, obv`

    `stbhijso`d l`djb kblpbjgms sp`kjflkbiiy ta r`duk` stjglb

    bssakjbt`d wjto l`mtbi jiim`ss. Ibumko`d jm b hibz` ac puhijkjty,

    hato obv` sjmk` k`bs`d du` ta cumdjmg kamstrbjmts bmd kobmg` jm

    gav`rml`mt prjarjtj`s.

    Kobmg` Aur Ljmds

    Kobmg` Aur Ljmdswbs b 8>22Ru``msibmd Gav`rml`mt jmjtjbtjv`ta bddr`ss to` stjglb bmd djskrjljmbtjam bssakjbt`d wjto

    l`mtbi jiim`ss. Jt bjl`d ta lbe` to` kallumjty bwbr` ac oaw

    m`gbtjv` bttjtud`s bmd h`obvjaurs bcc`kt to` ijv`s ac p`api` ijvjmg

    wjto l`mtbi jiim`ss, jmkiudjmg to`jr cbljij`s bmd kbr`rs. Jt bisa

    pralat`d pasjtjv` bttjtud`s, bkk`ptbmk` bmd sakjbi jmkiusjam ac

    p`api` ijvjmg wjto l`mtbi jiim`ss (Ru``msibmd Gav`rml`mt 8>22).

    I`ts Tojme ^asjtjv`

    To` ibmdlbre r`part, [t`ppjmg Pp6 B [akjbi Jmkiusjam Bktjam ^ibm

    car L`mtbi O`bito X`carl([auto Bustrbijbm Gav`rml`mt, 8>>7),

    r`kall`md`d b l`djb kblpbjgm sp`kjflkbiiy ta bddr`ss to` jssu`

    ac stjglb wjtojm to` kallumjty. Ibumko`d jm C`hrubry 8>28, to`

    [auto Bustrbijbm I`ts Tojme ^asjtjv`kblpbjgm kalprjs`d b s`rj`s

    ac toaugot-pravaejmg t`i`vjsjam bmd rbdja kall`rkjbis, bs w`ii

    bs amijm` bmd autdaar bds bmd hrakour`s.

    M`w V`bibmd

    Ije` Ljmd, Ije` Ljm`

    To` Ije` Ljmds, Ije` Ljm`puhijk `dukbtjam pragrbl bjls ta

    r`duk` to` stjglb bmd djskrjljmbtjam cbk`d hy p`api` wjto

    `xp`rj`mk` ac l`mtbi jiim`ss jm M`w V`bibmd. To` pragrbl

    stbrt`d jm 2::7bs b flv`-y`br puhijk o`bito praf`kt car hatombtjambi bmd kallumjty-i`v`i bktjvjtj`s, cumd`d hy to` Ljmjstry

    ac O`bito bmd gujd`d hy to` Ije` Ljmds Mbtjambi ^ibm. [jmk`

    8>>2, to` Gav`rml`mt obs cumd`d to` praf`kt bs b kar` puhijk

    o`bito bktjvjty.

    To` kblpbjgm kalhjm`s mbtjambi l`djb l`ssbgjmg wjto iakbi

    bktjvjtj`s ta kobmg` djskrjljmbtary bttjtud`s bmd h`obvjaurs.

    To` bjl js ta obv` b kallumjty wojko vbiu`s bmd jmkiud`s

    p`api` ijvjmg wjto l`mtbi jiim`ss5 car bii argbmjsbtjams ta obv`

    paijkj`s bmd prbktjk`s ta `msur` tobt p`api` wjto l`mtbi jiim`ss

    da mat `xp`rj`mk` djskrjljmbtjam5 bmd car jmdjvjdubis ta obv` to`

    sbl` appartumjtj`s jm `v`rydby ijc` bs p`api` woa da mat obv`b l`mtbi jiim`ss. Ije` Ljmds, Ije` Ljm`pravjd`s appartumjtj`s

    car kamtbkt bmd djr`kt jmt`rbktjams wjto p`api` ijvjmg wjto

    l`mtbi jiim`ss, bmd d`ijv`rs `dukbtjam bmd trbjmjmg pragrbls ta

    kobii`mg` bmd kobmg` stjglbtjsjmg bmd djskrjljmbtary bttjtud`s

    bmd h`obvjaurs.

    Bs emawi`dg` bhaut wobt js m``d`d bmd wobt wares obs

    d``p`m`d, to` cakus obs kobmg`d cral rbjsjmg bwbr`m`ss

    bmd pralatjmg bttjtud` kobmg` ta hrjmgjmg bhaut kobmg s jm

    h`obvjaur, prbktjk`s bmd paijkj`s.

  • 7/28/2019 A life without stigma : A SANE Report

    23/36

    2:

    Pmjt`d Ejmgdal

    Tjl` ta Kobmg`

    Ibumko`d jm 8>>7, Tjl` ta Kobmg`js b kalpr`o`msjv` jmjtjbtjv`

    ta mgbg` p`api` jm bii s`ktars bmd kallumjtj`s ta r`duk` to`

    stjglb bmd djskrjljmbtjam `xp`rj`mk`d hy p`api` wjto l`mtbi

    o`bito prahi`ls.

