Structural stigma and mental healthcare in Ghana: psychiatric nurses' perspectives.

Abstract

In this paper, we bring together medical anthropology of stigma with sociology and public health work on structural stigma to show how interpersonal and structural stigmas are co-produced through social, professional, and institutional exchange. Stigma of psychiatric nurses in Ghana works to exclude them from professional exchange - training, practice of skills, advocacy - and thereby co-produces interpersonal and structural stigma - lack of infrastructure, equipment, supplies, and funding for psychiatric care. Exchange also figured in the reasons nurses gave for the neglect of the mental health sector, which, they explained, did not generate revenue for the government or sufficiently restore patients into productive workers or human resources. At the same time, stigma may not simply exclude people from exchange but create other forms of exchange, such as care.