Working together to modify prejudices

It is impossible for some patients to have access to the efficient treatments which are available at present, due to the stigma and discrimination (open or concealed) the mentally ill suffer nowadays.

Some time ago, a psychiatric diagnosis often meant an unappealable sentence which led to invalidism and the psychic and social deterioration of the patient. Lately, the scientific-technological progress experienced by our speciality has led to important achievements as regards the understanding and treatment of these problems. Mental health professionals are proud of the fact that, nowadays, the majority of people with mental disorders can be successfully treated and well integrated in their social and family environment, leading a useful and productive life.

The 'good quality of life' objective may be attained thanks to: adequate policies and mental health programs; changes in the organization of health services; inclusion of scientific and technological advances; new therapeutical approaches (new drugs, etc.); inclusion of modern psychoeducational and psychosocial rehabilitation techniques; multiple evaluations (peer and consumers).

For instance, we know that people who suffer from schizophrenia are at high risk of chronicity; however, we also know that such risk can be reduced due to the previously mentioned progress. We also know that 40% of people on antipsychotic treatments do not respond favourably to them, but we believe that this is due to a number of factors which can be brought under control, especially if the good clinical practice criteria are followed.

In order to better achieve what was mentioned above, we adhere to the concepts listed in the consensus document on psychosocial rehabilitation produced by the World Health Organization and the World Association for Psychosocial Rehabilitation, which, among other things, sets the following definitions and objectives (1). Psychosocial rehabilitation is the process which: enables individuals who are deteriorated, handicapped or crippled by a mental disorder to reach an optimum level of independent functioning; improves the competence of individuals; promotes changes in their environment to inprove their quality of life. Its objectives are: to reduce symptomatology; to reduce iatrogenia; to improve social competence; to reduce discrimination and stigma; family support; social support; more power for the consumer. The document also recommends action strategies at different levels. As regards the social level, the recommendations are: to improve the pertaining legislation; to give more power to the consumer; to improve the public opinion and attitudes related to mental disorders (2).

There are many initiatives and programs which follow these strategies, as a means to fight stigma and discrimination, in a partnership with advocacy groups and patients' and relatives' associations. Contener Foundation is an Argentina based organization which aims at the promotion and guarantee of the rights of the mentally ill; the fight against stigma and discrimination and the promotion of changes in the attitude of the community; the acknowledgement of such issues among patients, relatives, community leaders, political and economic decision makers, mass media and the public.

The work of the Foundation has been welcome by both professionals and the community in the Latin American region. Its activities have been very successful, showing that there is increasing interest among the population, both professional and non-professional, in this type of initiatives (3).