    Tjl` ta Kobmg`js ap`rbt`d hy tor`` l`mtbi o`bito argbmjsbtjamsbmd obs bm bkbd`ljk `vbiubtjam pbrtm`r cral to` Jmstjtut` ac

    ^sykojbtry bt Ejmgs Kaii`g` Iamdam. To` mbtjambi kblpbjgm us`s

    hursts ac lbss l`djb bdv`rtjsjmg bmd puhijk r`ibtjams `x`rkjs`s

    ta kamv`y to` l`ssbg` tobt l`mtbi jiim`ss`s br` kallam, tobt

    p`api` wjto l`mtbi jiim`ss kbm i`bd b l`bmjmgcui ijc`, tobt

    djskrjljmbtjam `xp`rj`mk`d js act`m wars` tobm l`mtbi jiim`ss

    jts`ic, bmd tobt w` kbm bii da sal`tojmg ta o`ip. L`djb bktjvjtj`s

    br` suppart`d hy iakbi praf`kts.

    @vbiubtjam obs caumd ma ibrg`-skbi` sojct jm bttjtud`s bs y`t,

    oaw`v`r to`r` obv` h``m sal` sjgmflkbmt jlpbkts, pbrtjkuibriy

    wo`r` to`r` obs h``m p`rsambi kamtbkt wjto sal`am` wjtol`mtbi jiim`ss6 emawjmg sal`am` woa js ap`m bhaut obvjmg

    b l`mtbi o`bito prahi`l obs b ki`br bmd pasjtjv` jlpbkt

    am bttjtud` bmd h`obvjaur. To` `vjd`mk` sugg`sts b lad`st

    r`duktjam jm djskrjljmbtjam tawbrds p`api` wjto l`mtbi o`bito

    prahi`ls, bs w`ii bs sal` jlprav`l`mt jm puhijk bttjtud`s bs

    caiiaws6

    Kobmgjmg h`obvjaur bmd r`dukjmg djskrjljmbtjam

    B ;% jmkr`bs` jm to` mulh`rs ac p`api` r`partjmg ma

    djskrjljmbtjam jm to`jr ijv`s wbs mat`d, bmd b sjgmjflkbmt 22.0%

    r`duktjam jm to` bv`rbg` i`v`is ac djskrjljmbtjam r`part`d jm 8>22

    kalpbr`d ta 8>>?.

    Jlpravjmg puhijk bttjtud`s

    [jmk` to` ibumko ac Tjl` ta Kobmg`, to`r` obs h``m b 8.4%

    jlprav`l`mt jm puhijk bttjtud`s tawbrds p`api` wjto l`mtbi

    o`bito prahi`ls

    To` ijme h`tw``m to` kblpbjgm bmd jlprav`d bttjtud`s bmd h`obvjaur

    @vbiubtjam sugg`sts b b ki`br bmd kamsjst`mt ijme h`tw``m

    bwbr`m`ss ac to` Tjl` ta Kobmg`kblpbjgm bmd jlprav`d

    emawi`dg`, bttjtud`s bmd h`obvjaur braumd l`mtbi o`bito.

    [tbrtjmg kamv`rsbtjams bhaut l`mtbi o`bito

    B e`y prjmkjpi` ac Tjl` ta Kobmg`js sakjbi kamtbkt. Tojs l`bmsemawjmg sal`am` wjto b l`mtbi o`bito prahi`l. X`s`brko

    soaws tobt tojs js am` ac to` last paw`rcui jmdjkbtars ac

    jlprav`d bttjtud`s bmd h`obvjaurs, sa b iat ac Tjl` ta Kobmg`js

    bhaut kr`btjmg appartumjtj`s car lar` l`lh`rs ac to` puhijk ta

    kal` jmta kamtbkt wjto p`api` woa br` ap`m bhaut to`jr l`mtbi

    o`bito prahi`ls. [jmk` Tjl` ta Kobmg`ibumko`d to`r` obs h``m b

    sjgmjflkbmt jmkr`bs` jm to` mulh`r ac p`api` woa sby to`y emaw

    sal`am` wjto b l`mtbi o`bito prahi`l.

    [katibmd

    s`` l`

    [katibmds mbtjambi kblpbjgm ta `md to` stjglb bmd

    djskrjljmbtjam ac l`mtbi jii-o`bito, s`` l`, js ap`rbt`d hy bm

    biijbmk` ac flv` [kattjso l`mtbi o`bito argbmjsbtjams.

    Cuiiy cumd`d hy to` [kattjso Gav`rml`mt, s`` l`wbs ibumko`d jm

    8>>8bs b r`spams` ta iamg-stbmdjmg kamk`rms wjtojm to` l`mtbio`bito kallumjty tobt bktjam wbs m``d`d ta bddr`ss pr`fudjk`

    bmd djskrjljmbtjam.

    Wjto stramg jmvaiv`l`mt ac p`api` wjto djr`kt `xp`rj`mk`

    ac stjglb, to` `lpobsjs js am puhijkjty kblpbjgms ta rbjs`

    puhijk bwbr`m`ss ac to` jlpbkt ac stjglb am p`api` wjto

    l`mtbi jiim`ss bmd ta jlprav` umd`rstbmdjmg ac l`mtbi jiim`ss.

    To`s` kblpbjgms tbrg`t sp`kjflk graups, suko bs yauto, bmd

    `mvjraml`mts suko bs warepibk`s, bs w`ii bs to` g`m`rbi puhijk.

    Iakbi bktjvjty js mkaurbg d bmd pbrtm`rs br` suppart`d ta

    kamdukt bktjvjtj`s pravjdjmg r`saurk`s, bdvjk` bmd gujdbmk`.

    To` kblpbjgm bisa wares kias`iy wjto to` l`djb jm kobii`mgjmgm`gbtjv` partrbybis ac p`api` wjto l`mtbi o`bito prahi`ls.

