CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

Specifi c regulation
• (SPANISH) LAW 7/1985, 2 April, regulating the bases for the local regime. (BOE no. 80,
3 April 1985) whereby reference is made to specific care competences linked to local type
administrations:
Councils, regions, communities, provinces and other types of similar administrative
structures) http://www.boe.es/aeboe/consultas/bases_datos/doc.php?coleccion
=iberlex&id= 2003/03596
• (SPANISH) LAW on Promotion of personal autonomy and care for dependent people
(with special reference to people with mental health problems) Law 39/2006, 14
December, on Promotion of Personal Autonomy and Care for dependent people http://
www.imsersomayores.csic.es/landing-pages/ley-autonomia-personal.html
• (SPANISH) LAW 13/1982, 7 April, on Social Integration of the Disabled.
http://noticias.juridicas.com/base_datos/Admin/l13-1982.html
7. The stigma and Severe Mental Illness and how to cope with it
Despite the advances in the development of human rights, an analysis of social behaviour indicates
that there are still discriminatory attitudes towards people with mental illnesses, especially
if these are severe, resulting from stereotypes and prejudices that form an often insurmountable
barrier for the development of their rights as citizens, for their social integration, and they add
new suffering not attributable to the actual illness per se.
• Stereotypes are definitions about the illness and its evolution, resulting from partial analyses
or false beliefs: incurability, the unpredictability of their actions, non-responsibility,
lack of interests, inability to make decisions and a whole life is qualified by one diagnosis
or by the symptoms at a time of crisis.
• Prejudices are irrational attitudes derived from those beliefs: fear, disdain, aggressiveness,
annulment of the other, paternalism, etc.
• Discriminatory behaviours: social exclusion actions, segregation, non-access to services,
to work, to enjoyment of cultural benefits, leisure, personal enrichment, etc.
The stigma is the mark that these beliefs, attitudes and behaviours leave on the person who
suffers the illness and on the family. The social origin of this stigma dates back to times gone by,
so overcoming it is a slow process and it still has an impact on all social fields, to a greater or
lesser extent: families, neighbours, work, media and also in the health fields and mental health
professionals.
Thus, the person has to work to overcome the illness in a precarious situation of personal
impoverishment that compromises the progresses of the recovery process. As a whole, the group
of affected people has no power to recruit influence: either at work, in their environment and
sometimes not even in the services. This is one of the reasons for the limited resources in budgets
and the slow development of the services.
Facing the fi ght against stigmatisation
The fight against the stigma means adopting a conscious and active change in outlook: respect for
human rights, personal dignity and the right of people with SMI to develop their potentialities and
to contribute to society. Working in this direction is one of the basic responsibilities of the public
130 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS