Stigma as a Structural Power in Mental Health Care Reform: An Ethnographic Study Among Mental Health Care Professionals in Belgium

The growing interest among scholars and professionals in mental health stigma is closely related to different mental health care reforms. This article explores professionals' perceptions of the dehospitalization movement in the Belgian context, paying particular attention to the meaning of stigma. Combined participant observation and semi-structured interviews were used to both assess and contextualize the perceptions of 43 professionals. The findings suggest that stigma may function as a structural barrier to professionals' positive evaluation of de hospitalization, depending on the framework they are working in. It is important to move beyond a unilateral understanding of the relationship between stigma and de-hospitalization in order to attain constructive health care reform. (C) 2016 Elsevier Inc. All rights reserved.