    Jt js bkk`pt`d hy to` s`` l`pbrtm`rs tobt `mdjmg stjglb bmd

    djskrjljmbtjam tawbrds p`api` wjto l`mtbi jiim`ss lby tbe`

    lbmy y`brs ta bkoj`v`. To`jr Mbtjambi Bktjam ^ibm car y`brs ?-22

    ac to` kblpbjgm hujids am to` brij`r ware, tbkeijmg sal` ac

    to` lar` kalpi`x br`bs ac stjglb bmd djskrjljmbtjam, jmkiudjmg

    b cakus am o`bito bmd sakjbi kbr` s`ttjmgs. Hujit am to` `xjstjmg

    `vjd`mk` hbs`, kblpbjgm bktjvjtj`s br` t`st`d bmd `vbiubt`d ta

    lbe` sur` to`y br` bppraprjbt` bmd `cc`ktjv`.

    Kbmbdb

    Ap`mjmg Ljmds

    To` Ap`mjmg Ljmdsjmjtjbtjv` wbs `stbhijso`d hy to` L`mtbi

    O`bito Kalljssjam ac Kbmbdb jm 8>>:wjto to` bjl ac kobmgjmg

    Kbmbdjbms h`obvjaurs bmd bttjtud`s tawbrd p`api` ijvjmg wjto

    l`mtbi jiim`ss, ta `msur` to`y br` tr`bt`d cbjriy bmd bs cuii

    kjtjz`ms wjto appartumjtj`s ta kamtrjhut` ta sakj`ty.

    Ap`mjmg Ljmdsjs bddr`ssjmg stjglb wjtojm caur lbjm tbrg`t

    graups6 o`bitokbr` pravjd`rs, yauto, to` warecark` bmd to`

    l`djb. Bs suko, to` jmjtjbtjv` obs luitjpi` gabis, rbmgjmg cral

    jlpravjmg o`bitokbr` pravjd`rs umd`rstbmdjmg ac to` m``ds ac

    p`api` wjto l`mtbi o`bito prahi`ls ta `mkaurbgjmg yauto ta tbie

    ap`miy bmd pasjtjv`iy bhaut l`mtbi jiim`ss.

    To` uitjlbt` gabi ac Ap`mjmg Ljmdsjs ta kuitjvbt` bm `mvjraml`mt

    jm wojko p`api` ijvjmg wjto l`mtbi jiim`ss c``i kalcartbhi`

    s``ejmg o`ip, tr`btl`mt bmd suppart am to`jr faurm`y tawbrd

    r`kav`ry.

  • 7/28/2019 A life without stigma : A SANE Report

    24/36

    8>

    B mulh`r ac pragrbls bkrass Kbmbdb br` maw warejmg am

    r`dukjmg stjglb. Ap`mjmg Ljmdsobs h``m `vbiubtjmg lar` tobm

    7>ac to`s` praf`kts ta jd`mtjcy toas` wojko br` last `cc`ktjv`,

    sa to`y kbm h` r`pijkbt`d bkrass Kbmbdb. @vjd`mk` gbto`r`d

    toraugo to`s` `vbiubtjams wjii r`v`bi h`st prbktjk`s wojko wjii

    kamtrjhut` ta to` d`v`iapl`mt ac bmtj-stjglb taaiejts bmd ato`r

    r`saurk`s.

    Bt to` sbl` tjl`, to` Ap`mjmg Ljmds`vbiubtjam prak`ss js cargjmg

    tj`s toraugoaut Kbmbdbs l`mtbi o`bito fl`id, kr`btjmg b vbiubhi`

    m`tware car sobrjmg h`st prbktjk`s bmd pragrbls d`sjgm`d ta

    r`duk` stjglb.

    To` Bustrbijbm Mbtjambi L`mtbi O`bito Kalljssjam bmd to`

    L`mtbi O`bito Kalljssjam ac Kbmbdb obv` sjgm`d b carlbi

    L`larbmdul ac Pmd`rstbmdjmg ta sobr` emawi`dg` bmd

    sukk`sscui prbktjk`s jm l`mtbi o`bito r`s`brko. Tojs autijm`s oaw

    to` twa Kalljssjams wjii s``e appartumjtj`s ta ware tag`to`r

    jm br`bs suko bs l`mtbi o`bito bmd to` warepibk`, jmt`rmbtjambi

    emawi`dg` `xkobmg` bmd stjglb, wjto krass-pralatjam ac warejmcarl`d hy to` ijv`d `xp`rj`mk` ac toas` `xp`rj`mkjmg l`mtbi

    o`bito jssu`s, to`jr cbljij`s bmd suppart p`api`, bmd to` l`mtbi

    o`bito s`ktar.

  • 7/28/2019 A life without stigma : A SANE Report

    25/36

    82

  • 7/28/2019 A life without stigma : A SANE Report

    26/36

    Wobt

    wares1

  • 7/28/2019 A life without stigma : A SANE Report

    27/36

    8;

    B ijc` wjtoaut stjglb 0

    Wobt wares1

    @vjd`mk` sugg`sts to`r` br` strbt`gj`s wojko br` `cc`ktjv` jm r`dukjmg stjglb bmd djskrjljmbtjam ta

    jlprav` to` ijv`s ac p`api` bcc`kt`d hy l`mtbi jiim`ss.

    To`r` obv` h``m lbmy stjglb-r`duktjam pragrbls bmd

    kblpbjgms jm Bustrbijb bmd jmt`rmbtjambiiy av`r to` pbst

    t`m y`brs. To`s` obv` mat biwbys h``m rjgarausiy `vbiubt`doaw`v`r.

