Leaving the stigma to the patients? Frequency of crisis experiences among mental health professionals in Berlin and Brandenburg and how they cope with it.

BACKGROUND: Although mental health professionals' mental health problems are gaining increased attention, there is little systematic research on this topic. AIMS: This study investigated the frequency of crisis experiences among mental health professionals and examined how they approach these experiences in terms of their personal and social identities. METHODS: An online survey was conducted among mental health professionals in 18 psychiatric hospital departments in the German federal states of Berlin and Brandenburg (N = 215), containing questions about personal crisis experiences, help sought, service use, meaningfulness of lived experiences, causal beliefs of mental illness and psychotherapeutic orientation. Social identification was assessed via semantic differential scales derived from preliminary interview studies. To investigate relationships between the variables, explorative correlation analyses were calculated. RESULTS: Results showed a high frequency rate of crisis experiences, substantial rates of suicidal ideation and incapacity to work and high service use. Most participants regarded their experiences as meaningful for their personal identity. Meaningfulness was positively related to a psychosocial causation model of mental illness, to psychodynamic psychotherapeutic orientation and to a high degree of disidentification with users and crisis experienced colleagues. CONCLUSION: The (paradoxical) disintegration of personal and social identity of may be understood as a strategy to avoid stigmatization. A more challenging coping style among professionals is discussed.

Lived experiences matter: The role of mental health professionals' psychological crises and vulnerability in shaping their health beliefs and concepts.

Background: Mental health professionals are often affected by mental health problems and disorders. Yet, the effects of these lived experiences on their causal beliefs and health concepts have not been investigated. The current study investigates how professionals' lived depressive experiences and their perceived vulnerability to mental illness affect their causal beliefs about mental disorders, their general concept of mental health and their specific concepts of depression and burnout. Methods: An online survey was conducted with 218 mental health professionals from 18 psychiatric clinic departments in the German federal states of Berlin and Brandenburg, investigating their experiences with depression, self-assessed vulnerability, their causal beliefs of mental illness, their general health concept and specific illness concepts of depression and burnout. A path model was calculated to examine the relationships between these variables. Participants with and without lived experience of depression were grouped. Results: Lived experience of depression was indicated by 126 participants. For participants with no experience of depression, perceived vulnerability negatively predicted beliefs in biological causation, which positively predicted higher differentiation between depression and burnout. For participants with previous depression experiences, perceived vulnerability positively predicted beliefs in psychological and social causation. Continuum belief was predicted only in this group by the three variables of causal beliefs. Psychological and social causation was positively associated, while biological causes were negatively associated with continuum beliefs. Conclusion: Mental health professionals are not external to the clinical situation. Their lived experiences do matter, shaping their beliefs and concepts and, thus, possibly also their actions toward patients.

Internalized stigma in mental health staff with lived experience of mental crises-Does the professional role protect against self-stigmatization?

Objective: The stigma of mental illness is widespread in the general population and also among healthcare and psychiatric professionals. Yet, research on the self-stigma of the latter is still limited. The purpose of this article was to assess self-stigma and its correlates in mental health professionals with lived experiences of mental crisis and treatment. Methods: In a cross-sectional exploratory research project, 182 mental health professionals with lived experiences of mental crisis and treatment from 18 psychiatric hospital departments in the German federal states of Berlin and Brandenburg were surveyed on their lived experiences, self-stigma, perceived stigma in the workplace, subjective vulnerability to crises, and meaningfulness of lived experiences. To investigate the relationships between the variables, manifest and latent correlation analyses were calculated. Results: Results showed low levels of self-stigma and perceived public stigma in the workplace. Self-stigma was significantly and positively associated with workplace stigma and subjective vulnerability to crisis, but not with identification with lived experiences. Conclusion: The relationship between self-stigma, workplace stigma, and vulnerability should be investigated in terms of mutual causality in order to derive possible strategies of reducing self-stigma along with its detrimental effects. Possible reasons for the low levels of self-stigma are discussed in the light of limitations, including processes of self-selection, with highly self-stigmatizing individuals being possibly discouraged from participating. Strategies to enhance sampling quality are briefly discussed.