    To`r` js b g`m`rbi kams`msus tobt `cc`ktjv` stjglb-r`duktjam

    strbt`gj`s bkemawi`dg` djcc`r`mt carls ac stjglb, bmd tobt

    bktjams m``d ta h` w`ii kaardjmbt`d, kalpr`o`msjv`, iamg-t`rl,

    bt mbtjambi bmd iakbi i`v`is, wjto b rbmg` ac graups bmd, last

    jlpartbmtiy, jmvaivjmg p`api` wjto ijv`d `xp`rj`mk` ac l`mtbi

    jiim`ss.

    To`r` js bisa ki`br r`kagmjtjam tobt h`obvjaur kobmg` lust h`

    l`bsur`d bs w`ii bs bttjtud`s bmd h`ij`cs. Jt js mat gaad `maugo

    ta obv` w`ii-jmcarl`d kallumjty l`lh`rs, `lpiay`rs, paijky

    lbe`rs bmd o`bito ware`rs car `xblpi`, jc to`y kamtjmu` ta tr`bt

    p`api` umcbjriy fust h`kbus` to`y obv` b l`mtbi jiim`ss.

    @xp`rts obv` jd`mtjfl`d br`bs wo`r` to`r` obv` h``m kobmg`s jm

    stjglb av`r tjl` (Kbrt`r K`mtr` 8>>:).

    ^asjtjv` M`gbtjv`

    Jmkr`bs` jm wjiijmgm`ss ta

    djskuss l`mtbi jiim`ss

    Jmkr`bs` jm bssakjbtjam

    wjto vjai`mk`

    Jmkr`bs` jm wjiijmgm`ss ta

    s``e o`ip cral mam-l`djkbil`mtbi o`bito prac`ssjambis

    ^`rlbm`mk` jlpij`d wjto

    g`m`tjk `xpibmbtjam

    H`ij`c tobt marlbi ijv`s br`

    passjhi`

    H`ij`c tobt to` g`m`rbi

    puhijk js umkbrjmg bmd

    umsylpbto`tjk.

    [yst`lbtjk bkbd`ljk r`vj`ws soaw tobt to`r` br` twa `vjd`mk`-

    hbs`d bpprabko`s d`lamstrbt`d ta r`duk` stjglb.

    Kamtbkt wjto p`api`bcc`kt`d hy l`mtbi jiim`ss

    [p`mdjmg tjl` wjto p`api` wjto l`mtbi jiim`ss js b paw`rcui

    taai car kobmgjmg bttjtud`s, jmu`mkjmg c`br, sakjbi djstbmk`, bmd

    o`mk` stjglb.

    ^`api` kbm bisa g`t ta emaw sal`am` bcc`kt`d hy l`mtbi

    jiim`ss toraugo t`i`vjsjam ar flil partrbybis, wo`m to`s` br`

    bkkurbt` bmd r`spamsjhi` partrbybis. Tojs kbm bisa o`ip r`duk`

    s`ic-stjglb.

    To` r`k`mt `vbiubtjam ac to` flrst pobs` ac to` Tjl` ta Kobmg`

    kblpbjgm jm to` PE obs bisa d`lamstrbt`d tobt emawjmg

    sal`am` woa js ap`m bhaut obvjmg b l`mtbi o`bito prahi`l obs

    b ki`br bmd pasjtjv` jlpbkt am bttjtud` bmd h`obvjaur. (Tjl` taKobmg`, 8>2;).

    @dukbtjam

    @dukbtjambi jmt`rv`mtjams kbm r`duk` stjglb hy pravjdjmg

    jmcarlbtjam bhaut l`mtbi jiim`ss bmd jlpravjmg l`mtbi o`bito

    ijt`rbky emawi`dg` bmd h`ij`cs bhaut l`mtbi jiim`ss`s, wojko

    bjd to`jr r`kagmjtjam, lbmbg`l`mt ar pr`v`mtjam. To`s` obv`

    h``m soawm ta h` `cc`ktjv` wjto lbmy tbrg`t budj`mk`s bmd

    `xt`md ta amijm` jmt`rv`mtjams, wjto `vjd`mk` tobt Jmt`rm`t-hbs`d

    `dukbtjambi pragrbls kbm r`duk` to` stjglb bssakjbt`d wjtod`pr`ssjam, jmkiudjmg p`api` wjto ojgo psykoaiagjkbi djstr`ss

    (Grjcfltos `t bi 8>>4), bmd jm aid`r p`api` cral Gr``e bmd

    Jtbijbm hbkegraumds (Ejrrapauiaus t bi 8>22).

    X`s`brko soaws tobt jmt`rv`mtjams ta jlprav` puhijk emawi`dg`

    bhaut d`pr`ssjam obv` h``m sukk`sscui jm r`dukjmg to` `cc`kts ac

    stjglb. B h`yamdhiu` kblpbjgm ta jmkr`bs` emawi`dg` bhaut

    d`pr`ssjam bmd jts tr`btl`mt rbm bm jmt`msjv`, kaardjmbt`d

    pragrbl jm sal` [tbt`s bmd T`rrjtarj`s bmd mat jm ato`rs. ^`api`

    `xpas`d ta to` pragrbl lar` act`m r`kagmjs`d to` c`btur`s

    ac d`pr`ssjam, bmd w`r` lar` ije`iy ta suppart o`ip-s``ejmg

    car d`pr`ssjam ar ta bkk`pt tr`btl`mt wjto kaums`iijmg bmd

    l`djkbtjam (Farl `t bi 8>>0).

  • 7/28/2019 A life without stigma : A SANE Report

    28/36

    84

    Bm `dukbtjambi bpprabko ta r`duk` to` stjglb bssakjbt`d wjto

    skojzapor`mjb obs bisa h``m soawm ta h` `cc`ktjv` wjto yaumg

    p`api` jm b study kamdukt`d jm Gr``k`. B rbmdaljs`d kamtrai

    trjbi soaw`d tobt caiiawjmg jmt`rv`mtjam, pasjtjv` kobmg`s jm

    stud`mts h`ij`cs, bttjtud`s bmd d`sjr`d sakjbi djstbmk` w`r`

    r`kard`d, bitoaugo amiy kobmg`s jm bttjtud`s bmd h`ij`cs w`r`

    lbjmtbjm`d bct`r am` y`br. To` butoars r`kall`mdbtjams

    br` car bmtj-stjglb jmt`rv`mtjams ta h` d`ijv`r`d kamtjmuausiytoraugoaut to` skoaai y`brs bmd ta biiaw car jmt`rbktjams wjto

    p`api` woa ijv` wjto l`mtbi jiim`ss (@kamalau `t bi 8>28).

    Cjv` `ss`mtjbi prjmkjpi`s ac strbt`gjk stjglb kobmg` br` d`skrjh`d

    hy Karrjgbm (8>22) usjmg to`TIK;bkramyl. To`s` br` k`mtr`d

    am kamtbkt wjto p`api` wjto l`mtbi jiim`ss bs b cumdbl`mtbi pbrt

    ac to` kblpbjgm, r`qujrjmg tobt l`ssbg`s h`6

    c tbrg`t`d

    L`ssbg`s lust sp`be ta p`api` jm pasjtjams ac paw`r

    suko bs `lpiay`rs, ibmdiards, o`bitokbr` prac`ssjambis,

    t`bko`rs bmd l`djb jm ard`r ta kobmg` h`obvjaur.c iakbi

    D`sjgm`d car bmd bkemawi`dg` djcc`r`mk`s jm

    g`agrbpojk, sakja`kamaljk, r`ijgjaus ar kuiturbi graups.

    c kr`djhi`, kamtjmuaus kamtbkt

    To` kamtbkt p`rsam m``ds ta h` kr`djhi` bmd h`

    jd`mtjflbhi` hy to` tbrg`t graup. Car `xblpi`, b o`bito

    ware`r ar `lpiay`r wjto b l`mtbi jiim`ss woa js jm

    r`kav`ry tbiejmg ta ato`r o`bito ware`rs ar `lpiay`rs.

    ^`api` woa br` bkut`iy umw`ii ar woa obv` mat stbrt`d

    to`jr r`kav`ry lby obv` ma pasjtjv` jmu`mk` bmd

    lby `v`m lbe` tojmgs wars`. Kamtbkt soauid bisa h`kamtjmuaus5 am` kamtbkt lby h` pasjtjv` hut to` `cc`kt js

    usubiiy soart-t`rl.

    Woji` `xjstjmg r`s`brko da`s mat y`t pravjd` l`bmjmgcui

    `vjd`mk` bhaut to` jlpbkt ac bdv`rtjsjmg kblpbjgms, suko

    bs kobmg` jm stjglb, pr`fudjkjbi bttjtud`s bmd djskrjljmbtary

    h`obvjaurs, `vbiubtjam ac to`s` js maw bm jmt`grbi pbrt ac

    kurr`mt mbtjambi kblpbjgms jm @mgibmd, [katibmd bmd Kbmbdb car

    `xblpi`.

    Jm Bustrbijb, bs pbrt ac to` Mbtjambi L`mtbi O`bito [trbt`gy, b

    caur-y`br Bustrbijbm Mbtjambi Kallumjty Bwbr`m`ss ^ragrbl

    (KB^) kalprjsjmg mbtjambi puhijk bdv`rtjsjmg bmd `dukbtjamr`saurk`s stbrt`d jm 2::0. Woji` to`r` wbs stramg suppart car

    to` kblpbjgm bmd d`lbmd car jts `dukbtjam lbt`rjbis, autkal`

    `cc`kts w`r` slbii wjto ijtti` `vjd`mk` ac h`obvjaur kobmg`,

    ac wo`to`r p`api` wjto l`mtbi jiim`ss w`r` bktubiiy tr`bt`d

    djcc`r`mtiy. Tojs ojgoijgots to` jlpartbmk` ac b luitj-cbk`t`d

    kblpbjgm jmkarparbtjmg iakbi bmd tbrg`t`d bktjvjtj`s, bmd wjto

    jmvaiv`l`mt ac p`api` wjto l`mtbi jiim`ss bs bm jmt`grbi pbrt ac

    to` kblpbjgm.

    Wobt wares h`st

    B ijt`rbtur` r`vj`w kamdukt`d hy to` Ru``msibmd Biijbmk`

    (Ru``msibmd Biijbmk` 8>>:) sullbrjs`d r`kall`mdbtjams car

    wobt wares h`st jm stjglb r`duktjam. Drbwjmg am to` r`s`brko,

    jmt`rmbtjambi bmtj-stjglb pragrbls, bmd bdvjk` cral r`s`brko

    bmd pragrbl `xp`rts, to` caiiawjmg prjmkjpi`s car h`st prbktjk`

    w`r` jd`mtjfl`d6c Djr`kt p`rsambi kamtbkt wjto p`api` woa `xp`rj`mk`

    l`mtbi jiim`ss js to` h`st bpprabko.

    Djr`kt kamtbkt js to` h`st bpprabko ta kobmgjmg

    bttjtud`s bmd h`obvjaurs, pbrtjkuibriy wo`m to`r` js6 b

    r`ibtjamsojp ac `qubi stbtus5 b kamt`xt ac kaap`rbtjam, bm

    appartumjty car djskussjam5 bmd kr`djhi` pr`s`mt`rs woa

    djsbhus` lytos ac dbmg`rausm`ss, jmkalp`t`mk`, bmd

    jmkbpbkjty.

    c Jmcarlbtjam biam` da`s mat kobmg` bttjtud`s.

    To` gabi ac `dukbtjam js ta jmkr`bs` umd`rstbmdjmg ac to`

    kobii`mg`s r`bi p`api` cbk` (jmkiudjmg djskrjljmbtjam),oaw djcflkuitj`s br` av`rkal`, wobt o`ips, oaw ato`rs

    kbm h` suppartjv` bmd jmkiud` l`ssbg`s ac `qubijty,

    oap` bmd r`kav`ry. Ps` ac kr`btjv` brts bmd luitj-l`djb

    jmkr`bs`s jlpbkt.

    c L`mtbi o`bito prahi`ls br` h`st crbl`d

    bs pbrt ac aur sobr`d oulbmjty.

    L`mtbi o`bito prahi`ls br` bm umd`rstbmdbhi` r`spams`

    ta b umjqu` s`t ac kjrkulstbmk`s bmd mat pur`iy bs

    hjal`djkbi, g`m`tjkbiiy hbs`d, jiim`ss`s, ar b djs`bs`d

    stbt` ac hrbjm.

    c Kr`bt` b sjlpi` bmd mdurjmg mbtjambi vjsjam.B vjsjam tobt pralat`s oulbm rjgots, sakjbi jmkiusjam,

    cuii kjtjz`msojp, bmd b sobr`d r`spamsjhjijty car kobmg`

    wjii h` last `cc`ktjv`, usjmg luitj-l`djb, bmd sakjbi

    lbre`tjmg taais ta kr`bt` ki`br pragrbl autkal`s bmd

    h`mkolbres.

    c [uppart grbss-raats, iakbi pragrblljmg.

    B mbtjambi kblpbjgm tobt stjii jmkr`bs`s kamtbkt,

    `dukbtjam, bmd hujids kamsul`r i`bd`rsojp cral to`

    grbss-raats up js jlpartbmt. Kobmg` obpp`ms bt to`

    iakbi i`v`i. @mkaurbg` haid, kr`btjv` pragrblljmg bmd

    `vbiubt` kbr`cuiiy.c ^ibm strbt`gjkbiiy bt to` mbtjambi i`v`i.

    D`v`iap b mbtjambi strbt`gjk pibm tobt wares jm

    pbrtm`rsojp wjto gav`rml`mt bmd stbe`oaid`rs ta

    d`v`iap bmd d`ijv`r b luitj-i`v`i mbtjambi pibm tbrg`tjmg

    trbmscarlbtjv` syst`ljk kobmg` bt b s`rvjk` syst`l,

    i`gjsibtjv`, paijky bmd prbktjk` i`v`i.

    c [uppart p`api` ijvjmg wjto l`mtbi o`bito jssu`s

    jm bktjv` i`bd`rsojp.

    Kamsul`r i`bd`rsojp soauid h` `mkaurbg`d ta d`flm`

    jssu`s, d`sjgm pragrbls, umd`rtbe` r`s`brko, bmd

    `vbiubt` pragrbl sukk`ss. ^rat`st, djskiasur` bmdgraup jd`mtjflkbtjam br` karm`rstam`s ac `lpaw`rl`mt.

    [uppart kamsul`r i`bd`rsojp bmd `lpaw`rl`mt toraugo

    to` mbtjambi pragrbl.

  • 7/28/2019 A life without stigma : A SANE Report

    29/36

    80

    c X`dukjmg vjai`mt h`obvjaur blamg jmdjvjdubis wjto

    l`mtbi jiim`ss`s wjii r`duk` stjglb. Jc vjai`mt h`obvjaur

    hy l`mtbiiy jii p`rsams js bm jlpartbmt kbus` ac stjglb,

    to`m r`dukjmg vjai`mt h`obvjaur soauid iagjkbiiy r`duk`

    to` stjglb.

    To` m``d car jlprav`d bkk`ss ta tr`btl`mt jm ard`r ta hrjmg

    bhaut b r`duktjam jm stjglb js bisa bkemawi`dg`d jm Ma O`bitowjtoaut L`mtbi O`bito, to` Hrjtjso gav`rml`mts l`mtbi o`bito

    strbt`gy dakul`mt (D`pt ac O`bito 8>22)6

    Bitoaugo s`rjaus jmkjd`mts jmvaivjmg b p`rsam wjto s`v`r` l`mtbi

    jiim`ss br` `xtr`l`iy rbr`, w` r`kagmjs` to` puhijks kamk`rms bhaut

    sbc`ty. Oaw`v`r, w` bisa r`kagmjs` tobt suko s`rjaus jmkjd`mts kbm bdd

    sjgmjflkbmtiy ta to` stjglb surraumdjmg l`mtbi o`bito. L`mtbi o`bito

    s`rvjk`s lust piby to`jr pbrt jm r`dukjmg bmd lbmbgjmg rjses ac obrl,

    toraugo to`jr awm jmt`rv`mtjams wo`r` to`y br` h`st pibk`d ta jmt`rv`m`,

    ar hy o`ipjmg ato`r bg`mkj`s ta da wobt to`y br` h`st pibk d ta da.

    c Tbrg t pragrbls bt jmu`mtjbi graups.

    Jmu`mtjbi graups kauid jmkiud` `l`rg`mky r`spams`,

    paijkjmg bmd karr`ktjams, sakjbi s`rvjk` pravjd`rs,

    `lpiay`rs, `dukbtars, crj`mds, cbljiy, r`ijgjaus i`bd`rs.

    c Bssjst l`djb ta piby b sjgmjflkbmt rai`.

    X`qujr` l`djb ta obv` b sp`kjbi cakus am jmkr`bsjmg

    d`pjktjams ac p`api` bs kalp`t`mt, kbpbhi` bmdpraduktjv` kjtjz`ms bmd utjijs` flrst p`rsam mbrrbtjv`s.

    Kobii`mg` jmbkkurbt` ar djskrjljmbtary partrbybis ac

    p`api` wjto l`mtbi o`bito jssu`s.

    c Ptjijs` `vjd`mk`.

    ^ragrbls lust us` vjd`mk`-jmcarl`d bpprabko`s.

    Jmcarl`d pragrblljmg soauid bisa h` `vbiubt`d ta biiaw

    car kaurs` karr`ktjam. Hujid emawi`dg` toraugo r`s`brko

    bmd flmdjmgs sobr`d toraugo pragrbl m`twares.

    Jlprav`l`mt ac bkk`ss ta cc`ktjv` tr`btl`mt suppart

    car p`api` wjto l`mtbi jiim`ss js bisa bm jmt`grbi bsp`kt

    ac r`dukjmg stjglb.

    To`r` js ma dauht tobt umtr`bt`d l`mtbi jiim`ss kamtrjhut`s

    ta stjglbtjsjmg bttjtud`s. To`r` kbm h` b kr`djhjijty gbp

    h`tw``m wobt js sbjd hy p`api` warejmg jm stjglb r`duktjam

    bmd wobt to` g`m`rbi puhijk lby s`` braumd to`l `v`ry dby.

    Ljsumd`rstbmdjmg bmd c`br ac sal`am` wjto psykoatjk sylptals

    ar wjto to` umwbmt`d sjd`-`cc`kts ac tr`btl`mt, pravjd` c`rtji`

    graumd car stjglb bmd djskrjljmbtjam.

    Car `xblpi`, s``jmg sal`am` jm b soappjmg lbii woa js

    djrty bmd ume`pt, tbiejmg ta to`jr vajk`s, bmd gajmg toraugoruhhjso hjms wjii kr`bt` umd`rstbmdbhi` bmxj`ty bmd bvajdbmk`

    jm pbss`rs-hy woa obv` ma umd`rstbmdjmg ac to` `cc`kts ac

    kamdjtjams suko bs skojzapor`mjb bmd sylptals suko bs budjtary

    obiiukjmbtjams. M`ws r`parts ac bggr`ssjv` ar vjai`mt h`obvjaur

    hy sal`am` wjto l`mtbi jiim`ss taa act`m ljss to` kamt`xtubi

    jmcarlbtjam bhaut to` p`rsam ma r`k`jvjmg tr`btl`mt, sa to`

    `xbgg`rbt`d bssakjbtjam ac l`mtbi jiim`ss wjto vjai`mk` p`rsjsts.

    Dr Cuii`r-Tarr`y, b P[ psykojbtrjst bmd iamg-t`rl bdvakbt` car

    p`api` wjto s`v`r` bmd `mdurjmg l`mtbi jiim`ss, obs autijm`d to`

    bssakjbtjam h`tw``m vjai`mk` r`suitjmg cral umtr`bt`d jiim`ss bmd

    stjglb (Cuii`r-Tarr`y 8>22)6

    c To` p`rk`ptjam ac vjai`mt h`obvjaur hy l`mtbiiy jii

    p`rsams js bm jlpartbmt kbus` ac stjglb. Jt js ki`briy

    `stbhijso`d tobt vj`wjmg l`mtbiiy jii p`rsams bs

    dbmg`raus i`bds ta stjglbtjsbtjam.

    c Last `pjsad`s ac vjai`mk` kalljtt`d hy l`mtbiiy jii

    p`rsams br` bssakjbt`d wjto b cbjiur` ta tr`bt to`l. Tojs

    obs h``m d`lamstrbt`d jm lbmy studj`s.

    c Tr`btjmg p`api` wjto s`rjaus l`mtbi jiim`ss`s

    sjgmjflkbmtiy d`kr`bs`s `pjsad`s ac vjai`mk`. Luitjpi`

    studj`s obv` d`lamstrbt`d tobt to` tr`btl`mt

    ac jmdjvjdubis wjto s`rjaus l`mtbi jiim`ss`s wjto

    bmtjpsykoatjk l`djkbtjam . . . js `cc`ktjv` jm r`dukjmg

    brr`sts rbt`s bmd vjai`mt h`obvjaur.

  • 7/28/2019 A life without stigma : A SANE Report

    30/36

    [ullbry bmd

    r`kall`mdbtjams

  • 7/28/2019 A life without stigma : A SANE Report

    31/36

    87

    [tjglb js b lbfar jssu` car p`api` bcc`kt`d hy l`mtbi

    jiim`ss, jmu`mkjmg oaw to`y br` vj`w`d, bmd oaw to`y vj`w

    to`ls`iv s. Jt kbm bpp`br bt oal`, bt skoaai, bt ware, jmoaspjtbis, kijmjks, kiuhs, jm to` l`djb, bmd jm to` acflk`s ac

    d`kjsjam-lbe rs. Jt js d`struktjv`, ourtcui bmd `xkiudjmg.

    Jc w` br` ta ware tawbrds b sakj`ty wo`r` `v`ry p`rsam js

    vbiu`d, r`sp`kt`d, bmd h`iamgs, w` lust bddr`ss stjglb.

    Last ac us wjii h` bcc`kt`d hy l`mtbi jiim`ss sal`oaw bt

    sal` tjl` jm aur ijv`s, sa jt js jlpartbmt car `v`ryam` jm aur

    kallumjty ta c``i kalcartbhi` tbiejmg bhaut l`mtbi jiim`ss, bmd

    mat ta c`br djskiasjmg to`jr awm `xp`rj`mk`.

    B strbt`gy ta tbkei` stjglb bmd djskrjljmbtjam bssakjbt`d

    wjto l`mtbi jiim`ss js vjtbi, bmd soauid h` b mam-m`gatjbhi`

    kalpam`mt ac l`mtbi o`bito paijkj`s bmd pibms. Jt soauid h`

    bs mam-m`gatjbhi` bs tr`btl`mt bmd suppart pragrbls. Jt js

    `ss`mtjbi jc w` br` ta o`ip p`api` wjto l`mtbi jiim`ss ijv` b

    kamtrjhutjmg ijc`. Tojs strbt`gy wjii bisa h`m`flt r`krujtl`mt ac

    p`api` ta ware jm l`mtbi o`bito s`rvjk`s jm hato kijmjkbi bmd

    mam-kijmjkbi rai`s.

    [jgmjflkbmt pragr`ss obs h``m lbd` jm to` ibst t`m y`brs

    ta r`duk` to` stjglb bssakjbt`d wjto d`pr`ssjam. Amgajmg

    gav`rml mt bmd kallumjty suppart car argbmjsbtjams suko bs

    h`yamdhiu` bmd to` Hibke Dag Jmstjtut` wjii o`ip `msur` pragr`ss

    kamtjmu`s bmd `xt`mds ta bmxj`ty.

    Bustrbijb maw m``ds b mbtjambi, iamg-t`rl strbt`gy bmd

    kblpbjgm ta r`duk` to` stjglb bmd djskrjljmbtjam bssakjbt`d

    wjto l`mtbi jiim`ss, wjto b pbrtjkuibr cakus am psykoatjk jiim`ss.

    To` strbt`gy lust h` kamsjst`mt wjto mbtjambi bmd stbt` l`mtbi

    o`bito pibms bmd strbt`gj`s, to` sakjbi jmkiusjam bg`mdb bmd to`

    carwbrd warepibm ac to` Mbtjambi L`mtbi O`bito Kalljssjam.

    X`kall`mdbtjams

    Bustrbijb m``ds b mbtjambi strbt`gy ta bddr`ss stjglb wojko6

    c js kalpr`o`msjv`, tbrg`t`d, w`ii-kaardjmbt`d bmd

    rahustiy cumd`d

    c jmkiud`s p`api` wjto ijv`d `xp`rj`mk` ac l`mtbi jiim`ss

    bs jmt`grbi ta to` kblpbjgm jmkiudjmg bt b i`bd`rsojp

    i`v`i

    c obs b ki`br djgjtbi bmd sakjbi lbre`tjmg strbt`gy wojko

    jmkarparbt`s b rbmg` ac lbss l`djb jmjtjbtjv`s

    c i`brms cral to` h`st bvbjibhi` `vjd`mk` cral sjljibr

    kblpbjgms jm ato`r pbrts ac to` warid

    cwares kias`iy wjto bmd supparts kallumjtystbe`oaid`rs ta `msur` iakbi jmjtjbtjv`s r`jmcark`

    kblpbjgm l`ssbg`s

    c wares wjto bmd hujids upam kurr`mt `cc`ktjv` stjglb

    r`duktjam strbt`gj`s jm Bustrbijb, suko bs Ljmdcrbl`s

    ware wjto lbss l`djb prac`ssjambis ta jlprav` to`

    partrbybi ac l`mtbi jiim`ss bmd sujkjd`

    c wares wjto b rbmg` ac gav`rml`mt d`pbrtl`mts suko

    bs `lpiayl`mt, oausjmg, `dukbtjam, bmd fustjk` car

    `xblpi`, ta `msur` to`jr pragrbls bmd l`ssbg`s br`

    suppartjv` ac to` kblpbjgm

    c wares wjto b rbmg` ac stbe`oaid`r prac`ssjambi hadj`sjm to` kijmjkbi, `dukbtjam bmd `lpiayl`mt br`bs car

    `xblpi`, woa br` hato tbrg`ts bmd h`m`flkjbrj`s ac

    kblpbjgm l`ssbg`s

    c obs amgajmg lamjtarjmg bmd `vbiubtjam ac to` kblpbjgm

    bmd jts kalpam`mts ta gbto`r `vjd`mk` ac `cc`ktjv`m`ss,

    bdd ta puhijk emawi`dg` bhaut to` jssu`s, bmd car

    bkkaumtbhjijty. @vbiubtjam l`bsur`s ta jmkiud` l`bsur`s

    ac djskrjljmbtary h`obvjaur

    c kalpi`l mts bmd supparts `xjstjmg stjglb-r`duktjam

    kblpbjgm strbt`gj`s car d`pr`ssjam bmd bmxj`ty djsard`rs

    c wares wjto l`djb prac`ssjambis

    c `msur`s tobt bmy lbss l`djb kblpbjgm ware, suko bs

    t`i`vjsjam bmd kjm`lb bdv`rtjsjmg js `lh`dd`d jm bmd

    jmt`grbi ta to` av`rbii kblpbjgm, rbto`r tobm h`jmg jts

    lbjm cakus.

    B ijc` wjtoaut stjglb 3

    [ullbry bmd

    r`kall`mdbtjams

  • 7/28/2019 A life without stigma : A SANE Report

    32/36

  • 7/